2024 Edition 2
CLINICAL INITIATIVES, RESEARCH AND CURRENT UPDATES IN TREATMENT
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Changes to the National Immunisation Program shingles vaccine Penny Lee, Pharmacy Manager, Epic Pharmacy Lismore In November 2023, Shingrix® replaced Zostavax® on the National Immunisation Program (NIP), for the prevention of reactivation of the varicella-zoster virus (VZV) in a person who has previously been infected with VZV (i.e. chickenpox).1,2 VZV remains dormant in dorsal root ganglia nerve cells and may reactivate in some people as herpes zoster, commonly known as shingles.
Shingrix is administered as a two-dose schedule (refer to Table 1 for NIP eligibility criteria and schedule).1,2,4 Those who do not qualify for the NIP free vaccination program and and are aged over 18 years can still be vaccinated by private prescription. It has been shown that from the age of 50, the burden of shingles dramatically increases, therefore, anyone over the age of 50 is encouraged to be vaccinated.1,2
Shingles generally presents as a unilateral, painful, vesicular rash. Other symptoms include tingling, headache, malaise and itch.1-4 Although self-limiting, shingles can lead to long term complications such as post-herpetic neuralgia.1,2
Patients should be counselled on potential common side effects when administered Shingrix including pain, swelling and redness at the injection site. General post-vaccination care, such as paracetamol for pain or applying a cool, damp cloth to injection site, provides relief to most patients.1,2 Approximately 10% of people may experience generalised symptoms such as fatigue, muscle ache and headache, that may be severe enough to disrupt normal daily activities for 1-3 days; these typically go away without treatment.1,2
Unlike Zostavax, Shingrix does not contain live virus.1,2,4 Therefore Shingrix is suitable for use in people who are immunocompromised.1,2 Shingrix also contains an immunostimulant adjuvant system to help improve the body’s immune response to the vaccine over a longer period when compared to Zostavax.1,3,4
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