Shingrix vs Zostavax: Which Is Better?

There are two vaccines that are available to help prevent a shingles outbreak and the subsequent complications of shingles: Zostavax and Shingrix. Zostavax was licensed by the Food and Drug Administration (FDA) in 2006 but is no longer available in the United States as of November 2020.

This article will discuss the differences between these two vaccines as well as the expert recommendations regarding shingles vaccination.

Effectiveness

The Zostavax shingles vaccine, approved by the FDA in 2006, uses a weakened live shingles virus to cause the body's immune system to generate protection against a shingles infection. Zostavax is a one-injection vaccination. The research indicates Zostavax reduces an individual from having a shingles outbreak by 51% and reduces PHN by 67%.

Shingrix was approved by the FDA in 2017 as a vaccine to prevent a shingles infection. Shingrix, a two-injection vaccination, is a recombinant zoster vaccine which means it does not contain any components of the actual shingles virus.

Instead, recombinant vaccines target specific components of the virus, allowing for a focused immune response. Shingrix has shown a 90% effective rate at preventing shingles and PHN, with protection staying consistently above 85% for at least the first four years after receiving the complete vaccination series.

Zostavax vs. Shingrix Differences

The major differences between Zostavax and Shingrix are outlined below:

Similarities

Zostavax and Shingrix do have a few similarities:

• Both are vaccines intended to prevent a shingles infection.
• Both vaccines are administered as an injection into the muscle.
• While both vaccines have the potential for serious adverse reactions, most reactions consist of a sore arm around the injection site.
• Additional side effects include tiredness, headache, mild fever, and nausea; most of these tend to resolve on their own within two to three days of vaccination.
  

Which Is Better?

The Advisory Committee on Immunization Practices (ACIP) is a group of medical and public health experts that develop vaccine usage recommendations in the United States. ACIP also includes experts from several professional organizations, such as the American Academy of Pediatrics and the American Academy of Family Physicians.

ACIP reviewed several resources, including research and patient outcomes and cost effectiveness studies, for both Zostavax and Shingrix. ACIP then utilized an evidence-based analysis to develop the committee's final recommendations. ACIP recommended Shingrix be used as the primary vaccine for shingles due to the high level of evidence reviewed by the committee.

Do I Need to Get a Shingles Vaccine?

Since 1 out of every 3 people in the United States will develop a shingles infection, the Centers for Disease Control and Prevention (CDC) recommend anyone at least 50 years of age or older receive the shingles vaccine. Additionally, the risk of developing a significant complication, such as postherpetic neuralgia (PHN), is as high as 1 out of every 10 people affected by shingles.

With the Shingrix vaccination being incredibly effective at reducing the risk of a shingles infection, many healthcare professionals, such as primary care physicians, highly encourage people to receive the vaccine. It is important for you to have that discussion with your healthcare provider, such as a primary care physician, and decide if the vaccine is the right choice based on your personal medical history.

Summary

Shingles is an infection that occurs in adults, years after a childhood chickenpox infection. In addition to causing a painful, itchy or tingly rash, shingles can also cause postherpetic neuralgia (PHN) or other significant medical complications.

Because there is no definitive testing that can identify if individuals have the varicella-zoster virus (VZV) dormant, many healthcare professionals and experts highly encourage a shingles vaccine. The Shingrix vaccine is the only shingles vaccine available in the United States and offers significant protection against shingles; while over 90% effective initially, Shingrix has been shown to be at least 85% effective against both shingles and PHN.