Live Shingles (Zoster) Vaccine (ZVL)

Brand Name(s): Zostavax®

Why get vaccinated?

Live zoster (shingles) vaccine can prevent shingles.

Shingles (also called herpes zoster, or just zoster) is a painful skin rash, usually with blisters. In addition to the rash, shingles can cause fever, headache, chills, or upset stomach. More rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

The most common complication of shingles is long-term nerve pain called postherpetic neuralgia (PHN). PHN occurs in the areas where the shingles rash was, even after the rash clears up. It can last for months or years after the rash goes away. The pain from PHN can be severe and debilitating.

About 10 to 18% of people who get shingles will experience PHN. The risk of PHN increases with age. An older adult with shingles is more likely to develop PHN and have longer lasting and more severe pain than a younger person with shingles.

Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body and can cause shingles later in life. Shingles cannot be passed from one person to another, but the virus that causes shingles can spread and cause chickenpox in someone who had never had chickenpox or received chickenpox vaccine.

Shingles vaccine (live):

Live shingles vaccine can provide protection against shingles and PHN.

Another type of shingles vaccine, recombinant shingles vaccine, is the preferred vaccine for the prevention of shingles. However, live shingles vaccine may be used in some circumstances (for example if a person is allergic to recombinant shingles vaccine or prefers live shingles vaccine, or if recombinant shingles vaccine is not available).

Adults 60 years and older who get live shingles vaccine should receive 1 dose, administered by injection.

Shingles vaccine may be given at the same time as other vaccines.

Talk with your health care provider

Tell your vaccine provider if the person getting the vaccine:

• Has had an allergic reaction after a previous dose of live shingles vaccine or varicella vaccine, or has any severe, life-threatening allergies.

• Has a weakened immune system.

• Is pregnant or thinks she might be pregnant.

• Is currently experiencing an episode of shingles.

In some cases, your health care provider may decide to postpone shingles vaccination to a future visit.

People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting live shingles vaccine.

Your health care provider can give you more information.

Risks of a vaccine reaction

• Redness, soreness, swelling, or itching at the site of the injection and headache can happen after live shingles vaccine.

Rarely, live shingles vaccine can cause rash or shingles.

People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.

As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

What if there is a serious problem?

An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness), call 9-1-1 and get the person to the nearest hospital.

For other signs that concern you, call your health care provider.

Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website at http://www.vaers.hhs.gov or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff do not give medical advice.

How can I learn more?

• Ask your healthcare provider.

• Call your local or state health department.

• Contact the Centers for Disease Control and Prevention (CDC):

• Call 1-800-232-4636 (1-800-CDC-INFO) or visit the CDC's website at http://www.cdc.gov/vaccines

Shingles (Zoster) Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention. 10/30/2019.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

Selected Revisions March 15, 2020, American Society of Health-System Pharmacists® 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814 USA. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.