Frequently Asked Questions About Shingrix

A: You should administer Shingrix (recombinant zoster vaccine) intramuscularly in the deltoid region of the upper arm.

A: Yes, prepare Shingrix by reconstituting the antigen component with the adjuvant suspension component. Either administer it immediately, or store it in the refrigerator and use it within 6 hours of reconstitution. Otherwise, discard it. See the Shingrix package insert for detailed instructions.

A: Shingrix must be stored in the refrigerator between 2-8^oC. Do not freeze. Discard if the vaccine has been frozen.

A: Give Shingrix in a two-dose series, regardless of whether a patient has had shingles or received Zostavax (zoster vaccine live) in the past.

A: You should give the second dose of Shingrix 2 to 6 months after you gave the first dose. For individuals who are or will be immunodeficient or immunosuppressed and who would benefit from completing the series in a shorter period, the second dose can be administered 1 to 2 months after the first.

A: You should give the second dose as soon as possible. However, you do not need to restart the vaccine series.

A: Studies confirmed that Shingrix was safe and immunogenic when administered 5 or more years after Zostavax. Intervals shorter than 5 years have not been studied. However, there are no data or theoretical concerns to indicate Shingrix would be less safe or effective when given less than 5 years after Zostavax. You may consider an interval shorter than 5 years, especially if your patient was >70 years old when they received Zostavax. Wait a minimum of 8 weeks after a person received Zostavax to give Shingrix.

A: Wait a minimum of 8 weeks after a person received Varivax to give Shingrix.

A: Yes, Shingrix is an inactive vaccine so you can administer it with other inactive or live vaccines. If you administer Shingrix and another vaccine to someone on the same day, give them at different anatomical sites (e.g., different arms). For more information see the Best Practices of the Advisory Committee on Immunization Practices (ACIP).

A: Shingles vaccination is an essential preventive care service for older adults that should not be delayed or discontinued because of the COVID-19 pandemic, unless a patient is suspected or confirmed to have COVID-19.* Healthcare providers and eligible patients should make every effort to ensure that two doses of Shingrix are administered within the recommended interval of 2 to 6 months. If more than 6 months have elapsed since the first dose, administer the second dose as soon as possible. Do not restart the vaccine series.

Counseling about potential side effects is especially important during the COVID-19 pandemic, since some shingles vaccination side effects** may be similar to symptoms of COVID-19. Before administering Shingrix, healthcare providers should counsel patients about the risk of self-limited vaccine-associated side effects and the appropriate steps to take if side effects occur after vaccination. Healthcare providers should also counsel patients to consider the timing of vaccination based on personal and professional commitments.

If a patient experiences side effects, any local (e.g., redness, pain, swelling at the injection site) or systemic (e.g., fever, chills, headache, body aches) reactions normally resolve within 72 hours after vaccination. Because of concerns about COVID-19, if a patient develops fever after vaccination, he or she should stay home until they have been fever-free for 24 hours without the use of fever-reducing medications. Shingrix does not cause respiratory symptoms common in COVID-19, such as cough or shortness of breath. If a vaccine recipient develops symptoms of COVID-19 (e.g., cough or shortness of breath), or if fever does not resolve within 72 hours of vaccination without the use of fever-reducing medications, the recipient should contact their healthcare provider. If a vaccine recipient develops emergency warning signs for COVID-19, emergency medical care should be sought immediately.

For more information, see CDC’s Vaccination Guidance During a Pandemic.

A: To learn more about COVID-19 vaccine coadministration with other vaccines, see Interim Clinical Considerations for Use of COVID-19 Vaccines and COVID-19 Vaccine FAQs for Healthcare Professionals.