Dosing & Uses
Dosage Forms and Strengths
injection, single-dose IM suspension
- 0.5mL
Shingles Prophylaxis
Adults aged ≥50 years
Indicated for prevention of herpes zoster (HZ) (shingles) in adults ≥50 years
≥50 years: 0.5 mL IM x2 doses administered 2-6 months apart
Immunocompromised adults
- Indicated for prevention of HZ in adults aged ≥18 years who are or who will be at increased risk of shingles owing to immunodeficiency or immunosuppression caused by known disease or therapy
- For individuals who are or will be immunodeficient or immunosuppressed and who would benefit from a shorter vaccination schedule
- 0.5 mL IM x2 doses administered 1-2 months apart
ACIP recommendation
- Administer 2 doses of recombinant zoster vaccine (RZV) (Shingrix) 2-6 months apart to adults aged ≥50 years regardless of past episode of herpes zoster or receipt of zoster vaccine live (ZVL) (Zostavax); as of November 2020, Zostavax is no longer marketed in the United States
- Administer 2 doses of RZV 2-6 months apart to adults who previously received ZVL at least 2 months after ZVL
- Current immunization schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html
Dosing Considerations
Limitation of use
- Shingrix is not indicated for prevention of primary varicella infection (chickenpox)
Safety and effectiveness have not been established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (4)
- elivaldogene autotemcel
elivaldogene autotemcel, zoster vaccine recombinant. Either decreases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: The safety and effectiveness of vaccination during or following elivaldogene autotemcel treatment have not been studied. Vaccination is not recommended during the 6 weeks preceding myeloablative conditioning, and until hematological recovery following elivaldogene autotemcel treatment. Where feasible, administer childhood vaccinations before myeloablative conditioning. .
- ofatumumab SC
ofatumumab SC decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 2 weeks before initiating ofatumumab SC for inactivated vaccines, and whenever possible.
- siponimod
siponimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.
- teplizumab
teplizumab decreases effects of zoster vaccine recombinant by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Inactivated or mRNA vaccines are not recommended within 2 weeks before teplizumab treatment, during treatment, or 6 weeks after completion of treatment.
Monitor Closely (67)
- adalimumab
adalimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- alefacept
alefacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- anakinra
anakinra decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- anthrax immune globulin
anthrax immune globulin decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- antithymocyte globulin equine
antithymocyte globulin equine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- antithymocyte globulin rabbit
antithymocyte globulin rabbit decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- azathioprine
azathioprine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- basiliximab
basiliximab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- belatacept
belatacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- belimumab
belimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- budesonide
budesonide decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- cabazitaxel
cabazitaxel decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- canakinumab
canakinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- certolizumab pegol
certolizumab pegol decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- chloroquine
chloroquine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- cortisone
cortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- cyclosporine
cyclosporine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. If possible, complete all age-appropriate vaccinations at least 2 weeks before initiating immunosuppressant therapy. Patients vaccinated <14 days before starting immunosuppressive therapy or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued if immune competence has been restored. Longer waiting periods may be required for drugs that maintain their immunosuppressive effects for more than 3 months after discontinuation (eg, ocrelizumab). .
- deflazacort
deflazacort decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- dexamethasone
dexamethasone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- etanercept
etanercept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- everolimus
everolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- famciclovir
famciclovir decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- fingolimod
fingolimod decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- fludrocortisone
fludrocortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- glatiramer
glatiramer decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- golimumab
golimumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- guselkumab
guselkumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- hydrocortisone
hydrocortisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- ibrutinib
ibrutinib decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- ifosfamide
ifosfamide decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- infliximab
infliximab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- ixekizumab
ixekizumab decreases effects of zoster vaccine recombinant by pharmacodynamic synergism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- leflunomide
leflunomide decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- lomustine
lomustine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- mechlorethamine
mechlorethamine decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- melphalan
melphalan decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- mercaptopurine
mercaptopurine decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- methotrexate
methotrexate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- methylprednisolone
methylprednisolone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- muromonab CD3
muromonab CD3 decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- mycophenolate
mycophenolate decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- obinutuzumab
obinutuzumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- ocrelizumab
ocrelizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- onasemnogene abeparvovec
onasemnogene abeparvovec decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. When initiating systemic corticosteriod therapy, wait 2 weeks after an inactivated vaccine.
- oxaliplatin
oxaliplatin decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- pneumococcal vaccine polyvalent
pneumococcal vaccine polyvalent decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- ponesimod
ponesimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Use Caution/Monitor. If possible, complete all age-appropriate vaccinations at least 4 weeks before initiating ponesimod.
- prednisolone
prednisolone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- prednisone
prednisone decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- procarbazine
procarbazine decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- rilonacept
rilonacept decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- rituximab
rituximab, zoster vaccine recombinant. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.
- rituximab-hyaluronidase
rituximab-hyaluronidase, zoster vaccine recombinant. immunosuppressive effects; risk of infection. Use Caution/Monitor. When used for rheumatoid arthritis, follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of rituximab.
- sarilumab
sarilumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- satralizumab
satralizumab decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines. At least 2 weeks before initiating for non-live vaccines. .
- secukinumab
secukinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- sirolimus
sirolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- tacrolimus
tacrolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- temsirolimus
temsirolimus decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- tocilizumab
tocilizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- tralokinumab
tralokinumab will decrease the level or effect of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Use Caution/Monitor. Limited data are available regarding coadministration with non-live vaccines.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- ublituximab
ublituximab decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.
- ustekinumab
ustekinumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- vedolizumab
vedolizumab decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.
- voclosporin
voclosporin decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
Minor (1)
- ozanimod
ozanimod decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Minor/Significance Unknown. No clinical data are available on the efficacy and safety of vaccinations in patients taking ozanimod. Vaccinations may be less effective if coadministered with ozanimod.
Adverse Effects
>10%
50-59 years
- Pain (88.4%)
- Fatigue (57%)
- Myalgia (56.9%)
- Headache (50.6%)
- Redness (38.7%)
- Shivering (35.8%)
- Swelling (30.5%)
- Fever (27.8%)
- Gastrointestinal [GI] symptoms (24.3%)
- Pain, Grade 3 (10.3%)
- Redness >100 mm (2.8%)
- Swelling >100 mm (1.1%)
60-69 years
- Pain (82.8%)
- Myalgia (49%)
- Fatigue (45.7%)
- Headache (39.6%)
- Redness (38.4%)
- Shivering (30.3%)
- Swelling (26.5%)
- Fever (23.9%)
- GI symptoms (16.7%)
70-79 years
- Pain (69.2%)
- Myalgia (35.1%)
- Fatigue (36.6%)
- Redness (37.7%)
- Swelling (23%)
- Headache (29%)
- Shivering (19.5%)
- Fever (14.3%)
- GI symptoms (13.5%)
Immunocompromised adults
-
≥50 years
- Pain (74-75%)
- Fatigue (37-46%)
- Myalgia (37-43%)
- Redness (21-28%)
- Headache (15-25%)
- Shivering (11-21%)
- GI symptoms (18%)
- Swelling (10-15%)
- Fever (6-15%)
-
18-49 years
- Pain (81-82%)
- Fatigue (49-51%)
- Myalgia (41-51%)
- Fever (9-28%)
- Headache (23-38%)
- Shivering (20-26%)
- Redness (20-25%)
- Swelling (14-17%)
- GI symptoms (13-14%)
- Pain, Grade 3 (11%)
1-10%
50-59 years
- Myalgia, Grade 3 (8.9%)
- Fatigue, Grade 3 (8.5%)
- Shivering, Grade 3 (6.8%)
- Headache (6%)
- Redness >100 mm (2.8%)
- GI symptoms, Grade 3 (2.1%)
- Swelling >100 mm (1.1%)
60-69 years
- Pain, Grade 3 (6.9%)
- Shivering, Grade 3 (4.5%)
- Redness, >100 mm (2.6%)
- Swelling (1%)
70-79 years
- Pain, Grade 3 (4%)
- Fatigue, Grade 3 (3.5%)
- Redness >100 mm (3.1%)
- Myalgia, Grade 3 (2.8%)
- Shivering, Grade 3 (2.2%)
- Headache, Grade 3 (1.5%)
- Swelling >100 mm (1.3%)
- GI symptoms, Grade 3 (1.2%)
Immunocompromised adults
-
≥50 years
- Pain, Grade 3 (5-7%)
- Fatigue, Grade 3 (3-4%)
- Myalgia, Grade 3 (2-4%)
- Shivering, Grade 3 (1-3%)
- Headache, Grade 3 (0.1-2%)
- Swelling, >100 mm (2%)
- Redness, >100 mm (1-2%)
- GI symptoms, Grade 3 (1%)
-
18-49 years
- Fatigue, Grade 3 (6-10%)
- Myalgia, Grade 3 (4-8%)
- Shivering, Grade 3 (1-6%)
- Headache, Grade 3 (1-5%)
- Redness, >100 mm (1-2%)
- Fever, Grade 3 (>39.5°C/103 .1°F) (1%)
- GI symptoms, Grade 3 (1%)
- Swelling, >100 mm (0.1-1%)
<1%
50-59 years
- Fever, Grade 3 (0.4%)
60-69 years
- GI symptoms, Grade 3 (0.9%)
- Pain, Grade 3 (0.5%)
- Fever, Grade 3 (0.5%)
70-79 years
- Fever, grade 3 (0.1%)
Immunocompromised adults
-
≥50 years
- Fever, Grade 3 (0.1-02%)
Postmarketing Reports
General disorders and administration site conditions: Decreased mobility of injected arm which may persist for >1 week
Immune system disorders: Hypersensitivity reactions, including angioedema, rash, and urticaria
Nervous system disorders: Guillain-Barre syndrome
Warnings
Contraindications
Hypersensitivity (eg, anaphylaxis) to any component of the vaccine
Cautions
Review immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions; appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration (see Contraindications)
In a postmarketing observational study, an increased risk of Guillain-Barre syndrome was observed during the 42 days following vaccination
Syncope can be associated with injectable vaccine administration; may be accompanied by transient neurological signs (visual disturbance, paresthesia, tonic-clonic limb movements); procedures should be in place to avoid falling injury and to restore cerebral perfusion following syncope
Drug interactions overview
- Use caution with concomitant use of vaccine administration of zoster recombinant with inactivated influenza
- Immunosuppressive therapies may reduce effectiveness of the zoster vaccine
Pregnancy
Pregnancy
There is no available human data to establish vaccine-associated risks with the vaccine in pregnant women
Lactation
Unknown whether zoster vaccine is excreted in human milk
Data are not available to assess effects of the zoster vaccine on the breastfed infant or on milk production/excretion
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Conveys active immunity by stimulating production of endogenously produced antibodies
Vaccine boosts VZV-specific immune response, which is thought to be the mechanism by which it protects against zoster disease
Administration
IM Preparation
Reconstitute lyophilized varicella zoster virus glycoprotein E (gE) antigen with the AS01B adjuvant suspension
Reconstituted vaccine should be an opalescent, colorless to pale brownish liquid
Visually inspect for particulate matter and discoloration prior to administration, whenever solution and container permit
IM administration
IM use only
Withdraw 0.5 mL from reconstituted vial
Administer IM immediately
Store in refrigerator at 2-8°C (36-46°F) for up to 6 hr if unable to administer immediately
Preferred site for IM injection is the deltoid region of the upper arm
Storage
Before reconstitution
- Vials of adjuvant suspension and antigen component
- Refrigerate at 2-8°C (36-46°F)
- Protect from light
- Do not freeze; discard if adjuvant suspension or antigen component have been frozen
Reconstituted vials
- If not administered immediately, refrigerate at 2-8°C (36-46°F) for up to 6 hr
- Discard reconstituted vaccine if not used within 6 hr
- Do not freeze; discard if the vaccine has been frozen
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Shingrix (PF) intramuscular - | 50 mcg/0.5 mL kit |  | |
| Shingrix (PF) intramuscular - | 50 mcg/0.5 mL kit |  |
Copyright © 2010 First DataBank, Inc.
Formulary
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- View the formulary and any restrictions for each plan.
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