Vaccine against herpes zoster (shingles, shingles) 4/5 (2)

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One in four people will develop herpes zoster during their lifetime. The risk increases clearly from the age of 50 and with weakened immune systems, such as with the use of immunosuppressive drugs. The newer Shingrix vaccine is expected in practice to replace the older Zovirax vaccine.

Shingrix

A new, non-live vaccine (Shingrix) became available on the Norwegian market in 2022. The vaccine has over 90% protection and a relatively small risk of side effects in people over 50 years of age. Two injections are required. The vaccine is then assumed to work for 10 years (at least 7 years). Shingrix has not been systematically tested in autoimmune rheumatic diseases, but several years of experience from foreign centers indicate good safety (reference: Stevens M, 2020).

Zostavax

The older vaccine Zostavax which consists of live (attenuated) virus. The vaccine against Herpes zoster can prevent about 50% of cases and has an effect for at least 3 years. The content is essentially the same as in the vaccine against chickenpox, but in a higher dose. It is uncommon for the vaccine to trigger herpes zoster if given correctly (see contraindications below). Unlike the new vaccine (Shingrix), the "live", old vaccine (Zostavax) should not be given in weakened immune systems because one can then get herpes zoster symptoms even from the weakened vaccine virus. In practice, patients must receive the old Zostavax vaccine before treatment start with powerful immunosuppressive drugs that JAK inhibitors og Biological drugs against rheumatic disease, but also Prednisone and other immunosuppressive drugs. Centers for Disease Control and Prevention (CDC) In the United States, Herpes Zoster recommends the vaccine to people over the age of 60, whether they have had Herpes Zoster and / or chickenpox or not. The vaccine can be given at the same time as other recommended vaccines in this age group (flu and pneumococcal vaccines).

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