A New Vaccine for Prevention of Shingles Is a Major Advance.

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Dermatomal herpes zoster (shingles) has a lifetime risk of over 30% and carries a high risk of post-herpetic neuralgia which can be excruciating and even permanent. Rarely, the virus can disseminate (spread) and may even result in stroke. Further, recent studies have shown that the virus may be the trigger for giant cell arteritis, a disorder which can cause blindness.

There is thus an unmet need for an effective vaccine, especially because Zostavax, approved since 2006 for ages 60 or older, reduces risk by only 50% for ages 50-70, 38% for those 70-80, and 18% over the age of 80. Also, the protection wears off within several years.

The new vaccine, called Shingrix (not a great name), was approved in October 2017 for ages 50 or higher and is also recommended for those who have previously received the older vaccine. In studies comparing the two, Shingrix reduced risk by 90% compared to Zostavax’s 38% in those older than 70. It was 90% effective even for 80 year-olds. The risk of developing post-herpetic neuralgia in those over 60 was reduced 90% compared to 67% for Zostavax. Protection lasted for at least 4 years.

It was not associated with an increased risk of adverse effects, even in people with impaired immunity. It requires two injections two months apart (Zostavax requires only one). It is only slightly more expensive.

Truly, a major advance.

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