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Honored Contributor
Posts: 18,504
Registered: ‎05-23-2010

I thought people would be interested in reading this, from Medscape, an online medical news site intended for MDs and other healthcare professionals.

 

So - better, but requiring two doses and with more local side-effects. Sigh.

 

ACIP Narrowly Recommends Shingrix for Shingles Over Zostavax

 

Robert Lowes October 25, 2017

The federal government's Advisory Committee on Immunization Practices (ACIP) voted 8 to 7 today to recommend a new recombinant and adjuvanted herpes zoster vaccine (Shingrix, GlaxoSmithKline) over a live, attenuated virus version (Zostavax, Merck) for adults 50 years of age and older.


It was not as if the ACIP, part of the Centers for Disease Control and Prevention (CDC), as a whole lacked confidence in Shingrix or disputed that it was far more effective than Zostavax. Panel members voted 14 to 1 to recommend the new vaccine for immunocompetent adults aged 50 years and older, the same indication in last week's approval of Shingrix by the US Food and Drug Administration. And the group voted 12 to 3 in favor of immunizing these same adults with Shingrix even if they already had been vaccinated with Zostavax, which is approved by the US Food and Drug Administration for adults ages 50 years and older, but recommended by the ACIP for adults aged 60 years and older.


However, the ACIP split almost evenly on the preference question, with the debate centered on how much caution to take with a brand-new vaccine. Several ACIP members advocated collecting safety data on Shingrix for a year or 2 and waiting to see whether supplies proved adequate before endorsing it over Zostavax. Sandra Fryhofer, MD, a liaison representative for both the American Medical Association and the American College of Physicians, noted that the adjuvant in Shingrix that boosts the immune response "has never been out in the real world before."
"It does seem to be a little bit impulsive," Dr Fryhofer said about giving the vaccine a preferential recommendation, adding later, "I do know how wonderful this vaccine is."


However, ACIP members who voted to steer clinicians to Shingrix suggested it would be irresponsible not to acknowledge its superiority over Zostavax, and to allow more patients to suffer with shingles in the process.


"Physicians look to us to make recommendations based on the evidence in front of us," said Kelly Moore, MD, MPH, director of the immunization program in the Tennessee Department of Health. Similar to others, Dr Moore said the ACIP could retract a preferential recommendation if Shingrix did not live up to expectations.


Right now, those expectations are high. The ACIP heard from CDC epidemiologist Kathleen Dooling, MD, MPH, that although the two vaccines have not underdone head-to-head trials, the estimated efficacy of Shingrix significantly tops that of Zostavax across all age groups.


Table. Efficacy Estimates for Shingrix and Zostavax


Ages 60 to 69 Years

Shingrix 97%

Zostavax 64%

 

Ages 70 to 79 Years

Shingrix 91%

Zostavax 41%

 

Older Than 80 Years
Shingrix 91%
Zostavax 18%


Source: CDC

 

In addition, Dr Dooling said the efficacy of Shingrix appears to wane at a slower rate than that of Zostavax during the first 4 years of use.


An ACIP workgroup noted some possible drawbacks with Shingrix. Although Zostavax requires only one dose, Shingrix requires two, which could dampen patient uptake. Also, Shingrix is more reactogenic — think injection site soreness and fever. Despite these caveats, most members of the ACIP workgroup supported a preferential recommendation, and the ACIP followed suit, but narrowly so.


"This certainly is the closest vote in my experience at the ACIP," said ACIP Chair Nancy Bennett, MD, a professor of medicine and public health sciences at the University of Rochester in New York. "This discussion has been...very good, very transparent, very clear, but it's hard to have a divided committee."

 

Life without Mexican food is no life at all
Honored Contributor
Posts: 11,121
Registered: ‎02-27-2012

Re: Shingrix Shingles Vaccine

@Moonchilde

 

Thank you very much for the post.

 

Shingrix is also morally acceptable to me since Zostavax is derived from fetal cells obtained from controversial procedures.

 

Shingrix was approved for use in Canada as well.

Honored Contributor
Posts: 9,024
Registered: ‎01-10-2013

Re: Shingrix Shingles Vaccine

Appreciate the post,

Image result for thank you images

Honored Contributor
Posts: 48,854
Registered: ‎03-10-2010

Re: Shingrix Shingles Vaccine

Good article.  I wouldn't hesitate to get the Shingrix immunizations if and when they're offered.  I would do just about anything to avoid shingles.  When you live alone, it would be a disaster.

New Mexico☀️Land Of Enchantment
Esteemed Contributor
Posts: 6,306
Registered: ‎02-22-2015

Re: Shingrix Shingles Vaccine

I called both my Rheumatologist and PCP today about the new Shingles vaccination. Had my Shingles Shot in 2006. Both felt it was "Too early to go ahead with it and wanted to test it on people with healthy immune systems." Guess I'm not their guina pig! I love both Doctor's; they take such great care of me. 

New Member
Posts: 1
Registered: ‎07-28-2018

Re: Shingrix Shingles Vaccine

Here's my experience with Shingrix. I took the first dose in April 2018 and had painful side effects. My arm swelled a lot and was hot and painful to the touch. My arm was extremely red and sore for about a week. I received my second dose 3 months later (last Monday). My arm was sore and a little warm to the touch, but no visible signs of anything else.  By today, Saturday, there is no soreness left. I would not hesitate to recommend this vaccine as I saw my husband suffer through Shingles last Christmas. I would guess the first shot has higher side effects, but the second, is much easier to tolerate. Protect yourself from this painful illness of Shingles. 

Honored Contributor
Posts: 15,339
Registered: ‎03-10-2010

Re: Shingrix Shingles Vaccine

This is an oid post from 2017.  Didn't want anyone to think Moonchilde was back.


Day after day the whole day through, wherever my road inclined, four feet said 'I'm coming with you!' and trotted along behind. Kipling





Respected Contributor
Posts: 4,401
Registered: ‎07-02-2015

Re: Shingrix Shingles Vaccine

I have my doctor's printed order for the two-step Shingrix vaccine on my desk right now.  Just got it last week after a routine physical.

 

His office did not have any Shingrix on hand at the moment, and suggested I get it done at a pharmacy.

 

I already had the older vaccine two years ago.  Don't  know when I'll get around to getting the new one. 

 

Not exactly excited about asking a pharmacy to perform a task that I've always thought should be done in a doctor's office.  And considering how quickly the old vaccine went out of date, why should we think the new one won't be replaced by something else later?

Trusted Contributor
Posts: 1,627
Registered: ‎03-09-2010

Re: Shingrix Shingles Vaccine


@novamc wrote:

I have my doctor's printed order for the two-step Shingrix vaccine on my desk right now.  Just got it last week after a routine physical.

 

His office did not have any Shingrix on hand at the moment, and suggested I get it done at a pharmacy.

 

I already had the older vaccine two years ago.  Don't  know when I'll get around to getting the new one. 

 

Not exactly excited about asking a pharmacy to perform a task that I've always thought should be done in a doctor's office.  And considering how quickly the old vaccine went out of date, why should we think the new one won't be replaced by something else later?


@novamc  Check and see if the Clinic at Target has the vaccine. I go there for any vaccine not offered by my doctor. I feel better having a nurse practitioner give me my vaccine.  

 

I’ll be getting mine in the next week or two. My insurance only pays after 60.  Happy Birthday to me! 😶

"I've been here since October 2006. Wow!"
Valued Contributor
Posts: 623
Registered: ‎07-23-2014

Re: Shingrix Shingles Vaccine

My doctor told me that all pharmacists are trained to give vaccines.  I don't mind getting one from them because it's just a shot.  The problem, at least where I live, is that none of them have the Shingrix vaccine.  The pharmacist at my local CVS told me last week that it's a nationwide shortage and they have no idea when they'll get any more.