Why Now Daily.

Published

Shingles Vaccine Schedule: Who Needs Shingrix and When

CDC recommends two Shingrix doses for adults 50 and older and for adults 19 and older who are or will be immunocompromised. The usual interval is two to six months, with a one-to-two-month option for some immunocompromised people when faster completion is beneficial.

Timeline

  1. Dose 1: Eligible adults receive recombinant zoster vaccine after screening for current shingles, pregnancy, acute illness and severe allergy.
  2. Usually 2–6 months later: Give dose 2; selected immunocompromised adults may use a 1–2 month interval.
  3. If dose 2 is late: Give it as soon as practical without restarting the series.

Shingrix is the recombinant zoster vaccine used in the United States to prevent shingles and its complications, including postherpetic neuralgia. It is not a treatment for an active shingles episode. CDC recommends a two-dose series for immunocompetent adults age 50 or older and for adults age 19 or older who are or will be immunodeficient or immunosuppressed because of disease or therapy. There is no upper age limit in the recommendation. [1][2][3]

For most people, dose two is given two to six months after dose one. Immunocompromised people who would benefit from finishing sooner may receive dose two one to two months after the first, often to avoid a period of more intense immunosuppression. The clinician managing the condition or therapy can help choose timing. A dose given less than four weeks after dose one is too early and should be repeated at least four weeks after that invalid dose. [1][2]

A delay beyond six months does not erase the first dose. CDC says to give the second dose as soon as possible and not restart the series. Keep the vaccination record so a pharmacist or clinician can verify the date and product. If treatment that suppresses immunity is planned, vaccination is ideally completed before immunosuppression when feasible, but the benefits of waiting must be balanced against the risk of shingles and a weaker response during intense therapy. [1][2]

Prior shingles does not remove the need for vaccination because shingles can recur. CDC does not set a minimum wait after a past episode, but the acute illness should be over and the rash generally gone before vaccination. People who previously received the live vaccine Zostavax, which is no longer used in the United States, should still receive the two-dose Shingrix series. Routine antibody testing for past chickenpox is not required for most adults age 50 or older. [1][3][4]

Do not receive Shingrix during a current shingles episode, during pregnancy, or after a severe allergic reaction to a component or an earlier dose. Moderate or severe acute illness is a reason to defer until recovery, while a minor illness such as a cold usually is not. Adults with weakened immunity and no documented chickenpox, chickenpox vaccination or shingles history should discuss testing or varicella vaccination with a clinician because Shingrix does not prevent primary chickenpox. [3][4][5]

Pain, redness or swelling at the injection site, muscle pain, tiredness, headache, shivering, fever or stomach symptoms can temporarily interfere with normal activities. CDC advises completing dose two even if a non-allergic expected reaction followed dose one. Plan a lighter day if needed and ask a clinician about symptom relief. Hives, facial or throat swelling, trouble breathing, a fast heartbeat, dizziness or weakness after vaccination can signal a severe allergic reaction and require emergency help. [3][5]

Shingrix can be given at the same visit as other adult vaccines at different injection sites, but individual circumstances can affect timing. Bring a medicines list and planned chemotherapy, transplant, biologic or steroid dates to the visit. Recommendations can change, especially for immunocompromised groups, so confirm the current CDC schedule and FDA product information with the vaccinator rather than relying on an old reminder or restarting the series on your own. [1][2][5]

Sources

  1. CDC — Shingles Vaccine Recommendations
  2. CDC — Clinical Considerations for Shingrix in Immunocompromised Adults
  3. CDC — Shingles Vaccination
  4. CDC Pink Book — Zoster
  5. FDA — SHINGRIX

Related stories