Shingles (Herpes Zoster) Vaccine

What is the Shingles Vaccine Used For?

Shingles vaccines help prevent shingles caused by the Varicella Zoster Virus (VZV). VZV is the same virus that causes chickenpox. It stays inactive in your body and can cause shingles later in life. Though shingles cannot spread directly from one person to another, the VZV can spread and cause chickenpox in those who never had chickenpox or had never received the chickenpox vaccine. VZV is spread mainly by inhaling the infectious particles when an infected person coughs or sneezes. It can also be spread through direct contact with fluid from the shingles rash blisters. People with shingles cannot spread the VZV before their rash blisters appear or after the rash has crusted.

The first symptom of shingles is usually pain, which can be intense with even a slightest touch. Other symptoms of shingles include rash, fluid filled blisters, fever, headache, chills, or stomach upset.

A common complication of shingles, especially in older adults is a nerve pain, called postherpetic neuralgia (PHN), which can be severe and long-lasting, even after the rash has cleared. Other rare complications include lung infection (pneumonia), brain inflammation (encephalitis), hearing loss or blindness.

What Are the Types of Shingles Vaccine Available?

The recombinant Herpes Zoster vaccine (RHZV) is the Shingles vaccine available under the Singapore National Adult Immunisation Schedule (NAIS).

It does not contain the live VZV but contains a fragment of it (a protein)  for the body to recognise and obtain immunity from. 

Who Should Receive the Shingles Vaccine?

The Shingles vaccine, which is a single course of two doses, is recommended for the following groups:

• All persons aged 60 years and above

• Persons aged 18-59 years with the following immunocompromising conditions (having lower body resistance to infections), such as persons with:

  (i) Primary or acquired immunodeficiency (conditions with reduced immunity). Some examples include:

  • Acute and chronic leukaemia
  • Human Immunodeficiency Virus (HIV) infection (in advanced state/untreated)
  • Stem cell transplant (either in the previous 24 months, or more than 24 months ago but with ongoing immunosuppression or graft-versus-host disease)

        (ii) Iatrogenic immunosuppression (a weakened immune system due to medical treatment or procedure). Some examples include:

              o    Receiving treatment or have received treatment in the past 6 months which weakens the immune system, such as:

    Chemotherapy and radiotherapy for cancer
    Solid organ transplant
    Long-term steroid use
    Immunosuppressant use
    Medications (e.g. JAK inhibitors) for autoimmune diseases
 

 Please consult your doctor for more details (e.g. suitability to receive the vaccine and interval  between the two doses of the vaccine).

 You may also refer to the Singapore National Adult Immunisation Schedule (NAIS) for more  information.

What Precautions Should I Follow Before Receiving the Shingles Vaccine?

Inform your healthcare professional if:

• You are allergic to this vaccine or any of the other ingredients of this vaccine
• You had a serious reaction (e.g.anaphylaxis - a severe allergic reaction) to the previous dose of the vaccine
• You have a history of Guillain-Barré Syndrome (a rare nerve condition)
• You are pregnant, planning to become pregnant, or breastfeeding
• You have a history of bleeding disorders
• You are currently not feeling well and having a fever
• You are taking any other medications

How Is the Shingles Vaccine Given?

It is given by injection into a muscle, as a series of two doses. 

For persons aged 60 years and above who have yet to receive any shingles vaccine, two doses of RHZV are recommended at an interval of 2 to 6 months.

For immunocompromised persons aged 18 to 59 years, the interval for the two doses of RHZV may be shortened to 1 to 2 months if earlier protection is desired.

For persons who had previously received the live, attenuated Herpes Zoster vaccine (HZVL): 

•    An interval of at least 5 years between HZVL and RHZV is recommended in general.
•    A shorter interval of at least 12 months between HZVL and RHZV may be considered in persons aged 70 years and above due to a lower efficacy of HZVL in these individuals.
•    A minimum interval of 8 weeks between HZVL and RHZV should be observed for all recommended age groups.

What Are Some Common Side Effects of the Shingles Vaccine?

• Some people may feel faint after the vaccination
  • Sit for 15 minutes to avoid falling down
• Pain, redness and swelling at the injection site
  • You may place a cold compress over the affected area for relief
  • You may take paracetamol for pain relief
• Headache, muscle aches, fatigue
  • These side effects usually go away on its own
  • You may take paracetamol to treat the headache or muscle aches

Please see a doctor if these side effects do not get better or become worse.

What Are Some Rare But Serious Side Effects That I Need to Seek Medical Advice Immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

If you experience any of these symptoms, you should inform your healthcare professional immediately.