Health Professional Newsletter: The Data on Herpes Zoster Vaccines


Shingrix vs Zostavax

  • Shingrix – available 2018
    • Inactivated vaccine
    • 2 doses separated by 2-6 months
    • improved efficacy
    • maintained efficacy in age 70+
  • Zostavax
    • live attenuated vaccine
    • single dose

Evidence supports the vaccination of both immunocompetent and some immunocompromised individuals to reduce the risk of an acute shingles infection.

The Data

Zostavax – the efficacy is often quoted as 50%; when looking at the evidence, this translates into a NNT of 59 for shingles prevention and 364 for post-herpetic neuralgia prevention. Also, it has been noted that with increasing age the Zostavax may have lower efficacy, in particular for patients over 70.

Shingrix – The advertised efficacy for this vaccine is 97%. The data from the trials illustrates a NNT of 37 for shingles prevention, and 335 for post-herpetic neuralgia prevention. Although there is a reduction in the NNT, it is not nearly as impressive as the 97% that is being advertised. However, Shingrix does appear to maintain efficacy in the older patient cohorts.

The actual duration of coverage is a question left unanswered for both vaccines, as Zostavax has a confirmed efficacy up to 4 years, and Shingrix has similarly been studied for around 4 years.

Contact us if you have further questions about the herpes zoster vaccines.

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