It’s estimated that about 2.7 percent of U.S. adults, or about seven million people, are immunosuppressed, according to a national health survey published December 2016 in the Journal of the American Medical Association. Shingrix is a non-live recombinant adjuvanted zoster vaccine that’s designed to trigger a targeted immune response. It was first approved by the U.S. Food and Drug Administration (FDA) in 2017 for the prevention of shingles in adults age 50 and older.
Risk of Shingles Is Higher in People With Weakened Immune Systems
Close to one million people get shingles every year in the United States, and an estimated one in three people will develop shingles in their lifetime, according to the CDC. The risk increases as you get older, and the condition is most common in people age 50 and older. “The virus that causes shingles is called varicella zoster, and it’s something that many people are exposed to either when they first get chicken pox, or later in life without knowing it,” says Seth Cohen, MD, the medical director of infection prevention and control at the University of Washington Medical Center in Seattle. The virus that causes shingles, unlike SARS-CoV-2 and influenza, can lie dormant in your body and reactivate at times of stress or when your immune system is suppressed, says Dr. Cohen. “When it reactivates, it’s called shingles. People with compromised immune systems are at a much higher risk of reactivation of shingles and also a higher risk of complications due to this infection,” he says. This includes people with HIV, certain cancers, and those who are on immunosuppressive drugs, per MedlinePlus.
Shingles Can Cause Long-Term Nerve Pain in Up to 18 Percent of People
Shingles is a painful rash consisting of blisters that usually scab over in 7 to 10 days and fully resolve within two to four weeks. The rash occurs on one side of the face or body, and there can be tingling, pain, or itching in the area where the rash will develop for several days before it appears. Chills, fever, headache, and upset stomach are other common symptoms of shingles. Shingles on the face can impact the eye and cause vision loss, or in rare cases, blindness, according to the agency. The most common complication of the condition is postherpetic neuralgia (PHN), which occurs in about 10 to 18 percent of people who get shingles. PHN is long-term nerve pain that can be debilitating and interfere with daily life.
Full Approval for Shingrix Expected Soon
This recommendation is based on excellent data showing safety and efficacy of the shingles vaccine in people with compromised immune systems, including stem cell transplant recipients, solid organ transplant recipients, and people with cancer who are receiving chemotherapy, says Cohen. The ACIP recommendations will be forwarded to the director of the CDC and the U.S. Department of Health and Human Services for review and full approval, according to a GlaxoSmithKline statement. “Once approved, it will be published on the CDC website. I know my patients are thrilled about the possibility of full approval,” says Cohen. Further safety and immunogenicity data were generated in adults who were, or were anticipated to be, immunodeficient or immunosuppressed because of known disease or therapy, including patients with HIV, solid tumors, and renal transplants, according to the ACIP.
Immunosuppressed People May Be on Accelerated Shingles Vaccine Schedule
For adults over 50 who are not immunocompromised, Shingrix is intended to be administered in two doses, two to six months apart. For adults who are or will be immunodeficient or immunosuppressed because of known disease or therapy and who would benefit from a shorter vaccination schedule, the second dose can be administered one to two months after the first dose, per the GSK release.
After Full Approval, Talk With Your Doctor About Timing Your Shingles Vaccine
There are very few contraindications to receiving Shingrix, says Cohen. “It should not be given to people who have a history of a severe allergic reaction to a prior dose of this specific vaccine,” he says. If you have a moderate or severe acute illness, you should generally wait until you’re feeling better before receiving the vaccine, says Cohen. “Particularly for people who are immunocompromised or have received a transplant, it is generally best to discuss the timing of vaccines with your healthcare provider.”
