Shingles Vaccine

Shingles vaccine is a prescription medication belonging to the vaccine class.

The shingles vaccine is approved to prevent herpes zoster (shingles) and postherpetic neuralgia (PNH) in individuals 50 years and older.

The shingles vaccine is administered through muscle injection, which allows it to be swiftly absorbed into the bloodstream. It transmits active immunity by promoting the synthesis of naturally occurring antibodies.

The common side effects of Shingles vaccine include redness at the administration site, pain, fatigue, swelling, headache, etc.

Shingles vaccine is available in the form of an intramuscular injection.

Shingles vaccine is available in over 30 nations, including the EU, the US, Canada, Japan, Australia, and India.

Shingles vaccine is a prescription medication belonging to the vaccine class that acts as an adjuvanted non-live recombinant therapeutic agent. This vaccine uses an antigen made up of parts of the varicella-zoster virus to trigger a targeted immune response. When given, it primarily activates antigen-presenting cells. These cells recognize the vaccine's antigen. Then, activate both humoral and cellular immune pathways. This leads to the production of antibodies, IgG, and the activation of memory B and T cells.

Cmax and Tmax may vary, its protective effects generally last for years, effectively reducing the risk of shingles and related complications.

Shingles Vaccine is available in the form of an intramuscular injection. It is advised for anyone over the age of 50 to prevent herpes zoster (shingles).

Shingles Vaccine can help to prevent herpes zoster. It introduces a weakened version of the varicella-zoster virus into the body, activating the system. As a result, the body creates antibodies and memory cells that constantly scan for the virus, reactivating the immune system and hence preventing shingles from developing. This physiological response significantly lowers the risk of shingles and its painful complication, neuralgia.

Shingles Vaccine is approved for use in the following clinical indications:

• It is recommended for persons aged 50 and above to prevent herpes zoster (HZ) (shingles).

• in people aged 18 and older who are or will be at higher risk of HZ due to immunosuppression brought on by known illness or treatment

Intramuscular injection is used for administration. For every person, use a different sterile needle and syringe. The deltoid region of the upper arm is the optimal location for intramuscular injection. After reconstitution, vaccination needs to be used right away. This procedure ensures that the vaccination enters the bloodstream to help the body's immune system effectively combat the varicella zoster virus, which is the primary cause of shingles.

Shingles vaccine is available in 0.5 ml dosage strength

It is administered in two doses, the second at an interval of two to six months following the first.

Shingles vaccine is available in the form of intramuscular injection.

For immunocompromised adults:

Two doses of 0.5ml each are administered intramuscularly at an interval of 1 to 2 months.

For Adults aged 50 years or older:

Two doses of 0.5ml each are administered intramuscularly at an interval of 2 to 6 months.

The Shingles vaccine should be used in the prevention of herpes zoster along with appropriate dietary restrictions. The shingles vaccine doesn't come with any specific restrictions but it's essential to consider safety factors.

The dietary restriction should be individualized as per patient requirements.

Shingles vaccine may be contraindicated in the following conditions:

• The shingles vaccine is not a treatment for herpes zoster or postherpetic neuralgia (PHN)
• It should never be given to anyone who has recently received the vaccine, experienced a severe adverse reaction, including anaphylaxis, to any vaccination component, or
• to someone who is currently experiencing an acute episode of the disease.

The treating physician must closely monitor the patient and keep pharmacovigilance as follows.

• Management of Allergic Vaccine Reactions and Prevention:

The medical professional should study the patient's immunization record before administering the vaccine to check for any potential vaccine sensitivities and any prior adverse reactions. Proper medical care and supervision must be present to control possible anaphylactic reactions following administration.

• Syncope (fainting)

The clinically relevant drug interactions of shingles vaccine are briefly summarized here:

Immunosuppressive treatments (cyclosporine, tacrolimus, cancer treatment, and corticosteroids such as prednisone) may decrease vaccine efficacy.

The use of Shingles Vaccine should be prudent in the following group of special populations:

• Pregnancy

A chance of birth defects, miscarriage, or other unfavorable consequences exists with every pregnancy. The information is inadequate to determine whether Shingles vaccination in pregnant women carries any danger. To be safe, getting chickenpox or shingles immunizations is not advised while pregnant.

• Lactating Mother

Shingles vaccine may pass across the human milk barrier, however, this is unknown. There is no data available to evaluate the vaccine's impact on breastfeeding children or milk production

• Paediatric Use

It is unknown whether the medication is safe and effective in people under 18.

• Geriatric Use

There was no difference in the vaccine's effectiveness for people 60 and older, but there was for immunocompromised persons 65 and older. Subjects 65 and older reported a frequency of solicited local and overall unpleasant reactions that were typically comparable to or lower than those of younger persons.

Pharmacodynamics

The main way the shingles vaccine works is, by boosting the system to defend against the varicella zoster virus. When given through a muscle injection the vaccine contains a recombinant antigen or weakened form of the virus . This antigen triggers a response that produces antibodies, IgG and activates memory B cells and T cells. The effectiveness of the shingles vaccine lies in its ability to generate a specific response involving antibodies and cellular defenses. The memory cells stay alert and ready to respond if the actual varicella zoster virus tries to reactivate thus preventing shingles from occurring.

Pharmacokinetics (A/D/M/E)

How the body absorbs, distributes, metabolizes, and eliminates substances (A/D/M/E) the shingles vaccine differs from medications.

• Absorption: The vaccine is given through an injection allowing it to be quickly absorbed into the bloodstream. This method ensures delivery to cells promoting an effective immune response.
• Distribution: The vaccine components spread throughout the body, focusing on antigen-presenting cells like cells. These cells play a role, in initiating the response.
• Metabolism: The shingles vaccine differs from medications as it doesn't go through metabolic processes. Its main function is to activate the system of interacting with enzymatic pathways or undergoing hepatic metabolism.
• Excretion: The shingles vaccine doesn't follow the excretion routes associated with pharmaceuticals. Instead, it works within the system, where cells identify and process vaccine components.

There are some clinical studies of the shingles vaccine mentioned below:

Seroprevalence in India above 40 years – 91% Lokeshwar MR, Agrawal A, Subbarao SD, Chakraborty MS, Ram Prasad AV, Weil J, Bock HL, Kanwal S, Shah RC, Shah N. Age-related seroprevalence of antibodies to varicella in India. Indian Pediatr. 2000 Jul;37(7):714-9. PMID: 10906803

Cohen KR, Salbu RL, Frank J, Israel I. Presentation and management of herpes zoster (shingles) in the geriatric population. P T. 2013 Apr;38(4):217-27. PMID: 23785227; PMCID: PMC3684190.