Medically reviewed by, Russell Braun RPH
Imagine having so much pain that it hurt to wear clothes or lay in bed. Basically anything touching your skin caused excruciating pain. This could last from a week to a few months. The pain experienced from having shingles can vary greatly and be this severe all the way to just feeling a little sick and itchy. Either way, it doesn’t seem worth it. Does this have you wondering if the Shingrix vaccine to prevent this is live or dead?
The herpes zoster virus (HZV) causes shingles. It can lay dormant in nerve cells after infecting someone early in life with chicken pox. It is caused by the varicella zoster virus (VZV) and then reappear later in life as HZV which can cause shingles.
The great news is there are now vaccines to treat VZV and HZV infection and prevent shingles. Next, you should understand why it so important you get the Shingrix vaccine
1. Why you need the Shingrix vaccine
Also known as PHN, posherpetic neuralgia is just a fancy way of saying nerve pain. It is the most common complication of shingles.
There are two main reasons you want to avoid this painful complication of shingles.
- It can last for years after a shingles infection.
- The pain can be so severe it can interfere with your daily life.
The older you are the more at risk you are for getting PHN. Even worse the older you are the more severe the PHN typically will be.
The eyes are also a common target for the shingles virus. This can cause vision problems including blindness.
2. Is Shingrix the best vaccine?
There are two vaccines to prevent shingles that have been approved in the United States.
Zostavax was approved by the Food and Drug Administration (FDA) in 2006. Shingrix was not approved until 2017. The Advisory Committee on Immunization Practices currently recommends Shingrix vaccine over Zostavax for prevention of shingles.
3. So, Is Shingrix Vaccine live or dead?
Before focusing on Shingrix, let’s discuss the difference in a live vs dead vaccine.
This refers to a vaccine made from the actual virus (in this case, some other vaccines could be bacteria) is used to make the vaccine. However, it has been weakened by scientists in a laboratory to prevent causing an actual infection, and is also called an attenuated virus. This allows you immune system to see, recognize and build an immune response. Then if you were to come in contact with the actual virus your immune system can eliminate it before it does harm.
Also known as inactivated vaccines, these use a version of the virus that has been killed. In some cases only a portion of the virus or bacteria is included in the vaccine. Because they are dead, your immune response is not as great. Therefore, many times booster shots are required with dead vaccines. These boosters help them generate similar immunity as a live vaccine.
Live vaccines generate a large initial immune response. However, they contain a weakened live virus, which could be a problem for someone with a suppressed immune system. Also, live vaccines need to be kept cool so they don’t die before the dose has been given.
Shingrix is a dead vaccine
Shingrix is a dead vaccine. However, the manufacturer does not take a live Herpes Zoster Virus (HZV) and kill it. Rather they use a process called recombinant DNA technology. Chinese hamster ovary cells are programed with a gene from the virus to make a protein found on the surface of HZV.
While it may seem strange that they use hamster cells to make a vaccine for a virus, the practice is quite common today. Many drugs that have made major advancements in medicine are made in a similar fashion. This process is often referred to as biotechnology.
4. Shingrix vaccine schedule
Shingles, which results from herpes zoster virus is caused when something triggers the reactivation of the virus that has been dormant in nerve cells. Typically, the trigger is some type of illness or stress.
Therefore, Shingrix is not used to prevent chicken pox, which normally occurs earlier in life. That is why the minimum age for getting a shingles vaccine is 50.
Who should get Shingrix?
Many people get confused about if they should get Shingrix or not. In general you should get Shingrix if:
- previously had chicken pox
- did not have chicken pox
- already received zostavax
The table below gives a breakdown on who should receive Shingrix based on age.
|18-49||No dose should be given.|
|18-49||If a dose was somehow given, repeat dose should not occur until >50.|
|50||Should receive dose after turning 50. Follow up dose 2-6 months after first.|
|50+||If over 50 and had shingles, can have Shingrix vaccine as soon as rash and symptoms go away. Follow up dose 2-6 months after first.|
|50+||If over 50 and had Zostavax or chickenpox vaccine, two doses of Shingrix should still be given.|
It is important to remember there is no maximum age to get Shingrix. If you are over 50 and not had this vaccine, you should get it!
5. How long does Shingrix last?
You can go to your doctors office or pharmacy to get the Shingrix vaccine. The dose is given as an intramuscular injection in the upper arm. Due to the fact that Shingrix is not a live vaccine, a booster shot is required.
Once that booster shot is administered how long does that protection last? It has been shown that protection against shingles infection is 85% after four years. The immunity from the vaccine likely stays high for many more years, but to date that is as far out as it has been studied.
At this time no further booster shot (after the second dose) is recommended by the CDC.
6. Shingrix second dose?
Once you get a first dose, you know a second one is going to be needed. That second dose should be given between 2 to 6 months after the first. A minimum of 4 weeks should separate the two doses, so don’t be in a rush to go back too soon!
In fact, if your doses are given less than 4 weeks apart it is recommended to get another dose 8 weeks after that. You don’t want to have to get an extra shot do you?
What if the second dose is more than 6 months after the first?
Life doesn’t always go as planned. Something could come up that could cause you to forget about getting that follow up booster shot. What should you do then?
In this case, the manufacturer recommends you just get the second shot as soon as possible. You will not need to restart the entire process, shew!
7. What happens if you don’t get a second Shingrix shot?
There is strong evidence that Shingrix is highly effective at preventing a shingles infection. When you get two shots the efficacy has been shown to be as high as 97% effective!
|50-69 years old||97% effective|
|over 70 years old||91% effective|
If you don’t get the second shot you should not expect the efficacy to be as high. Although one shot would probably still provide some protection. There have been not studies to date that confirm how well only getting one shot works.
8. Which vaccines should not be given together?
Shingrix is a recombinant vaccine, which could also be considered dead. That means it can be given with other vaccines, regardless of if they are live or dead. Typically your doctor or pharmacist will administer the shot in a different area on your body if you get more than one vaccine at a time. The Shingrix vaccine is normally given in the upper arm.
There are several vaccines that are important for you to make sure you get for optimal health. Follow this advice and you can save money by preventing sickness, medications and even hospital stays. These key vaccines to get include:
|Hepatitis B||Once as an adult|
|HPV||Once as an adult|
|Shingles||Two times after 50 years of age|
9. Shingrix vaccine cost
The Shingrix vaccine was approved by the FDA in the United States in 2017. The vaccine is still available as brand only because it is still under patent. There will not be a generic available until the patent has expired.
If you went to a pharmacy and bought Shingrix with a pharmacy discount card such as GoodRx you would expect to pay around $155 for one dose. That is the price the pharmacy would charge without insurance.
The good news is with almost all health insurers Shingrix is viewed as preventative care. That means it will be covered by insurance and have no out of pocket cost to you. That is as long as you are at a in network prescribers’ office or pharmacy.
Again, this would apply only if you are over age 50!
Medicare covers Shingrix under the prescription drug plan also referred to as Part D. If you do not have Part D or are unsure you can check that status on Medicare.gov.
10. Shingrix cost with no insurance?
If you are not covered by commercial insurance or Medicare there is still an option for you. GlaxoSmithKline the manufacturer of Shingrix has a Patient Assistance Program (PAP). You have to qualify and if you the cost of the vaccine will be paid by the PAP.
To qualify for this you must meet the following criteria:
- Have no insurance coverage.
- Be over 19 years of age.
- Live in the 50 states, Disctrict of Columbia or Puerto Rico.
- Have an annual income below the programs criteria.
Ask your doctor as they will have to help enroll you in the program. This little bit of effort will be well worth it to prevent getting a painful bout of shingles.
11. Shingrix vs Zostavax
Zostavax was on the market many years prior to Shingrix. It was widely used and now many people wonder which vaccine they should get.
Zostavax is a live version of the herpes zoster virus the has been weakened. Typically people with weakened immune systems have better results when they used dead vaccines. That is one reason why Shingrix has gained popularity. Another important reason is that studies have shown that Shingrix is actually more effective at preventing infection.
At this point the Centers for Disease Control (CDC) recommends Shingrix. There are times when Zostavax may still be used like when a patient is thought to be allergic to Shingrix.
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