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

Private GP

Parsons Green

Fulham