Shingrix

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Recombinant, highly effective, adjuvant subunit totivaccine. Shingrix is the first dead vaccine against Herpes Zoster that triggers a targeted immune response through a specially developed adjuvant. This induces a strong and sustained immunity in older people. The vaccine Shingrix contains the glycoprotein E as antigen and is designed to induce an antigen-specific cellular and humoral immune response in persons already immune to Varicella zoster virus.

Indication
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Prevention of zoster and post-zoster neuralgia (PZN) in adults aged 50 years and older

Dosage and method of use
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Shingrix is administered intramuscularly twice at intervals of 2-6 months

Undesirable effects
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pain at the injection site, myalgia (muscle pain), fatigue and headaches

Preparations
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Shingrix was investigated in two placebo-controlled studies involving a total of 38,000 adults. The main indicator of efficacy in both studies was the number of people with zoster in each group. The number of people who developed post-zosteric neuralgia after vaccination was also determined.

In the first study (patients age 50 years and > 50 years), 7,695 people received Shingrix and 7,710 received a placebo. In the follow-up period of 3 years on average, 6 patients in the Shingrix group developed zoster (210 adults in the placebo group). After almost 4 years, none of the adults in the Shingrix group had developed post-zosteric neuralgia (18 patients in the placebo group). In this study, Shingrix prevented the occurrence of zoster in 97% of cases and post-zosteric neuralgia in 100% of cases.

In a second study (patients age 70 years and > 70 years) 8,250 people received Shingrix and 8,346 PLazebo. In the follow-up period of 4 years on average, 25 adults who received Shingrix received zoster infection (284 patients in the placebo group). Over a period of 4 years, 4 patients in the Shingrix group developed post-zosteric neuralgia (36 patients in the placebo group).

Note(s)
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Besides Shingrix, Zostavax (MSD Sharp & Dohme) is a (live) vaccine against herpes zoster.

Literature
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  1. Bharucha T et al (2017) A critical appraisal of 'Shingrix', a novel herpes zoster subunit vaccine (HZ/Su or GSK1437173A) for varicella zoster virus. Hum Vaccine Immunother 13:1789-1797.
  2. James SF et al (2018) Shingrix: The New Adjuvanted Recombinant Herpes Zoster Vaccine. Ann Pharmacother 52:673-680.
  3. Symoniak MR et al (2018) Herpes zoster subunit vaccine for the prevention of herpes zoster. At J Health Syst Pharm 75:861-869.

Outgoing links (2)

Postherpetic Neuralgia; Zoster;

Authors

Last updated on: 29.10.2020