Announcement: Our clinic is now named Love & Joy Family Clinic, formerly Virtue Medical Clinic (Sunset Way), rest-assured that everything else remains the same. 

Shingles Vaccination: The Shingrix Vaccine

What exactly is Shingles?

Herpes Zoster, also known as “Shingles”, is caused by the reactivation of the varicella-zoster-virus (VZV), also known as “chicken-pox virus”, that remains dormant or “hides” inside our nerves after the initial “chicken-pox” infection during our childhood or teenage years. 

The virus reactivates and “attacks” our nerves, therefore it’s presentation is unique and oftentimes mis-diagnosed. Typically, a rash appears which can be painful and/ or itchy at the same time and the pain is often described like a muscle ache, or it can be dull, burning or tingling. The pain intensity varies from mild to severe excruciating pain, and it is not uncommon for shingles to be mistaken as a “heart attack” or even a “brain bleed” in the Emergency room due to the severity of the pain preceding the appearance of the rash.

The pattern of the rash follows one or two consecutive nerve distribution or “dermatome” and is therefore on one side of the body or face only i.e. “unilateral”. 

The rash appears as crops of “vesicles”, or small blisters, on a red base, and without medications, it may take up to two to four weeks before drying up and scabbing. 

Unfortunately, the rash often leaves unsightly scabs and skin pigmentation changes. 

Worse, the pain may last for weeks longer even after the disappearance of the rash. This is known is Post-herpetic neuralgia (PHN), and may result in chronic pain syndrome. 

Shingles is most feared if it occurs in the eye, also known as Herpes zoster opthalmicus. If left untreated, it may result in loss of vision. 

In Singapore, an estimated 30,000 cases of shingles occur every year, as over 90 per cent of adults above the age of 50 already harbour the dormant virus in their nerves, as chicken-pox vaccination didn’t exist in the past. 

Risk factors for Shingles attack are age due to the weakening the immune system with time, and having a compromised immune system caused by diabetes, immunosuppressive medications and cancer treatment. 

SHINGRIX is a highly-effective vaccine approved by FDA since 2017 and by HSA since 2021 in preventing Shingles, for those 50 years old and above. It is a remarkable vaccine in both efficacy and safety data, such that the previous Zostavax shingles vaccine developed in 2006 has been discontinued since 2020.  

Name of Vaccine

Our Clinic Price

Dose schedule

Shingrix

Complications of Shingles

Shingles is not a trivial disease as it can greatly impact one’s quality of life due to it’s characteristic feature of pain, which can be severe and long-lasting. Besides cosmetic scarring and an unsightly rash, other more serious complications from shingles include :

Postherpetic Neuralgia (PHN)

Often described as "excruciating" and "debilitating", pain from PHN may last for weeks or become chronic, long after the rash has healed.

Herpes Zoster Ophthalmicus (HZO) "Eye Complications"

Shingles attacking in or around the eye may lead to permanent loss of vision

Neurological Complications

Shingles may lead to neurological complications such as facial paralysis, hearing loss. Rarely, it causes inflammation of the brain (encephalitis), which can be fatal.

Secondary Skin Infections

The blistering rash causes by Shingles may become infected leading to skin and soft-tissue bacterial infection.

Whole-body spread of infection

One of the most feared complication is "disseminated zoster", which is the spread of the Shingles virus to other organ systems, which is life-threatening.

Weakened immunity

Individuals with weakened immunity from auto-immune disease, blood disorders, HIV, or certain medications or cancer treatment are at risk of "disseminated zoster" or whole-body spread of the Shingles virus.

Shingrix - Highly-effective in Preventing Shingles

Shingrix is highly-effective in preventing the development of Shingles and its complications. Here are the facts about the vaccine Shingrix:

Highly Effective

Shingrix is over 90% effective in preventing shingles, and 91% effective in preventing post-herpetic neuralgia (PHN). Zostavax, a defunct vaccine, in comparison has an efficacy of around 50%.

Long-Lasting Protection

Studies from the first group of patients receiving the vaccine have demonstrated that the protection is long-lasting, and there is currently no need for a booster shot.

Recommended for Older Adults

Shingrix is currently approved for all adults aged 50 and older. This includes those with previous episodes of shingles infections, those who previously received Zostavax, or those who cannot recall if they had been infected with chicken-pox in their lifetime.

Two-Dose Series

Shingrix is administered as in two-doses, with the second dose given ideally two months later (up to 6 months) after the first dose. 2-doses are required for full protection.

Minimizes Complications

Shingrix is highly effective in preventing the development of shingles as well complication of post-herpetic neuralgia (PHN), which is pain affecting one's quality of life.

Why You Should Get the Shingrix Vaccine

The CDC recommends Shingrix for all adults aged 50 and older, even if they have had shingles before or received the Zostavax vaccine. It is also recommended for individuals with chronic medical conditions or those who are immunocompromised, with certain precautions. Those with a severe allergic reaction to any component of the vaccine or a current shingles outbreak should not receive Shingrix.

Now that we understand the impact of shingles and the effectiveness of Shingrix, let’s examine the compelling reasons why you should consider getting vaccinated:

The most obvious reason to get the Shingrix vaccine is to prevent shingles itself. Shingles can be excruciatingly painful and cause a range of complications. By getting vaccinated, you significantly reduce your risk of experiencing this debilitating condition.

The most obvious reason to get the Shingrix vaccine is to prevent shingles itself. Shingles can be excruciatingly painful and cause a range of complications. By getting vaccinated, you significantly reduce your risk of experiencing this debilitating condition.

Shingles can disrupt your daily life, making it difficult to carry out routine activities, go to work, or enjoy your hobbies. By getting vaccinated, you can maintain your quality of life and avoid the pain and discomfort associated with shingles.

Shingles is contagious, and coming into contact with the rash can lead to chickenpox in those who haven’t had it or been vaccinated against it. Getting vaccinated not only protects you but also prevents the potential spread of the virus to others.

While the Shingrix vaccine has a cost, it is a cost-effective investment when compared to the expenses associated with treating shingles and its complications, including doctor’s visits, medications, and lost productivity.

As you age, maintaining your health becomes increasingly important. The Shingrix vaccine is a proactive step in protecting your health during your retirement years, allowing you to enjoy this phase of life to the fullest.

The most common side effects 7-day post vaccination are pain, redness, swelling at the injection site, body ache, fatigue and headache. Other side effects may include nausea, vomiting, diarrhea and/or abdominal pain, fever and chills. However, serious or long-term side effects are rare.

Compared to Zostavax, Shingrix offers superior protection and a longer duration of immunity. While Zostavax is a live attenuated vaccine, Shingrix’s recombinant adjuvanted formula provides a more robust immune response, making it the preferred choice for shingles prevention.

The real-world impact of Shingrix is evident in numerous testimonials and statistical data. Patients who have received the vaccine report a significant reduction in shingles incidence and severity. Public health data also shows a decrease in shingles cases and associated complications since the introduction of Shingrix, underscoring its effectiveness.

Despite its benefits, some individuals may hesitate to receive the Shingrix vaccine due to concerns about side effects or misinformation. Addressing vaccine hesitancy through education and reassurance from healthcare providers is crucial. Improving access to the vaccine and launching educational campaigns can help increase vaccination rates, ensuring more people are protected from shingles.

The Shingrix vaccine is a vital tool in preventing shingles and its debilitating complications. With its high efficacy and safety profile, Shingrix offers a significant advantage in protecting older adults from this painful condition. If you are 50 or older, talk to your healthcare provider about getting vaccinated with Shingrix. Taking this step can greatly enhance your quality of life and safeguard your health.

The Social and Economic Impact of Shingles

Shingles not only affects individuals but also has broader social and economic implications. Understanding these impacts can shed light on why getting the Shingrix vaccine is essential.

Social Impact of Shingles

Pain and Suffering

Shingles can be excruciatingly painful, affecting an individual's ability to perform daily tasks, work, and enjoy life. This pain can lead to stress, anxiety, and a diminished quality of life.

Isolation

Shingles is contagious to those who haven't had chickenpox or received the chickenpox vaccine. As a result, individuals with shingles often isolate themselves to avoid exposing others, which can lead to feelings of loneliness and social withdrawal.

Loss of Productivity

Shingles can lead to missed workdays and decreased productivity, which affects not only the individual but also their employer and the economy as a whole.

Economic Impact of Shingles

Healthcare Costs

Treating shingles and its complications can be expensive. Medical visits, prescription medications, hospitalization, and rehabilitation add to the overall healthcare costs.

Lost Workdays

Shingles often lead to missed workdays or decreased productivity. This can result in financial loss for both individuals and businesses.

Vaccination Costs

While there is a cost associated with the Shingrix vaccine, it is an investment in long-term health and can be more cost-effective than treating shingles and its complications.

Public Health Programs

Government and public health programs may bear the burden of shingles cases, which can strain healthcare resources.

Conclusion

Shingles is a painful and potentially debilitating condition that can impact individuals, families, and communities. The Shingrix vaccine offers a compelling solution to significantly reduce the risk of shingles and its complications. It is highly effective, provides long-lasting protection, and is recommended for most adults aged 50 and older.

By getting the Shingrix vaccine, you take a proactive step towards a healthier and more fulfilling future. Your well-being, quality of life, and contribution to your community are all reasons to consider vaccination.

Don’t wait—talk to your healthcare provider, explore your options, and take control of your health journey. The choice to get the Shingrix vaccine is a choice for a healthier and shingles-free future. Your health is your most valuable asset, so invest in it wisely.

Frequently Asked Questions

Shingrix is likely to offer long-term protection for life. As it is a new vaccine, data from the latest Oct 2022 follow-up study shows that the clinical benefit is sustained for at least 10 years. The study is on-going and more results will follow in the years to come.

It is recommended to get Shingrix as soon as you turn 50 years old so as to reduce the chance of ever developing Shingles.

Shingrix should be given as a two-dose series, regardless of whether you have had shingles or received Zostavax (zoster vaccine live) in the past.

You should get the second dose between 2 to 6 months after the first dose. If you are immunosuppressed, you would benefit from completing the series in a shorter period, the second dose can be administered 1 to 2 months after the first.

The main difference is effectiveness with Shingrix being much more effective. Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old, whereas Zostavax is only 51 to 70% effective.

Another difference is that Zostavax is a live, attenuated herpes zoster vaccine, unlike Shingrix. In other words, Zostavax contains a weakened version of the actual virus to produce an immune response. For this reason, Zostavax is not recommended for those who are immunocompromised. Otherwise, the vaccine may cause a symptomatic infection, even weeks following vaccination.

Shingrix is currently the preferred Shingles vaccine, according to the Centers for Disease Control and Prevention (CDC). Zostavax was discontinued in the United States in November 2020.

Studies confirmed that Shingrix was safe and immunogenic when administered 5 or more years after Zostavax. Intervals shorter than 5 years have not been studied. However, there are no data or theoretical concerns to indicate Shingrix would be less safe or effective when given less than 5 years after Zostavax. You may consider an interval shorter than 5 years, especially if you are >70 years old when you first received Zostavax.

The guideline is to wait a minimum of 8 weeks if you have had Zostavax before getting Shingrix.

Yes, Shingrix is an inactive vaccine so you can get the shot with other inactive or live vaccines. If you get Shingrix and another vaccine, it would be administered at different anatomical sites (e.g., different arms).

Unfortunately, as shingles vaccination is currently not on the National Adult Immunization Schedule, it is currently ineligible for government subsidies. There have been calls for our government to lead procurement of the vaccine to reduce its cost to make it more accessible so as to reduce the incidence of Shingles on our population and the healthcare burden Shingles imposes.

At Love & Joy Family Clinic, we offer our residents Shingrix at a nett price of $410 per dose* or $800 for a 2-dose package, without any additional consultation fee. Book an appointment with us for Shingrix today! 

*Second dose is required for full protection two-months after the initial dose.