A new, non-live vaccine (Shingrix) on the European market, but not yet available on the Norwegian market (as of 2019). The vaccine should have about 90% protection and a relatively small risk of side effects. Two injections are required. The vaccine is then assumed to work for 10 years.

• The current vaccine in Norway is Zostavax, which consists of live viruses
  • Vaccine against Herpes zoster can prevent about 50% of cases
  • Effect for at least 3 years
  • The vaccine is recommended for people over 50 years of age who are particularly susceptible to Herpes zoster
  • The vaccine consists of living (weakened) viruses
  • The content is essentially the same as in the vaccine against chickenpox, but in a higher dose
  • It is unusual for the vaccine to trigger Herpes zoster if it is given correctly (see contraindications below)

Contraindications (indicating that the vaccine should not be given)

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 U.S.
  • Recommend the Herpes zoster vaccine to people over 60 years, whether they have had herpes zoster and / or chickenpox or not
  • The CDC considers that routine immunization testing (if one is protected from infection or not) is not necessary before any vaccination.
  • The vaccine can be given at the same time as other recommended vaccines in this age group (flu and pneumococcal vaccines)

Literature

• Shingrix.com
• Mug CC, 2019
• Olsen DB, Legislative Associations, 2015
• Bjark p, 2017
• Public Health
• Wikipedia

• Vaccines (Bindevevsykdommer.no)
• Bindevevssykdommer.no
• Vaskulitt.no