Spartan Nurse Monthly: What You Need to Know about the New Shingles Vaccine

About this document: As the former writer for MSU’s College of Nursing’s Marketing and Communications team, I proofed a variety of documents. More notably, the Spartan Nurse Monthly’s, which feature hot takes on pressing health concerns authored by the esteemed professors at MSU’s College of Nursing. I edited the technical information so it could easily be read by someone not versed in the healthcare vernacular. ​

The Spartan Nurse Monthly’s are featured on the College of Nursing website and social platforms, as well as the monthly e-Newsletter.

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Have you ever had the “chickenpox”? Most people over the age of 30 had this virus in their childhood. After a person recovers from varicella (chickenpox), the virus becomes inactive and lives along a nerve pathway. This shingles virus, also known as herpes zoster, can resurface at any time causing significant discomfort. This pain is described as itchy, burning, and painful when touched.

In October, the Advisory Committee on Immunization Practices (ACIP) approved a new shingles vaccine, Shingrix®, for adults 50 years and older. The other shingles vaccine, Zostavax®, has been the only recommended shingles vaccine since 2006. The Centers for Disease Control and Prevention (CDC) now recommends Shingrix® as the preferred vaccine to prevent shingles (CDC, 2018) as it is more effective and provides longer immunity.

Symptoms and Treatment Options
Lying along the route of a nerve, shingles causes significant pain and usually appears as a rash. There are some cases where a rash never appears. However, when the rash does surface, it looks like red bumps that develop into fluid-filled blisters. 

They can be itchy, painful to the touch, or both. Although the infection can occur anywhere on the body, the most common location is the side of the torso. It only appears on one side and does not cross the center of the body. If located on the face near the eye, damage to the eye can occur and be quite serious. 

Unfortunately, the pain associated with shingles, post-herpetic neuralgia, can cause significant discomfort for many months or even years after the rash has healed. It is frequently debilitating and difficult to treat (Dooling, et al., 2018).

Vaccination is the best method to prevent shingles and its associating complications. Zostavax® and Shingrix® are both available to consumers. The older vaccine, Zostavax®, contains the live virus and cannot be given to anyone with a low immune system. The new vaccine, Shingrix®, does not contain live virus and is safe for those with a mildly low immune system. This includes persons taking low-dose steroid medications or who do not have a spleen. The CDC has not yet approved the vaccine for persons with HIV or those receiving immune suppressive therapy (CDC, 2018).

FAQs about the New Vaccine (Shingrix®)

• What if I already had the old vaccine (Zostavax®)? 
  You can still receive the new vaccine if you already have had the old vaccine. It is recommended that two months pass before getting the new vaccine (CDC, 2018).
• What if I have already had shingles? 
  Even if you have had shingles, you can get infected again. The vaccine is the best method to prevent this. If you have a current shingles infection, it is advised to get the vaccine after the rash symptoms are gone.
• What if I have never had chickenpox? 
  Over 90% of the population 50 years and over has had exposure to chickenpox, so it can be assumed that the virus is in your system and you will benefit from the vaccine. The CDC does not recommend testing for chickenpox exposure prior to receiving the vaccine (CDC, 2018).
• How is Shingrix® administered? 
  Shingrix® is administered in two doses, 2-6 months apart. It is important to not forget the second dose for the best immunity.
• What are the side effects of Shingrix®? 
  As with any vaccination, there may be tenderness at the vaccine site. Reactogenicity, or the production of a hyperactive immune response, can occur after vaccination and typically lasts 2-3 days. Symptoms include pain or redness at the site of the shot, headaches, and shivering. This reaction is more common in adults under the age of 70. Ask your healthcare provider how to manage these symptoms.
• Is it expensive? 
  According to Consumer Reports (2018), Shingrix® costs approximately $280 for the two doses ($213 for Zostavax®). There may be an administration fee charged by the pharmacy or clinic. Most private health insurance plans cover vaccines recommended by the CDC. 
  
  It is always best to call your insurance company to ask about your coverage and out-of-pocket costs. Medicare Part D/Medicare Advantage covers the cost of Shingrix® with a prescription from your healthcare provider, although there may be a co-pay required. Medicare Part B does not cover either shingles vaccines (US Centers for Medicare and Medicaid Services, 2018).
  
  

Kara Elena Schrader
DNP, NP-C
Family Nurse Practitioner
Assistant Professor, Health Programs

Additional Information 
https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

References

• Centers for Disease Control and Prevention
• Consumer Reports (2018)
• Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines
• US Centers for Medicare and Medicaid Services (2018)​