Shingrix

Overview

What is Shingrix?   

Shingrix is a vaccine developed by GlaxoSmithKline (GSK) for the prevention of shingles (herpes zoster) in adults aged 50 years and older or adults aged 18 years or older who are at increased risk of HZ. It is a recombinant, adjuvanted vaccine that helps boost the body's immune response to the varicella-zoster virus, thereby reducing the risk of developing shingles and its associated complications. 
 
Quick breakdown of the vaccine’s structure: 

Shingrix contains a non-live antigen, glycoprotein E, which is a component of the varicella-zoster virus. This antigen is combined with an adjuvant system, AS01B, designed to enhance the immune response. The adjuvant system helps to produce a stronger and longer-lasting immunity by stimulating the body's immune system to recognize and fight the virus more effectively. 

Global Name

• Generic name: Herpes zoster vaccine (recombinant, adjuvanted)
• Brand name: Shingrix

Usage

What is Shingrix used for? 

Shingrix is used to prevent shingles (herpes zoster) in adults aged 50 years and older, as well as adults aged 18 years or older who are at increased risk of HZ. The vaccine helps to boost the body's immune response to the varicella-zoster virus, thereby reducing the risk of developing shingles and its associated complications. It is not used as a treatment for active shingles or as a substitute for the chickenpox vaccine. 

How do you use Shingrix? 

Availability: 
 Shingrix is available as an injectable vaccine with powder and suspension for suspension for injection. 

Dosage information: 

• Adults (50 years and older): A two-dose series of Shingrix, with each 0.5 mL dose administered intramuscularly. The second dose should be administered 2 to 6 months after the first dose. 

• Adults (18 years and older who are at increased risk of Shingles): A two-dose series of Shingrix, with each 0.5 mL dose administered intramuscularly. The second dose can be administered 1 to 2 months after the first dose.

Are the following suitable for getting the vaccine 

• Children: Not recommended for individuals under 18 years of age. 

• Adults: Approved for adults 50 years and older, and for adults 18 years and older who are at increased risk of herpes zoster. 

• Elderlies: Suitable for elderly patients, as they are at a higher risk for herpes zoster. 

• Pregnancy and Lactation: There is limited data on the use of Shingrix in pregnant or lactating women. The vaccine should only be used if the potential benefits justify the potential risks. 

Is there anyone who shouldn’t get the vaccine?   

• People under 18 years of age  

• Patients with known allergies to the active ingredients or excipients

Warnings and Precautions: 

• Shingrix should be administered intramuscularly only. 

• Do not administer Shingrix to individuals with a current severe febrile illness. 

• Store Shingrix refrigerated between 2°C and 8°C (36°F and 46°F). Do not freeze 

Interactions and contraindications of Shingrix: 

• Shingrix may be administered concomitantly with other vaccines 

• Use caution with immunosuppressive therapy 

Side Effects

Common side effects include pain, redness, and swelling at the injection site, muscle pain, tiredness, headache, shivering, fever, and gastrointestinal symptoms. 

Pharmacist Tips

• Keep Shingrix refrigerated and do not freeze. 

• Ensure Shingrix is given intramuscularly, preferably in the deltoid region of the upper arm. 

• Inform patients about the potential side effects and when to seek medical attention. 

Availability

Where is Shingrix available in Hong Kong?

Shingrix is a prescription medication that can be prescribed by healthcare providers .

FAQs

If a person does not remember whether they had chickenpox, should they receive the Shingrix vaccine? 

Chickenpox and shingles are related because they are caused by the same virus (varicella-zoster virus). After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. It can reactivate years later and cause shingles. 

You can get Shingrix whether or not you remember having had chickenpox in the past. 

More than 97% of Hong Kongers aged 39 or above have had chickenpox, even if they don’t remember having the disease. 

Can someone who has experienced an episode of shingles be vaccinated with zoster vaccine?  

Yes. Adults with a history of herpes zoster should receive Shingrix. If a person is experiencing an episode of zoster, vaccination should be delayed until the acute phase of the illness is over and symptoms abate. 

Is booster dose necessary for Shingrix vaccine?

No. According to the CDC, you do not need a booster dose after getting the two doses of Shingrix. 

Can Shingrix and other vaccines be given concomitantly?

Yes. CDC’s “General Best Practice Guidelines for Immunization” advise that non-live vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with any other live or non-live vaccine, including the vaccines you listed, as well as COVID-19 vaccines. They should be given as separate injections, not combined in the same syringe.

Who are at increased risk of shingles? 

Individuals at increased risk of shingles include older adults, particularly those over 50 years old, due to a naturally weakening immune system. Those with weakened immune systems, such as HIV/AIDS patients, cancer patients undergoing chemotherapy, organ transplant recipients, and individuals on immunosuppressive medications, are also at higher risk. Additionally, people with chronic medical conditions like diabetes and chronic kidney disease, those with a history of chickenpox, and individuals experiencing high levels of stress or with autoimmune diseases are more susceptible to developing shingles.