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Zoster (herpes zoster/shingles) is a reactivation of the varicella-zoster virus in an individual who has previously had varicella disease (chickenpox). There is an increasing incidence of zoster reactivation with age; with a lifetime risk of approximately 1 in 3.

For those aged over 85 years, the risk is 1 in 2.

Shingrix vaccine

Shingrix vaccine is effective

  • Over 90% efficacy against both zoster and post herpetic neuralgia in participants aged over 50 years.
  • Over 84% for at least 7 years, in those over 70 years, including those with comorbidities.

It is a 2 dose course with no booster

  • Second dose is given 2–6 months after the first dose. If a longer interval occurs between the two doses, there is no need to restart the course.
  • Two doses provide good protection for at least 8 years, with no evidence of waning.
  • No booster required.

 Common responses to the vaccine

  • Generally well tolerated.
  • Commonly pain at the injection site, myalgia and fatigue, headache, shivering, fever and gastrointestinal symptoms.
  • Mild to moderate and last 1–3 days.

 Shingrix can be given at different sites with all NIS vaccines

  • Any vaccine can be administered at the same time as Shingrix, provided they are given at separate sites.
  • FLUAD QUAD, Shingrix and Nuvaxovid utilise adjuvants to gain a good immune response. Consumers should be informed of the possibility of a stronger post-vaccination response, where two or more of these vaccines are administered at the same visit.

Funding and eligibility

 Only funded if first dose is at 65 years

  • At 65 years of age only (ie first dose anytime in the 12 months following the 65th birthday).
  • Second dose can be given at 66 years of age.

 Approved for use from 50 years, or 18 years at increased risk, but not funded

  • 50 years or older to prevent zoster and post herpetic neuralgia
  • 18 years for those at increased risk of zoster and post herpetic neuralgia, eg due to immunocompromise.

Order non-funded vaccine from HCL

  • Non-funded Shingrix must be ordered from HCL.


Shingrix and the patient/customer

 Patient history issues

  • previous varicella disease or vaccination doesn't matter, still vaccinate with Shingrix.
  • previous vaccination with Zostavax: can receive Shingrix after at least 12 months, a two dose course of Shingrix is still required.
  • those who have recently had shingles can wait 12 months before having Shingrix as immunity will provide protection.
  • previous hypersensitivity to Shingrix or any component of the vaccine: do not use Shingrix
  • previous ocular complications from zoster - wait 12 months after resolution.

Immunocompromised patients can have Shingrix

  • Shingrix is not a live vaccine so can be given to immunocompromised people.

Zoster antivirals - patients can have Shingrix

  • Shingrix is not a live vaccine so can be given to patients on antiviral medication.

Acutely unwell - do not give Shingrix to acutely unwell or febrile patients

As with all vaccines, it should not be given to a patient who is acutely unwell or febrile with a temperature >38˚C.

Pregnancy - get advice if patient is pregnant

  • Due to a lack of data for Shingrix in pregnancy, please contact IMAC if Shingrix is indicated for a pregnant individual.


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Last updated:
Mar 2023