Shingles Vaccination: The Shingrix Vaccine

Understanding Shingles

Shingles is essentially a reactivation of the varicella zoster (chicken-pox) virus in your nerves. It presents as a painful and/or itchy shingles rash, usually on one side of the body or face. The rash, made up of small blisters, usually forms scabs after 1 week. For most people, the shingles rash clears up in two to four weeks, however the pain may last much longer.

In Singapore, there are an estimated 30,000 new cases of shingles every year, and it has been estimated that over 90 per cent of adults above the age of 50 already carry the virus that causes shingles. If you have experienced shingles before, the “nerve pain” is known to be excruciating.
Complications can include postherpetic neuralgia (PHN), a condition where pain persists long after the rash has healed, as well as vision loss if the eyes are affected.

Risk factors for shingles include age, as the immune system weakens over time, and a history of chickenpox. Immunocompromised individuals, such as those undergoing cancer treatment or taking immunosuppressive medications, are also at higher risk.

The Shingrix vaccine is a crucial tool in preventing shingles, a painful condition caused by the reactivation of the Varicella-Zoster Virus (VZV), which also causes chickenpox. As we age, the likelihood of developing shingles increases, making vaccination an essential preventive measure.

Vaccination

Price

Recommended doses

Shingrix

$398 nett per dose
$780 nett for 2-dose

2 doses
Dose 2 can be taken 2-6 months after initial dose

The Impact of Shingles

Shingles can have a significant impact on an individual’s quality of life. The most common symptom is pain, which can be severe and long-lasting. The rash itself is often unsightly and may lead to scarring. Other complications of shingles can include:

Postherpetic Neuralgia (PHN)

This is the most common and debilitating complication of shingles. PHN is characterized by persistent pain in the area of the shingles rash long after the rash has healed.

Ophthalmic Shingles

When shingles occur in or around the eye, it can lead to vision problems or even permanent vision loss.

Neurological Complications

Shingles can sometimes lead to more severe neurological issues, including facial paralysis, hearing problems, and inflammation of the brain (encephalitis).

Skin Infections

The blisters from shingles can become infected, which requires medical treatment.

Generalized Infections

In severe cases, shingles can spread throughout the body, leading to systemic infections.

Weakened Immune System

Shingles can be especially severe in individuals with weakened immune systems, such as those with HIV/AIDS or cancer.

The Shingrix Vaccine: A Game-Changer

Until recently, the Zostavax vaccine was the primary vaccine available for preventing shingles. However, Shingrix, a newer vaccine, has emerged as a more effective and highly recommended option. Here’s what you need to know about Shingrix:

Highly Effective

Shingrix is over 90% effective at preventing shingles, making it significantly more effective than Zostavax, which has an efficacy rate of around 50%.

Long-Lasting Protection

Shingrix provides protection for a longer duration. Clinical trials have shown that it maintains its effectiveness for at least four years, and studies are ongoing to determine if it provides protection beyond that time.

Recommended for Most Adults

Shingrix is recommended for all adults aged 50 and older, including those who have previously received the Zostavax vaccine. It is even recommended for individuals who have had shingles in the past.

Two-Dose Series

Shingrix is administered as a two-dose series, with the second dose given two to six months after the first. This series is essential for full protection.

Minimizes Complications

Shingrix not only reduces the risk of shingles but also lowers the risk of postherpetic neuralgia, a debilitating complication of shingles.

Why You Should Get the Shingrix Vaccine

The CDC recommends Shingrix for all adults aged 50 and older, even if they have had shingles before or received the Zostavax vaccine. It is also recommended for individuals with chronic medical conditions or those who are immunocompromised, with certain precautions. Those with a severe allergic reaction to any component of the vaccine or a current shingles outbreak should not receive Shingrix.

Now that we understand the impact of shingles and the effectiveness of Shingrix, let’s examine the compelling reasons why you should consider getting vaccinated:

Prevents Shingles

The most obvious reason to get the Shingrix vaccine is to prevent shingles itself. Shingles can be excruciatingly painful and cause a range of complications. By getting vaccinated, you significantly reduce your risk of experiencing this debilitating condition.

Understanding Shingles

Postherpetic neuralgia (PHN) is one of the most feared complications of shingles, as it can cause long-term, persistent pain. Shingrix substantially lowers the risk of PHN, providing peace of mind and a better quality of life.

female healthworker speaking with a male patient

Maintains Your Quality of Life

Shingles can disrupt your daily life, making it difficult to carry out routine activities, go to work, or enjoy your hobbies. By getting vaccinated, you can maintain your quality of life and avoid the pain and discomfort associated with shingles.

Protects Others

Shingles is contagious, and coming into contact with the rash can lead to chickenpox in those who haven’t had it or been vaccinated against it. Getting vaccinated not only protects you but also prevents the potential spread of the virus to others.

Cost-Effective

While the Shingrix vaccine has a cost, it is a cost-effective investment when compared to the expenses associated with treating shingles and its complications, including doctor’s visits, medications, and lost productivity.

Ensuring a Healthy Retirement

As you age, maintaining your health becomes increasingly important. The Shingrix vaccine is a proactive step in protecting your health during your retirement years, allowing you to enjoy this phase of life to the fullest.

The Side Effects of Shingrix

The most common side effects 7-day post vaccination are pain, redness, swelling at the injection site, body ache, fatigue and headache. Other side effects may include nausea, vomiting, diarrhea and/or abdominal pain, fever and chills. However, serious or long-term side effects are rare.

Comparing Shingrix with Other Vaccines

Compared to Zostavax, Shingrix offers superior protection and a longer duration of immunity. While Zostavax is a live attenuated vaccine, Shingrix’s recombinant adjuvanted formula provides a more robust immune response, making it the preferred choice for shingles prevention.

Real-World Impact

The real-world impact of Shingrix is evident in numerous testimonials and statistical data. Patients who have received the vaccine report a significant reduction in shingles incidence and severity. Public health data also shows a decrease in shingles cases and associated complications since the introduction of Shingrix, underscoring its effectiveness.

Overcoming Barriers to Vaccination

Despite its benefits, some individuals may hesitate to receive the Shingrix vaccine due to concerns about side effects or misinformation. Addressing vaccine hesitancy through education and reassurance from healthcare providers is crucial. Improving access to the vaccine and launching educational campaigns can help increase vaccination rates, ensuring more people are protected from shingles.

The Shingrix vaccine is a vital tool in preventing shingles and its debilitating complications. With its high efficacy and safety profile, Shingrix offers a significant advantage in protecting older adults from this painful condition. If you are 50 or older, talk to your healthcare provider about getting vaccinated with Shingrix. Taking this step can greatly enhance your quality of life and safeguard your health.

The Social and Economic Impact of Shingles

Shingles not only affects individuals but also has broader social and economic implications. Understanding these impacts can shed light on why getting the Shingrix vaccine is essential.

Social Impact of Shingles

Pain and Suffering

Shingles can be excruciatingly painful, affecting an individual's ability to perform daily tasks, work, and enjoy life. This pain can lead to stress, anxiety, and a diminished quality of life.

Isolation

Shingles is contagious to those who haven't had chickenpox or received the chickenpox vaccine. As a result, individuals with shingles often isolate themselves to avoid exposing others, which can lead to feelings of loneliness and social withdrawal.

Loss of Productivity

Shingles can lead to missed workdays and decreased productivity, which affects not only the individual but also their employer and the economy as a whole.

Economic Impact of Shingles

Healthcare Costs

Treating shingles and its complications can be expensive. Medical visits, prescription medications, hospitalization, and rehabilitation add to the overall healthcare costs.

Lost Workdays

Shingles often lead to missed workdays or decreased productivity. This can result in financial loss for both individuals and businesses.

Vaccination Costs

While there is a cost associated with the Shingrix vaccine, it is an investment in long-term health and can be more cost-effective than treating shingles and its complications.

Public Health Programs

Government and public health programs may bear the burden of shingles cases, which can strain healthcare resources.

Conclusion

Shingles is a painful and potentially debilitating condition that can impact individuals, families, and communities. The Shingrix vaccine offers a compelling solution to significantly reduce the risk of shingles and its complications. It is highly effective, provides long-lasting protection, and is recommended for most adults aged 50 and older.

By getting the Shingrix vaccine, you take a proactive step towards a healthier and more fulfilling future. Your well-being, quality of life, and contribution to your community are all reasons to consider vaccination.

Don’t wait—talk to your healthcare provider, explore your options, and take control of your health journey. The choice to get the Shingrix vaccine is a choice for a healthier and shingles-free future. Your health is your most valuable asset, so invest in it wisely.

Frequently Asked Questions

How long will the Shingrix vaccine last?
Shingrix is likely to offer long-term protection for life. As it is a new vaccine, data from the latest Oct 2022 follow-up study shows that the clinical benefit is sustained for at least 10 years. The study is on-going and more results will follow in the years to come.
It is recommended to get Shingrix as soon as you turn 50 years old so as to reduce the chance of ever developing Shingles.
Shingrix should be given as a two-dose series, regardless of whether you have had shingles or received Zostavax (zoster vaccine live) in the past.
You should get the second dose between 2 to 6 months after the first dose. If you are immunosuppressed, you would benefit from completing the series in a shorter period, the second dose can be administered 1 to 2 months after the first.
You should get the second dose as soon as possible. However, you do not need to restart the vaccine series.

The main difference is effectiveness with Shingrix being much more effective. Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old, whereas Zostavax is only 51 to 70% effective.

Another difference is that Zostavax is a live, attenuated herpes zoster vaccine, unlike Shingrix. In other words, Zostavax contains a weakened version of the actual virus to produce an immune response. For this reason, Zostavax is not recommended for those who are immunocompromised. Otherwise, the vaccine may cause a symptomatic infection, even weeks following vaccination.

Shingrix is currently the preferred Shingles vaccine, according to the Centers for Disease Control and Prevention (CDC). Zostavax was discontinued in the United States in November 2020.

Studies confirmed that Shingrix was safe and immunogenic when administered 5 or more years after Zostavax. Intervals shorter than 5 years have not been studied. However, there are no data or theoretical concerns to indicate Shingrix would be less safe or effective when given less than 5 years after Zostavax. You may consider an interval shorter than 5 years, especially if you are >70 years old when you first received Zostavax.

The guideline is to wait a minimum of 8 weeks if you have had Zostavax before getting Shingrix.

Yes, Shingrix is an inactive vaccine so you can get the shot with other inactive or live vaccines. If you get Shingrix and another vaccine, it would be administered at different anatomical sites (e.g., different arms).
Unfortunately, as shingles vaccination is currently not on the National Adult Immunization Schedule, it is currently ineligible for government subsidies. There have been calls for our government to lead procurement of the vaccine to reduce its cost to make it more accessible so as to reduce the incidence of Shingles on our population and the healthcare burden Shingles imposes.

At Virtue Medical, we are offering Shingrix at  $398 per dose or $780 nett for 2 doses, with no additional consultation fee or GST. Book an appointment for Shingrix today!

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