Shingrix vs Zostavax
- Shingrix – available 2018
- Inactivated vaccine
- 2 doses separated by 2-6 months
- improved efficacy
- maintained efficacy in age 70+
- 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.
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.
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