Concerns Over Zostavax, Shingrix Side Effects May Be Affecting Shingles Vaccination Rates

According to an editorial published recently in a leading medical journal, the public is becoming increasingly hesitant to get either the Shingrix or Shingrix or Zostavax shingles vaccine, due to reports of reactions, the need for multiple shots in the case of Shingrix, and the fact that the inoculations are not always covered by insurance.

In a report published in the Journal of the American Medical Association (JAMA) on August 7, Rebecca Voelker notes that overall vaccination rates are lower than expected as part of an editorial primarily about increasing rates of shingles in the eyes.

Zostavax (varicella zoster vaccine; VZV) was introduced by Merck in 2006, involving a single dose of a live virus vaccine, which was designed to protect older adults against the development of shingles. However, the vaccine injection has been linked to reports of individuals developing severe and more persistent shingles outbreaks, as well as other infections and auto-immune disorders, shortly after exposure to Zostavax.

Shingrix (recombinant zoster vaccine; RZV) was the second vaccine approved for prevention of shingles among adults, which involves two doses for inoculation. Shingrix does not involve the use of a live virus, which has been linked to reports of problems among patients who received Zostavax. However, concerns about Shingrix have emerged following a large number of adverse events involving injection site reactions.

Shingles is linked to about 96 deaths per year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC). However, this latest report notes that, according to a survey conducted in 2018, only 43% of immunocompetent patients aged 60 or older had been vaccinated. Only 11% of those ages 50-59 were vaccinated, according to their doctors.

By comparison, 67% of patients got the flu vaccine and 72% had reportedly received the pneumococcal vaccine.

The article points to side effects of the shingles vaccines as a possible deterrent, particularly with Shingrix, which also requires two shots. Some may even feel ill from the first injection and miss the second dose.

In addition, some patients may find the shots are not fully covered, and can sometimes have to pay $150 to $200 per dose.

The findings came amid reports that cases of shingles causing eye complications, such as eyelid edema or skin lesions, as well as cornea damage, glaucoma and even blindness are on the rise since the 1990s. That increase has come with an increase in shingles overall, which some say may be the result of widespread vaccinations and adults not being exposed to the virus, as young adults, when their children get chickenpox, which some believe boosts the body’s resistance. There are arguments for and against the “immune boost” theory.

Use of the older Zostavax vaccine has largely been replaced in recent years with the newer Shingrix vaccine, which does not involve the same live virus that has caused severe complications in some users.

Merck now faces hundreds of Zostavax lawsuits brought by individuals nationwide who experienced severe shingles outbreaks or auto-immune disorders after receiving the older, single-dose version of the shingles vaccine, involving allegations that the live virus was “under-attenuated” and not sufficiently weakened to avoid the risk of reactivating the dormant virus in many individuals.