Shingrix is a non-live safe vaccine that is very effective in preventing shingles, the potentially devastating painful reoccurrence of the herpes zoster or chickenpox (varicella) virus (VZV).
Keep in mind that you can’t catch shingles from anyone else but yourself. If you have ever had chickenpox (varicella) and 99% of those over 50 have, then the herpes zoster virus never leaves the body and become dormant in the nerve roots.
Should the virus wake up when the body is stressed or immunocompromised (think CLL) then the virus can become active again causing painful clustered blisters that resemble shingles and follow the distribution of the infected nerve.
Zoster outbreaks on the face can be particularly dangerous if they involve the eye.
But the worst part may come after the rash has resolved. Some 10-18% of folks may have to deal with post-herpetic neuralgia (PHN) a difficult to treat extremely painful complication of shingles that can last years.
No-one wants shingles, but it is more common as we age and our immunity wanes, and it is even more common and severe in CLL patients. It is estimated to occur in one in three older adults at some time in their lifespan.
There are two highly effective preventive measures.
There are very safe, inexpensive generic oral antivirals that you can take daily to prevent outbreaks: acyclovir, valcyclovir and famciclovir.
There is also the Shingrix vaccine. The old herpes zoster vaccine was a live vaccine so we couldn’t use it. It is no longer available in the USA. The new one is much more effective and has long been approved for all those over 50, but there was always a question about its use in the immunocompromised. As of July 26, 2021, all those 18 years old and up who have impaired immunity can and we believe generally should receive the vaccine.
It is two shots usually given 2-6 months apart.
As with all vaccines, our response is less predictable, but many have a strong rise in antibodies. Dr. Pleyer of the NIH give more details here.
Here is the GSK Press release: Shingrix approved in the US for prevention of shingles in immunocompromised adults.
We recommend that you discuss getting the Shingrix vaccine with your healthcare team if you haven’t already.
Stay strong. We are all in this together.
Brian Koffman MDCM (retired) MS Ed
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.