What Is the Shingrix Vaccine?

Shingrix (recombinant zoster vaccine) is a newer vaccination, approved in 2017 by the Food and Drug Administration (FDA) for the prevention of shingles (herpes zoster).

According to the Centers for Disease Control and Prevention (CDC), a Shingrix vaccination is one of the most effective ways to protect against shingles, as well as a serious complication of shingles called postherpetic neuralgia (PHN).

Recommendations

Who Should Get Shingrix?

According to the CDC, Shingrix is advised for adults who:

• Have had shingles before: Shingles is a condition that can recur over and over again, so having shingles in the past does not make one immune to getting the disease again. If you have a current bout of shingles, you should wait until the rash is gone before getting Shingrix, but other than that, there is no stipulation on how long you should wait to get the vaccine after having shingles.
• Have received Zostavax: Zostavax is a live attenuated herpes zoster vaccine that was released in 2006. A live attenuated vaccine is one that is composed of a weakened version of the virus, such as the one that causes shingles. As of November 18, 2020, Zostavax is no longer available in the United States. Zostavax was not nearly as effective in preventing shingles or complications from shingles—like PHN—as Shingrix, according to the CDC.  Be sure to talk to your healthcare provider about when to schedule a Shingrix vaccine if you had Zostavax in the past.
• Are unsure if they have had chickenpox: The varicella-zoster virus, which causes chickenpox, is the same virus that resides in the nerve root, then later becomes active to cause shingles. A person must have had chickenpox or the chickenpox vaccine to get shingles. According to the CDC, studies show that more than 99% of Americans born on or before 1980 have had chickenpox, even if they don’t remember having the disease.  Many people are unsure if they have had chickenpox—Shingrix is safe, even for those who are unsure.
• Are 50 years of age or older: There is no limit on how old an adult can be to get a Shingrix vaccine after the age of 50.
• Have immunocompromising conditions (including HIV): Shingrix is recommended for use in people who are or will be immunodeficient or immunosuppressed because of disease or therapy.

Who Should Not Get Shingrix?

Those who should not get a Shingrix vaccine include those who:

• Have experienced a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
• Have been tested for immunity to the virus that causes shingles (varicella-zoster) and tested negative (this indicates that you may need to get a chickenpox vaccine and not a shingles vaccine)
• Currently have an acute case of shingles
• Are pregnant
• Have an acute (sudden) severe or moderately severe illness

Warnings and Precautions

In 2021, the FDA issued a new warning about a possible association between the Shingrix vaccine and a very rare neuro autoimmune disorder called Guillain-Barre syndrome (GBS). GBS is a condition involving damage to peripheral nerves.

The FDA further reported, however, that there was insufficient evidence to establish a definitive link between the vaccine and GBS, assuring the public that the benefits of the vaccine continue to outweigh any risks and that the vaccine is still safe and effective.

The update that the FDA enacted to the warnings section of the Shingrix drug label was a result of an observational study conducted by federal agencies that notated a risk of GBS during a 42-day follow-up on people who had been vaccinated. Again, according to the FDA, there was not enough clinical research study evidence to definitively link the cases of GBS with the Shingrix vaccine.

Dosing Schedule

Shingrix is administered as an injection which is usually given in the muscle of the upper arm, called the deltoid muscle. It’s administered by a healthcare provider in the healthcare provider’s office or at a pharmacy. The first dose is administered, then you’ll need a second dose two to six months after the initial dosage is given. 

How Well Does Shingrix Work?

According to the CDC, two dosages of the Shingrix vaccine are over 90% effective at preventing shingles in those aged 50 or older. Shingrix is more than 90% effective at preventing PHN. Among people 70 years and older, protection was 85% effective four years after vaccination.

Side Effects

Side effects or adverse reactions are those that are unintended and are linked with a specific medication (such as Shingrix).

In clinical research trials, Shingrix was not found to cause any serious side effects. In fact, according to the Department of Health and Human Services, side effects from vaccines are normally mild and go away quickly, without medical intervention.

That said, adverse reactions associated with Shingrix can be significant, and include:

• Pain, redness, and swelling at the injection site
• Muscle pain
• Fatigue
• Headache
• Chills
• Fever
• Gastrointestinal symptoms (such as nausea or stomach pain)

Side effects of Shingrix are usually temporary. In some people, the side effects impact the ability to perform simple activities for up to three days after vaccination.

Note, for mild reactions to the Shingrix vaccine (such as muscle pain), many people take over-the-counter pain relievers such as ibuprofen (Motrin) or acetaminophen (Tylenol).

Serious Side Effects

As with any other medication, serious side effects of Shingrix may include a severe allergic reaction. Symptoms of an allergic reaction (called anaphylaxis) include:

• Hives
• Weakness
• Dizziness
• Confusion
• Swelling of the throat, mouth, and tongue
• Blue lips or skin
• Difficulty breathing
• Tachycardia (a rapid heart rate)
• Fainting or collapsing
• Loss of consciousness

Symptoms of anaphylaxis are serious; they may be life-threatening without immediate medical intervention. If you have any symptoms of a severe allergic reaction after a Shingrix vaccination, seek immediate emergency medical care.

Cost

The Shingrix vaccine can be paid for by:

• Medicare Part D: There may be a small out-of-pocket cost, depending on the plan. Note, Medicare Part B doesn’t cover the shingles vaccine.
• Some Medicaid plans: Contact your insurance provider to find out if your plan covers the shingles vaccine.
• Many private health insurance plans: There may be a small out-of-pocket cost, so be sure to contact your insurance provider to find out if Shingrix is covered.
• Vaccine assistance programs: Some pharmaceutical companies offer assistance for people without insurance to cover the expense of vaccines to eligible adults who are unable to pay. Check with the Shingrix vaccine manufacturer to apply for the vaccination assistance program offered by GlaxoSmithKline.

The qualifying criteria for the GSK Patient Assistance Program include that a person:

• Must be an adult, age 18 or older
• Must live in one of the 50 U.S. states, Puerto Rico, or the District of Columbia
• If living in Puerto Rico, must not be eligible for Puerto Rico’s Government Health Plan Mi Salud
• Must not have third-party insurance coverage for Vaccines OR be enrolled in Medicare Part D Prescription Drug Plan and have spent at least $600 on prescriptions through your plan during this calendar year
• Must have a total household income that falls within the qualifying limit, which can be found on the GSK Patient Assistance Program page

Download your vaccination assistance application form at gskforyou.com.

A Word From Verywell

The Shingrix vaccine is available at some pharmacies that administer vaccines, as well as at your healthcare provider’s office. If you have questions or concerns about the vaccine, contact your healthcare provider.