What is shingles / herpes zoster?
- Shingles, also known as herpes zoster, is caused by the same virus as chickenpox. After chickenpox blisters heal, the herpes zoster virus stays, hiding in the body’s nerve cells.
- The virus may be inactive for many years, but for unknown reasons, it can become active again and cause shingles. It can happen to anyone who has had chickenpox, but the risk increases as you get older, especially if you are over 50 years of age – two thirds of shingles cases occur over the age of fifty.
- Nearly one in three Canadians develops shingles during their lifetime.
- Shingles causes a painful, blister-like rash that usually appears on one side of the body or face. Up to 4 days before the rash appears, there is often pain, itching or tingling at the site.
- The blisters scab over in 3 to 5 days and can last for 2 to 4 weeks. You might also have a fever, chills, headache and upset stomach.
- In addition to the pain from the rash, the underlying nerve pain caused by shingles has been described as burning, throbbing and/or stabbing. It can last for months or years.
- People with shingles may have other complications, including scarring, bacterial skin infections, weakness, muscle paralysis and loss of hearing and/or vision.
Who should get the shingles vaccine, Shingrix®?
- Shingrix® is recommended for the prevention of shingles in individuals 50 years of age and older. It is a 2-dose series, with the second dose given 2 to 6 months after the first dose.
- Ontario Seniors ages 65 to 70 years (i.e. from the 65th birthday to the day prior to the 71st birthday) area eligible for publicly funded Shingrix provided they have not already had publicly funded Zostavax vaccine (but if Seniors aged 65 to 70 years of age previously paid for Zostavax, they are eligible for publicly funded Shingrix).
Note: Seniors born in 1949 to 1953 (turning 71 in 2020 to 2024) who missed Zostavax are eligible for publicly funded Shingrix, with 2nd dose completed by December 31, 2024. - You should get the vaccine even if you don’t remember whether you have had chickenpox. There is no need to check with a blood test.
- Immunocompromised individuals may have Shingrix®, but they should be informed that they may not receive the full benefit from the vaccine.
Who should not get the shingles vaccine?
- Anyone who has had a serious allergic reaction to this vaccine in the past, or to any component of the vaccine: Varicella Zoster Virus gE; Plant extract: Quillaja saponaria Molina fraction 21; Bacterial extract: 3-0-desacyl-4-, monophosphoryl lipid A; Powder (gE): dipotassium phosphate, polysorbate 80, sodium dihydrogen phosphate dehydrate, sucrose; Suspension: dioleoyl phosphatidylcholine, cholesterol, disodium phosphate anhydrous, potassium dihydrogen phosphate, sodium chloride.
(Stopper is butyl rubber, not natural rubber latex.) - Anyone who has had a case of shingles in the past year.
- Anyone who has had the other shingles vaccine, Zostavax®, in the past year.
- Anyone with a high fever or moderate to severe illness should wait until they feel well.
- Anyone with a bleeding disorder should tell their health care provider since it is an intramuscular injection.
What are the common side effects of the shingles vaccine?
- You may feel sore, swollen, or itchy for a few days where the needle was given.
- You may feel unwell for a day or two with headaches, fatigue, fever, flu-like symptoms such as stomach
pain, nausea, vomiting or diarrhea. - Tylenol® or ibuprofen may be taken afterwards, as directed, to reduce discomfort or fever.
- If a rash appears, please inform Public Health at 613-966-5500.
What else do I need to know?
- Shingrix® reduces the risk of shingles by an average of 97% in people 50 to 69 years of age, with an
average of 90% reduction in people 70 years of age and over. - Even if you have been vaccinated, you can still develop shingles, but the vaccine can help to reduce the
intensity and length of time your nerve pain will last. - If you think you may have a case of shingles, see your health care provider as soon as possible since
an antiviral medication may reduce the severity of the illness. - Shingrix vaccine may be given at the same time as unadjuvanted flu vaccines, the pneumococcal
vaccine Pneu-P 23, and the combined diphtheria-tetanus-acellular pertussis vaccine, but in the other
arm. Fever and shivering are more common when Shingrix and Pneu-P 23 are given together. - You may be able to claim Shingrix® if you have a drug plan.
- There is no current recommendation for boosters.
- You cannot catch shingles from someone with chickenpox.
When should I seek medical help after immunization?
- If you have any unusual side effects after immunization, seek medical attention and notify us.
- Call 911 or go to Emergency at a hospital right away if you have any of the following after immunization:
o swelling of the face and neck
o problems breathing
o hives and itchy, reddened skin
Your Record of Protection
After you receive any immunization, make sure your health care provider updates your personal
immunization record. Keep it in a safe place. Please inform us of any immunizations not received here.
References
GSK Product monograph Nov 2022; NACI Updated Recommendations HZ Vaccines June 2018;
Canadian Immunization Guide Dec 2021
