Let’s explore a topic we are often asked about, shingles vaccines. Specifically, Shingrix and Zostavax. Understanding these vaccines is crucial. Shingles, is a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. It affects many people, particularly as they age.
Shingles: A Brief Overview
Shingles, or herpes zoster, manifests as a painful rash. The rash usually follows the path of a single nerve group. It’s a consequence of the reactivation of the dormant varicella-zoster virus in the body. While not generally fatal, shingles can lead to serious complications like post-herpetic neuralgia, a severe chronic pain condition.
Shingles Vaccines: Zostavax and Shingrix
- Zostavax: This was the go-to shingles vaccine for many years. It’s a live attenuated vaccine, meaning it uses a weakened form of the live virus. Zostavax effectively reduced shingles cases but less so in those over 70. Also, it couldn’t be used in immunocompromised individuals.
- Shingrix: The newer player in the field, Shingrix is an inactivated recombinant vaccine. It contains only a part of the virus, making it safe even for those with weakened immune systems. Its efficacy surpasses Zostavax, offering better protection against shingles, even in older adults.
Comparing Effectiveness
- Efficacy Over Time: Shingrix has shown higher and longer-lasting effectiveness compared to Zostavax. This is particularly so in the older population.
- Safety for Immunocompromised Individuals: Unlike Zostavax, Shingrix is suitable for those with compromised immune systems.
Dosage and Side Effects
- Shingrix requires two doses, spaced 2-6 months apart, while Zostavax was a single dose.
- Side Effects: Shingrix may have more frequent mild side effects. But these are generally short-lived and manageable.
Recommendations for Those Vaccinated with Zostavax
- Given Zostavax’s reduced effectiveness over time, it’s recommended that individuals previously vaccinated with Zostavax consider getting re-vaccinated with Shingrix.
My Perspective
Given the higher efficacy and broader suitability of Shingrix, it stands out as the preferred choice for shingles vaccination. Remember, shingles is not only painful but can also lead to debilitating long-term complications. Consider that one in three people may develop shingles in their lifetime. Thus, opting for the most effective vaccine available seems a prudent choice.
DR J HUGH COYNE
MBBS BSc PGDip (with merit) MRCGP DRCOG DCH
Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.
British Association of Sports and Exercise Medicine · European Atherosclerosis Society ·
Independent Doctors Federation
As seen in The Independent, The Daily Mail and Tatler
For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.