Shingles vaccine for the immunosuppressed

The Travel Doctor has been able to obtain SHINGRIX®, a vaccine that is safe for the prevention of shingles, caused by the Herpes zoster virus, in persons who are immune compromised.

There was a much cheaper, live vaccine (Zostavax) available in the past for non-immune compromised patients. This has since been discontinued by manufacturers and pulled from the market in South Africa, leaving Shingrix the only option for vaccination against shingles.

Shingrix ® is indicated for the prevention of herpes zoster (HZ) and post-herpetic neuralgia (PHN), in adults 50 years of age or older and in immunocompromised persons older than 19 years.

What is shingles / herpes zoster?

Shingles is a rash with blisters that is often painful. It usually occurs in one part of the body and can last for several weeks.

• Shingles is caused by the same virus that causes chickenpox.
• After you have had chickenpox, the virus that caused it stays in your body in nerve cells.
• Sometimes, after many years, if your immune system (the body’s natural defences) becomes weaker (due to age, an illness or a medicine you are taking), the virus can cause shingles.

 In immunosuppressed patients it may cause potentially life-threatening, overwhelming infections with multi-organ failure and death.

What is post herpetic neuralgia?

It is long lasting nerve pain – sometimes severe – in the area where the shingles blisters were. It may last for months or even years.

This vaccine reduces the chance of getting shingles significantly. It cannot be used to treat shingles or post-herpetic neuralgia if you already have it.

Please note that this vaccine is not registered in South Africa yet and is made available as a Schedule 21 medication to selected patients.

How Well Does Shingrix Work?

Two doses of Shingrix®, two months apart, provide strong protection against shingles and postherpetic neuralgia (PHN), the most common complication of shingles.

• In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles; in adults 70 years and older, Shingrix was 91% effective.
• In adults 50 years and older, Shingrix was 91% effective in preventing PHN; in adults 70 years and older, Shingrix was 89% effective.
• In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
• In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.

IMPORTANT NOTES:

• Please note that this vaccine is not registered in South Africa yet and is made available as a Schedule 21 medication to selected patients.
• You should have a letter from your doctor recommending the vaccine.
• You will have to complete a form acknowledging that you will be receiving a Schedule 21 medication.
• We will do follow-up calls with you to record any possible side-effects you may have, which we have to report to SAHPRA.
• You should ask your medical aid in advance whether they will pay for two doses (A primary series) of the vaccine. Some medical aids do, many don’t.
• We will require payment up front and provide you with a receipt for the amount you paid.
• We do not have a mechanism with which to bill your medical aid directly.

If you think that you may want to receive the vaccine, please complete the online form.

One of our nurses will contact you to discuss your need and expectations and the practicalities of receiving the vaccine.