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Most sections were revised to include information and practice recommendations for the new recombinant zoster vaccine RZV which is now available in Canada. Changes include:. Refer to Table 1 for a summary of factors to consider and management options for HZ immunization and to Table 2 for a comparison of herpes zoster vaccines authorized for use in Canada. Herpes zoster shingles is a manifestation of reactivation of the varicella-zoster virus VZVa DNA virus of the Herpesvirus family, which, as a primary infection, causes varicella chickenpox.

VZV can be spread from a person with HZ to an individual that has never had varicella by direct contact with localized skin lesions. Less frequently, transmission can occur from fomites, such as articles freshly soiled by discharges from vesicles or, in the case of disseminated HZ, mucous membrane secretions.

The person who acquires VZV through these routes will develop varicella chickenpox. HZ is less likely to result in transmission of VZV than varicella. Persons with HZ are infectious until all lesions are crusted over. Any person who has had varicella is at risk of developing HZ. However, HZ occurs most frequently among older adults and immunocompromised persons.

Age is the most important risk factor for development of HZ. This age-related risk may be explained by both waning immunity over time following the initial varicella infection, and the loss of components of VZV-specific cell mediated immunity as a result of natural aging processes.

The severity of illness associated with HZ and its complications also increases markedly with age.

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VZV causes two distinct clinical syndromes: primary infection varicella, also called chickenpox and reactivation of latent infection HZ, also called shingles. Following varicella, VZV establishes latency in the sensory nerve ganglia, and may reactivate later as HZ. HZ infection is characterized by pain and a unilateral vesicular eruption, usually in a single dermatome. Complications of acute HZ are potentially severe. Because treatment options for PHN are of limited effectiveness, PHN often has major adverse impacts on quality of life.

Older adults, people living with chronic conditions such as diabetes or autoimmune diseases, and persons who are immunocompromised may be at greater risk of developing PHN. They are also at risk of experiencing longer lasting HZ rash than the general population.

For complete prescribing information, consult the product leaflet or information contained within the product monograph available through Health Canada's Drug product database. In studies that assessed vaccine immunogenicity antibody, the response to RZV was found to be more robust independent of age and with more stable antibody concentrations over time than the response to LZV.

While protection against HZ remains statistically significant up to 3 years following immunization with LZV, significant waning of protection has been observed one-year post immunization, particularly in older age groups. Immunization with a 2 dose series of RZV is recommended for the prevention of HZ and PHN for adults 50 years of age or older without contraindications.Zoster vaccines are two vaccines that have been shown to reduce the rates of herpes zoster also known as shingles.

One type, Zostavaxis essentially a larger-than-normal dose of the chickenpox vaccineas both shingles and chickenpox are caused by the same virus, the varicella zoster virus VZV.

While the recombinant version appears to prevent more cases of shingles, it has greater side effects and requires two doses. A Cochrane review concluded that "herpes zoster vaccine is effective in preventing herpes zoster disease and this protection can last three years".

zostavax vs shingrix ontario

The need for re-vaccination has not been defined. Inthe U. Unlike Zostavax, which is given as a single shot, Shingrix is given as two intramuscular doses, two to six months apart. The absolute decrease in risk of herpes zoster following immunization over three and a half years is 3. The live vaccine Zostavax is very safe; one to a few percent of people develop a mild form of chickenpox, often with about five or six blisters around the injection site, and without fever.

The blisters are harmless and temporary. However, the rates of serious adverse events were comparable between the Zostavax group 0. Data from healthy children and adults point in the same direction. Zostavax should not be used in people with compromised immune function.

Temporary side effects from the Shingrix shots are likely, and can be severe enough in one out of six people to affect normal daily activities for up to three days.

Comparing Shingrix vs Zostavax

The Zostavax vaccine contains live attenuated varicella-zoster virus. Shingrix is a suspension for intramuscular injection consisting of a lyophilized recombinant varicella zoster virus VZV glycoprotein E gE antigen that is reconstituted at the time of use with AS01B suspension as an immunological adjuvant.

The antigen is a purified truncated form of the glycoprotein, expressed in Chinese hamster ovary cells. The AS01B adjuvant suspension is composed of 3-O-desacyl-4'- monophosphoryl lipid A MPL from Salmonella Minnesota strain and a saponin molecule QS purified from Quillaja saponaria soap bark tree extract, combined in a liposomal formulation consisting of dioleoyl phosphatidylcholine DOPC and cholesterol in phosphate-buffered saline solution. A study found that the live vaccine is likely to be cost-effective in the U.

Inthe European Medicines Agency EMA issued a marketing authorization for the zoster vaccine to Sanofi Pasteur for routine vaccination in individuals aged 60 and over.

Shingrix was approved for medical use in the European Union in Marchwith an indication for the prevention of herpes zoster HZ and post-herpetic neuralgia PHN in adults 50 years of age or older. People aged either 70 or 79 on 1 Septemberwere offered the vaccine. People aged 71 to 78 on that date would only have an opportunity to have the shingles vaccine after reaching the age of As of June 30,Merck discontinued the sale of Zostavax in the U.

Existing vaccine already in the hands of practitioners, none having expiration dates later than Novembercould still be administered up to the expiration date. The U. Centers for Disease Control and Prevention CDC recommends that healthy adults 50 years and older get two doses of Shingrix, at least two months apart.

Initial clinical trials only tested a gap of less than six months between doses, but unexpected popularity and resulting shortages caused further testing to validate wider spacing of the two doses. From Wikipedia, the free encyclopedia. Redirected from Zostavax.

zostavax vs shingrix ontario

Vaccine to prevent shingles. AU : B2 [1]. DB DB Retrieved 23 January Retrieved 6 September June The New England Journal of Medicine. Shingles Prevention Study Group March The Journal of Infectious Diseases.On October 25th, that CDC Centers For Disease Control announced that Shingrix is now the preferred vaccine for the prevention of shingles also known as herpes zosterreplacing the long used Zostavax vaccine, which has been on the market since In addition to being the preferred vaccine for the prevention of shingles, the CDC also announced the following :.

These new recommendations beg the question, how is Shingrix different from Zostavax? According to published data, Shingrix reduced the risk of developing shingles by Adapted From Shingrix Package Insert. This is a way to normalize data based on the length of the clinical trial. For instance, the Shingrix trial had an average follow up time of 3. In the overall population that received the vaccine, that amounts to 23, years 7, patients times 3.

The number of cases of shingles during this time period was 6. Therefore, the incidence per years is 0. Zostavax Package Insert. In addition to the actual herpes zoster vaccine, Shingrix contains an immune response boosting 'adjuvant' known as AS01B.

zostavax vs shingrix ontario

Adjuvants are a common component of many vaccines and are classified as a ' molecule that can boost the potency, quality or longevity of a specific immune response'. Zostavax does not contain an immune boosting adjuvant. Shingrix is a recombinant, non-live vaccine unlike Zostavax, which is a live vaccine. Non-live vaccines typically have less stringent storage requirements and that is the case with Shingrix. Shingrix must be refrigerated while Zostavax must be frozen. In addition, most live vaccines like Zostavax need to be used with caution in patients that may be immunocompromised as this can increase the risk of adverse reactions.

Although Shingrix is more likely to be safer in this patient population, there is no definitive information regarding this. Shingrix is given via intramuscular injection in a two dose serieswith each dose separated by 2 to 6 months.

Zostavax is given via subcutaneous injection as a single dose. Shingrix has is approved and recommended for use in people aged 50 years old and over. Zostavax is also approved for use in people aged 50 years old and over. However, immunization guidelines only recommend use in people aged 60 years old and over due to concerns of lasting effectiveness at older ages.CDC recommends Shingrix recombinant zoster vaccine for the prevention of herpes zoster shingles and related complications.

CDC recommends two doses of Shingrix separated by 2 to 6 months for immunocompetent adults age 50 years and older:. This fact sheet describes vaccine storage and administration as well as patient counselling for the vaccine. For patients who previously had herpes zoster. There is no specific amount of time you need to wait before administering Shingrix to patients who have had herpes zoster. However, you should not give Shingrix to patients who are experiencing an acute episode of herpes zoster.

Zostavax is no longer available for use in the United States, as of November 18, Studies examined the safety of Shingrix vaccination five or more years after Zostavax vaccination. Shorter intervals were not studied, but there are no theoretical or data concerns to indicate that Shingrix would be less safe or effective if administered less than five years after a patient received Zostavax. You may consider an interval shorter than five years between Zostavax and Shingrix based on the age at which the patient received Zostavax.

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Differences in efficacy between Shingrix and Zostavax are most pronounced among older patients. Studies have shown that the effectiveness of Zostavax wanes substantially over time, leaving recipients with reduced protection against herpes zoster. You should wait at least 8 weeks after a patient received Zostavax to administer Shingrix. When vaccinating adults age 50 years and older, there is no need to screen for a history of varicella chickenpox infection or to conduct laboratory testing for serologic evidence of prior varicella infection.

Therefore, even if a person does not recall having chickenpox, serologic testing for varicella immunity is not recommended. It is often a barrier to herpes zoster vaccination, and false negatives are common. However, if serologic evidence of varicella susceptibility becomes available to the healthcare provider, providers should follow ACIP guidelines for varicella vaccination. Shingrix has not been evaluated in persons who are seronegative to varicella, and it is not indicated for the prevention of varicella.

Shingrix has not been studied in pregnant women or women who are breastfeeding. Providers should consider delaying Shingrix vaccination for these women.

Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of Skip directly to site content Skip directly to page options Skip directly to A-Z link. Vaccines and Preventable Diseases. Section Navigation.

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Facebook Twitter LinkedIn Syndicate.I've had the Zostavax vaccine to prevent shingles, but now I've heard there is a new vaccine that is supposed to be more effective. Should I get the new vaccine? And can I get it, since I already had the Zostavax shot?

You heard correctly. Doses are given two to six months apart. Research has also shown that Zostavax loses its ability to prevent shingles after five years. If you've ever had chickenpox, you are at risk for shingles, which is essentially a re-emergence of the virus that caused your chickenpox. The CDC says you should get vaccinated with Shingrix even if you aren't sure you've had chickenpox and if you've already had shingles.

Shingrix vs. Zostavax: How do Various Shingles Vaccines Stack Up?

Although it's uncommon, you can get shingles more than once. In addition, you should get the Shingrix vaccine even if you already got the Zostavax vaccine — although you should wait at least eight weeks from the time you received Zostavax to get the Shingrix shot.

Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Harvard Women's Health Watch. Ask the doctors Published: June, E-mail Address. First Name Optional.Shingles is thought to occur when the dormant chickenpox virus is reactivated in the central nervous system.

As indicated by Sciencenews. It may or may not ever reactivate, but if it does the results can be both excruciating and devastating. The virus may be activated by stress, age, illness, or numerous other factorsaccording to the Mayo Clinic. The outbreak can also occur around one or both eyes or in an ear as well and are usually accompanied by a great deal of pain. The blisters may scab over in seven to 10 days, but it could take two to four weeks to clear up entirely. Although shingles can really hurt, the real danger lies in its potential complications.

The most common complication is persistent, severe pain known as postherpetic neuralgia PHN. PHN is endemic to the nerve and not a response to outside stimuli or sources. It is believed to be caused by damage to the actual structure of the nerve. People with shingles may also suffer from vision loss. Scientists are discovering a relationship between the way the virus affects arteries which contribute to problems with eyesight, as well as increasing chances of severe headache, and fatal cardiovascular events such as stroke.

There has also been some data generated that is pointing to a link between getting shingles in and around the eye and developing dementia later on. Finally, shingles sufferers may develop inflammation of the brain itself, hearing problems, facial paralysis, balance problems, and ongoing skin infections. In order to prevent shingles and its complications, the Centers for Disease Control and Prevention recommends adults 50 and older get the vaccine. There are two vaccinations available: Shingrix and Zostavax.

The Centers for Disease Control and Prevention CDC says that the two-part vaccination series provides over 90 percent protection from both shingles and postherpetic neuralgia. The unexpected high demand for Shingrix has resulted in a nationwide shortage. However, there may be supply gaps through Gretchen LaSalle, a Washington doctor, told Newsday.

I think the manufacturer underestimated how popular the vaccine would be, and it takes six to nine months to make the shingles vaccine. If individuals are unable to secure Shingrix, they may be able to get Zostavax, the other shingles vaccination. Zostavax is the oldest shingles vaccine available and has been around since We respect your privacy.

All email addresses you provide will be used just for sending this story. Shingrix is the first new shingles vaccine in more than a decade and only the second to ever be approved Zostavax was the first by the Food and Drug Administration. Now the CDC is recommending that Shingrix—a two-dose vaccine—be given to people starting at age 50, a full 10 years earlier than its advice for getting Zostavax. Marvin M. Lipman, M. Did we need a new shingles vaccine?

To answer that question, it helps to have a bit of background on this infection. Almost all adults older than 40 carry the chickenpox virus—and the older we get, the more the risk of getting shingles climbs.

According to the CDC, the infection strikes about 1 million people in the U. The two to four weeks of shingles, marked by symptoms such as a blistery and painful rash on one side of the body, can be difficult enough. But about one in five people with shingles go on to develop postherpetic neuralgiaor PHN, which is nerve pain that can linger for months or even years.

Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry. When all ages are taken into consideration, Zostavax cuts the chance of shingles by only 51 percent and the risk of PHN by 67 percent.

And research presented in the fall at IDWeek, an annual meeting for infectious disease professionals, suggests that Zostavax may actually wane after only three years.

Zostavax vs. Shingrix

The Shingrix vaccine whose two doses are to be given two to six months apartaccording to the CDC, offers 97 percent protection in people in their 50s and 60s and roughly 91 percent protection in those in their 70s and 80s. And it appeared to retain similarly high effectiveness throughout a four-year study period and cut PHN risk by 86 percent. There are key differences between the ways Shingrix and Zostavax are designed.

This may be what makes Shingrix both more effective and longer-lasting, says Schaffner at Vanderbilt. As with Zostavax, the recommendation is that those who are or will soon be on low-dose immunosuppressive therapy such as less than 20 mg a day of the steroid prednisoneand those who have recovered from an illness that suppresses the immune system, such as leukemia, can get the vaccine. Right now, Shingrix is not recommended for older adults who are immunocompromised or are taking moderate to high doses of drugs that suppress the immune system.

But because the new shingles vaccine contains a nonliving viral particle, it may ultimately be deemed appropriate for those with compromised immunity. Zostavax contains live—although weakened—herpes zoster virus, so those with significantly weakened immune systems should not receive it.

Those who are severely allergic to any component of Shingrix should not get the vaccine, and anyone with active shingles should wait until symptoms resolve.

Like every vaccine, Shingrix has the potential for side effects, although so far, none seem particularly worrisome.

The new shingles vaccine does appear to be more likely to cause pain during injection and at the site of injection for up to three days afterward than Zostavax does. In clinical trials, the side effects also included injection site redness and swelling, muscle pain, and immune system responses such as headache, shivering, feverand upset stomach.

The New Shingles Vaccine: What You Should Know About Shingrix

Most, according to GlaxoSmithKline, its manufacturer, lasted less than three days. Though Shingrix was tested on some 16, adults in clinical trials, its real-world use has been limited.

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The company will be conducting additional safety and efficacy studies over the next few years, and the CDC will be monitoring any adverse events that are reported.