Shingles Vaccination

What is the shingles vaccine?

The shingles vaccine protects against shingles, a painful rash caused by the varicella-zoster virus (VZV) - the same virus that causes chickenpox.

After recovering from chickenpox, the virus remains dormant in the body's nerve cells. In about 1 in 3 people, the virus can reactivate later in life, causing shingles, often referred to locally as 'snake disease'.

Shingles usually starts with an itching, tingling, or burning sensation on the skin, followed by a painful rash of fluid-filled blisters. These blisters typically appear on one area of the body, such as the torso, face, neck or eyes. The blisters will eventually crust over and heal fully within 2 - 4 weeks.

In addition to the rash, shingles may cause other symptoms such as fever, headaches, light sensitivity, and stomach upset.

The risk of shingles increases with age, especially for people over 50, and rises sharply after age 60.

How the shingles vaccine works

The shingles vaccine stimulates the body's immune system to defend against VZV. This helps the body recognise and fight the virus if it reactivates, thus reducing the risk of developing shingles and its complications.

Types of shingles vaccines

There are 2 types of shingles vaccines available:

• Live attenuated vaccine (e.g. Zostavax)
• Recombinant adjuvanted vaccine (e.g. Shingrix)

The recombinant adjuvanted Shingrix vaccine is preferred over the Zostavax vaccine, as it is generally considered to be safer and provides longer-lasting protection. Shingrix vaccine is available at Parkway Shenton clinics.

Differences between the shingles vaccines

• Live attenuated vaccine. This contains a weakened form of the virus and is given as a single injection under the skin. It prompts the body to produce an immune response against VZV. Since a live virus is used, there is a small risk of developing a symptomatic infection, which is why it is not recommended for individuals who are immunocompromised.
• Recombinant adjuvanted vaccine. This contains a specific protein from the virus – the varicella-zoster glycoprotein E antigen – that stimulates an immune response, along with an adjuvant to boost this response. Since the virus is non-live, it is safer and suitable for people with weakened immune systems.

Why do you need the shingles vaccine?

While shingles itself cannot be spread from person to person, the virus that causes it is contagious. A person with shingles can spread the VZV to others through direct contact with the fluid from shingles blisters.

Shingles can lead to severe complications such as nerve pain (postherpetic neuralgia), which can last for months or even years after the rash has healed. In rare cases, it may result in secondary bacterial infections, vision or hearing loss, or even brain inflammation.

Vaccination helps prevent shingles and its long-term complications, especially for:

• Seniors, as the risk of shingles increases with age
• Individuals with weakened immune systems, as shingles can be more severe

It is possible to have shingles more than once.

When do you need the shingles vaccine?

Shingles vaccination is recommended for:

• Seniors aged 50 years and older, regardless of whether they have had prior episodes of shingles or chickenpox, even if they have been vaccinated with the live attenuated vaccine (Zostavax) in the past.
• Individuals aged 18 years and older with chronic medical conditions (unless a contraindication or precaution exists), after consulting with their doctor.

Who should not receive the shingles vaccine?

Individuals should avoid the shingles vaccine if they:

• Have had a severe allergic reaction to any component of the vaccine or after a previous dose of the vaccine
• Have had a severe allergic reaction to any component of the vaccine or after a previous dose of the vaccine
• Have active, untreated tuberculosis
• Are experiencing an acute illness or fever
• Have a weakened immune system
• Have recently had a blood transfusion or bone marrow transplant

How do you prepare for the shingles vaccine?

Before getting vaccinated, discuss with your doctor:

• Any allergies you have
• Your medical history, especially any immune conditions or blood disorders
• If you are pregnant, planning to become pregnant, or breastfeeding
• Any medications you're currently taking, including over-the-counter products
• If you're unwell or running a fever

What can you expect when getting the shingles vaccine?

The recombinant shingles vaccine is given as an intramuscular injection in the upper arm, in two doses. The second dose is typically administered 2 - 6 months after the first. The process is quick, and you may need to stay briefly after the vaccination to ensure there are no immediate reactions.

What are the common side effects of the shingles vaccine?

Common side effects include:

• Mild pain, redness, or swelling at the injection site
• Low-grade fever
• Fatigue
• Headache
• Muscle aches
• Joint pain
• Gastrointestinal symptoms

These side effects usually resolve within a few days.

What are the serious side effects that require medical attention?

Serious side effects are rare but can include:

• Swelling of the face, eyes or lips, which are possible signs of a severe allergic reaction (anaphylaxis)
• Difficulty breathing
• A fast heartbeat
• Dizziness or weakness
• High fever
• Itchy rashes or hives

If you experience any of these symptoms, seek medical attention immediately.