Author Topic: Shingles vaccine (Zostavax, Shingrix)  (Read 371 times)

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Offline agate

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Shingles vaccine (Zostavax, Shingrix)
« on: November 24, 2014, 05:17:49 pm »
The older you are, the more likely you are to be hit by herpes zoster if you had chickenpox at some time or other, but the herpes zoster vaccine (Zostavax) has been shown to be quite effective if given to people over 60.

One problem is that it's probably no longer effective after 5 years, and whether revaccination is a good idea hasn't been decided yet.

For information on this vaccine, see Medscape "Update on Recommendations for Use of Herpes Zoster Vaccine," November 23, 2014.]http://www.medscape.com/viewarticle/830306]Medscape "Update on Recommendations for Use of Herpes Zoster Vaccine," November 23, 2014.
« Last Edit: November 13, 2018, 09:32:15 pm by agate »
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Offline agate

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Is the new shingles vaccine better than the old one?
« Reply #1 on: November 13, 2018, 09:31:28 pm »
From NEJM Journal Watch, "Summary and Comment" (November 13, 2018):


Quote
FREE FULL-TEXT ARTICLE  SUMMARY AND COMMENT | GENERAL MEDICINE, INFECTIOUS DISEASES
Is the New Zoster Vaccine Better Than the Old One?


 Abigail Zuger, MD reviewing Tricco AC et al. BMJ 2018 Oct 25
A meta-analysis suggests more toxicity but better efficacy from the recombinant vaccine.

The new two-dose recombinant zoster vaccine (RZV; Shingrix) has been greeted with enthusiasm because of its impressive efficacy rates during clinical trials and its presumed safety in immunocompromised patients. ... Still, researchers have not yet assessed RZV's performance in clinical settings or directly compared its performance with that of the older live attenuated vaccine (LAV; [Zostavax]).

To compare the two vaccines indirectly, researchers conducted a meta-analysis of 27 randomized and observational studies that involved more than 2 million patients (age, >50). The investigators were able to conclude that, for preventing both suspected and confirmed herpes zoster, the performance of RZV appeared to be statistically superior to that of the LAV. For preventing ophthalmic zoster, the performance of RZV also appeared to be statistically superior to that of LAV (although the authors cautioned that the data were too sparse to call this conclusion firm). Risk for developing postherpetic neuralgia was slightly lower with RZV than with LAV.


Adverse events, both local and systemic, were significantly more likely with RZV than LAV, but neither vaccine affected mortality. Safety and efficacy in immunocompromised patients could not be compared because of inadequate data.


COMMENT

RZV certainly looks good on paper, and in theory it should be a boon to immunocompromised patients who cannot receive live vaccines. On the other hand, the toxicity of RZV (along with the requirement for a second dose of vaccine in patients who might have had a bad experience with the first dose) is likely to limit its real-world performance. A head-to-head trial to compare RZV with LAV is ongoing and should provide interesting data.
« Last Edit: November 13, 2018, 09:41:44 pm by agate »
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

Offline ewizabeth

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #2 on: December 31, 2018, 09:32:15 am »
Hi Agate,


This is something I've been wondering about. My PCP and neurologist both think I need the shingles vaccine but according to my late mother, I never had chicken pox, or any other childhood illness that went through the neighborhood.


When our boys were small, they had a bad case of chicken pox and I never had it then either.




Offline agate

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #3 on: December 31, 2018, 12:15:53 pm »
https://www.cdc.gov/shingles/downloads/shingles-factsheet-adults.pdf


According to that information sheet in the link, 99% of the population born before 1980 has had chicken pox. You may have had it without knowing it--that happens fairly often because there are mild cases.


My doctor has been advising me to get the Shingrix vaccine even though I had the Zostavax vaccine some years ago.  Shingrix is given in 2 doses, 2 -6 months apart, but there is a shortage of the vaccine in many areas. I'm waiting a while and hoping that the doctor's office will get a supply of it before long.


I'm not overly eager to have these two shots because of the side effects but shingles can be far worse, and supposedly 1 in 3 people over 50 gets shingles.


You could take your chances and spare yourself those side effects. I'm probably going to go ahead and get the vaccine because I've heard enough stories about how severe shingles can be.
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

Offline ewizabeth

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #4 on: December 31, 2018, 03:07:46 pm »
That makes sense. Maybe it was so mild that I didn't even have a rash as a kid. My mom was busy with six kids and I was the youngest so there's a chance she wouldn't even notice. I guess I'll break down and get the vaccines.

Offline agate

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #5 on: December 31, 2018, 04:13:09 pm »
It might have seemed like a slight cold, and the rash may have been so slight it went unnoticed, or it might have been thought to be  one of those odd things that will go away. I have a feeling that busy moms tend to hope many problems will go away if given enough time just because taking a sick child to a doctor or clinic can be a big project--and the problems usually do go away but then sometimes a mild case of something like chickenpox gets overlooked.
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

Offline agate

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #6 on: February 01, 2019, 07:52:29 pm »
Seems that 24% of the people receiving the Shingrix vaccine have had fever as a reaction. The brief article below (from New England Journal of Medicine's Journal Watch, February 1, 2019) contains a link to the CDC report, which is much more detailed:





New Shingles Vaccine Doesn't Carry Higher Risk for Serious Adverse Events

By Kelly Young
Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS
The new recombinant zoster vaccine (RZV; Shingrix) does not appear to pose a significant risk for serious adverse events, according to an analysis of postmarketing voluntary reporting in MMWR.

In the first 8 months after its approval, 3.2 million doses were distributed. During this time, the CDC recorded roughly 4400 adverse events related to RZV. Of these, only 3% were considered serious (e.g., hospitalization, life-threatening illness), for a rate of 4.0 serious events per 100,000 doses distributed. In comparison, the older, live-attenuated zoster vaccine has a serious event rate of 4.4 per 100,000.

Some of the most commonly reported adverse events were fever (24% of all reports), injection site pain, and chills.
The authors, calling the findings reassuring, conclude, "Counseling patients to expect self-limited adverse reactions such as pain, swelling and redness at the injection site, fever, chills, and body aches might ease concerns and encourage completion of the 2-dose RZV series."

What Our Editors Had to Say
William E. Chavey, MD, MS:

From my experience in having given at least 100 doses, the majority of patients have reported body aches and/or fevers, but none of my patients have had more serious reactions.
MMWR article (Free)
« Last Edit: February 15, 2019, 09:42:42 pm by agate »
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

Offline ewizabeth

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #7 on: February 15, 2019, 08:43:44 pm »
I see my PCP soon and I'll be getting this vaccine even though it's highly doubtful that I had chicken pox. I don't want to risk getting shingles.

Offline agate

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Consumer Reports on shingles and the vaccine
« Reply #8 on: July 24, 2019, 09:27:40 pm »

Consumer Reports (July 24, 2019) has a good article, "What to Know about Shingles and Its Vaccine":


http://bit.ly/2Y49ql4


ewizabeth, did you get the Shingrix vaccine yet? I've heard varying reports about the side effects.
MS Speaks--online for 17 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010. Glatopa (glatiramer acetate 40mg 3 times/week) since 12/16/20.

Offline ewizabeth

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Re: Shingles vaccine (Zostavax, Shingrix)
« Reply #9 on: July 25, 2019, 09:50:44 am »
I don't know which one I got but my PCP told me I had it in 2014 or so. I don't remember having any side effects. I was required to have had it to start taking Ocrevus.

 

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