Shingrix Vaccination Guidance
Introduction to Shingrix Vaccination
- The Centers for Disease Control and Prevention recommends that patients can and should receive Shingrix vaccine after exposure to shingles, as there is no contraindication to vaccination following exposure, and the recombinant vaccine poses no risk of causing disease even in recently exposed individuals 1, 2
Key Considerations for Vaccination
- The American Academy of Family Physicians notes that Shingrix is a non-live recombinant vaccine, which means it cannot cause varicella-zoster virus infection under any circumstances, including after exposure to active shingles 3
- The vaccine will not worsen or complicate potential incubating infection from the exposure, and completing the vaccine series after symptom resolution remains indicated if the patient develops shingles from the exposure 1
Post-Exposure Prophylaxis
- The Centers for Disease Control and Prevention recommends post-exposure prophylaxis with varicella-zoster immune globulin (VZIG) for susceptible individuals within 96 hours of varicella exposure, but this does not apply to Shingrix vaccination 4, 5
- VZIG is for preventing primary varicella (chickenpox) in non-immune individuals, whereas Shingrix is for preventing herpes zoster reactivation 4, 5, 1
Clinical Algorithm for Exposed Patients
- For patients scheduled to receive Shingrix who are exposed to shingles, the patient should be confirmed to be ≥50 years old (or ≥18 years if immunocompromised) before administering the vaccine 1, 3
- The vaccine should be administered as planned without delay or modification, and the patient should be monitored for development of shingles from the exposure over the next 10-21 days 1, 2