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Shingles is a viral condition of the skin and mucous membranes that particularly affects older people. If Zostavax was previously recommended for adults aged 65 to 74, a new, more effective vaccine will now be offered.
Shingles is an infection of the skin and mucous membranes that can affect anyone who has had chickenpox. It is caused by reactivation of the varicella-zoster virus, which can occur when the immune system is weakened due to, for example, illness, treatment (such as chemotherapy) or age.
Neuropathic pain preventable thanks to the vaccine
The biggest disadvantage of shingles is that it causes persistent neuropathic pain called “post-herpetic”, and is not harmless, especially in the elderly. Thus its incidence increases with age: there are nearly 10 cases per 1,000 people among those over 80 years old. Furthermore, shingles causes an average of 2,600 hospitalizations each year, 72% of which concern people over 65 years old.
But since 2013, a vaccination schedule has been recommended in France, which aims to prevent shingles and reduce post-herpetic pain. It consists of one dose of the Zostavax vaccine, for all adults aged 65 to 74.
A new vaccine recommended today, as safe but more effective
But another vaccine, Shingrix, obtained marketing authorization in 2018 for adults aged 50 and over, extended in 2020 to adults aged 18 and over with an increased risk of shingles. Its primary vaccination schedule includes two doses, which must be administered two months apart (up to six months if necessary).
In response to a referral from the General Directorate of Health, HAS evaluated the available data to position it in the shingles vaccination strategy.
“At the end of this evaluation, it recommends vaccination against shingles with the Shingrix vaccine for people aged 18 and over whose immune system is failing, as well as for all people aged 65 and over, preferentially with the Zostavax vaccine” ewrote the HAS this March 7 on its site.
Thus, the effectiveness of the Shingrix vaccine would be greater than that of the Zostavax vaccine. It prevents the appearance of shingles in 79.3% of people vaccinated, compared to 45.9% for Zostavax. It also reduces more pain. But, good news, it shows no difference in adverse effects.
Recommended for people with compromised immunity and those aged 65 and over
The HAS therefore recommends vaccinating people aged 18 and over with Shingrix whose immune system is failing.
For the rest, it is a usual vaccination offered to those over 65 years of age, as can be the booster against diphtheria, tetanus and poliomyelitis at (then every 10 years from the age of 65), the annual vaccination against influenza and against Covid-19.
The Shingrix vaccine can be administered at the same time as these vaccines, at a different injection site.