Shingrix (Recombinant varicella zoster virus)

Shingrix is a brand-name vaccine. It’s approved by the Food and Drug Administration (FDA) to help prevent shingles in certain people. This condition can cause a painful skin rash, among other symptoms.

Shingrix is approved for use in:

• adults ages 50 years and older
• adults ages 18 years and older who have certain conditions that increase their risk of shingles

It’s important to note that Shingrix is not used to help prevent chickenpox. (Chickenpox is caused by the same virus that causes shingles.)

For more information about shingles and how this vaccine is used, see the “Shingrix: Uses” section below.

The following table provides key facts about Shingrix.

* ”Recombinant” means the vaccine is made from parts of the virus it’s used to protect against. In this case, Shingrix is made from parts of the shingles virus.

If you’re interested in receiving this vaccine, search here to find a doctor who might prescribe it.

Shingrix is a biologic drug. It only comes as a brand-name vaccine. It isn’t currently available in biosimilar form.

Shingrix is considered a biologic because it’s made from proteins found on the shingles virus.

Medications made from chemicals can have generic forms. These are exact copies of the active drug in the brand-name form.  However, biologics aren’t made from chemicals, so they can’t be copied exactly. Instead of generics, biologics have biosimilar forms.

Biosimilars are considered as safe and effective as their parent drugs. Like generics, biosimilars may cost less than brand-name drugs.

As with most vaccines, it’s possible to have side effects with Shingrix. These can include some mild side effects but also some serious ones.

To learn more about Shingrix’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this vaccine.

Note: The Food and Drug Administration (FDA) tracks side effects of vaccines it has approved. If you would like to notify the FDA about a side effect you’ve had with Shingrix, you can do so through the Vaccine Adverse Event Reporting System (VAERS).

Mild and serious side effects of Shingrix are listed in the table below. This table does not include all of Shingrix’s possible side effects.

* This is not a complete list of Shingrix’s mild side effects. To learn about other mild side effects of this vaccine, ask your doctor or pharmacist. Or you can view the vaccine’s prescribing information.
† For more information about this side effect, see “Shingrix’s side effects explained” below.

Most of the time, mild side effects of a vaccine go away within a few days. Talk with your doctor or pharmacist if any side effects don’t go away or become severe.

Serious side effects from Shingrix aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Below, you can find detailed information about some of Shingrix’s side effects. To learn more about other side effects of this vaccine, talk with your doctor. 

Injection site reactions are a common side effect of Shingrix. These are reactions that happen around the area where Shingrix is injected.

Pain, swelling, and redness or discoloration at the injection site were the most common reactions in clinical studies of Shingrix. To learn more about how often these reactions occurred in clinical studies, see the vaccine’s prescribing information.

Injection site reactions can happen after the first and second dose of the vaccine. However, these reactions should go away within a few days after receiving Shingrix.

To help reduce swelling, you can apply a cold pack to the affected area for 20 minutes at a time. You can repeat this as often as needed. However, be sure to take breaks between sessions to allow your skin to warm up again.

If you’re still having pain after the swelling goes down, you can apply a warm pack to the area for 20 minutes at a time. You can do this as often as you need to. However, allow your skin to rest for at least 10 minutes in between each application.

If you have other questions about injection site reactions with Shingrix, talk with your doctor or pharmacist.

Headache was a common side effect in clinical studies of Shingrix. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

In rare cases, Shingrix may cause a severe headache that keeps you from completing your usual daily activities.

Headaches can happen after the first and second dose of the vaccine. However, this side effect should go away within a few days after receiving Shingrix.

If you have a bothersome, persistent, or severe headache, talk with your doctor. They can suggest ways to manage this side effect. For example, doctors may recommend that you take acetaminophen (Tylenol) to relieve your headache.

Flu-like symptoms were a common side effect in clinical studies of Shingrix. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

Flu-like symptoms with vaccines are usually mild. Examples of flu-like symptoms that can happen with Shingrix include:

• chills
• diarrhea
• fatigue
• feeling unwell
• fever
• muscle pain
• nausea and vomiting

Flu-like symptoms may happen after the first and second dose of the vaccine. However, these side effects should go away within a few days after receiving Shingrix.

If you have flu-like symptoms with Shingrix, be sure to get plenty of rest and stay hydrated. However, if your symptoms are bothersome or become severe, tell your doctor right away.

Below you’ll find dosages and vaccine schedules that are commonly recommended for Shingrix. However, you should follow the dosage schedule your doctor prescribes for you. They’ll recommend one that is best for your needs.

The Shingrix vaccine is available as follows:

• Form: powder that’s reconstituted (mixed with liquid to form a suspension) and given as an intramuscular injection
• Strength: 50 micrograms (mcg) of recombinant* shingles virus in 0.5 milliliters (mL) of suspension

* ”Recombinant” means the vaccine is made from parts of the virus it’s used to protect against. In this case, Shingrix is made from parts of the shingles virus.

Recommended dosages for Shingrix are described below.

• First dose: 0.5 mL of suspension
• Second dose: 0.5 mL of suspension, given 2 to 6 months* after your first dose

After two doses of Shingrix, you won’t need a booster dose. You’ll be protected against shingles after two doses.

* If you have certain conditions that increase your risk of shingles, you may receive your second dose of Shingrix after 1 to 2 months instead. For details about who can receive Shingrix, see the “Shingrix: Uses” section below.

Below are some things to consider about Shingrix’s dosage.

• Missing a dose. If you miss your second dose of Shingrix or get behind in your vaccine schedule, get your second dose as soon as possible. Guidelines from the Centers for Disease Control and Prevention (CDC) recommend having two doses of Shingrix to be fully protected against shingles. To help avoid missing your second dose, you can sign up for reminders on the vaccine manufacturer’s website.
• Length of treatment. Doctors usually don’t prescribe Shingrix as a long-term treatment. Instead, only two doses of Shingrix are needed.

Here are some common questions about Shingrix and brief answers to them. If you’d like to know more about these topics, ask your doctor.

In general, side effects from Shingrix second doses are expected to be the same as for first doses.

In most cases, side effects of Shingrix should go away within a few days after getting the vaccine.

It’s not common, but Shingrix may cause Guillain-Barré syndrome. This is a rare but serious reaction to vaccines that leads to nerve damage. For some people, recovery from Guillain-Barré syndrome can take many months or years.

Guillain-Barré syndrome wasn’t reported in clinical studies of Shingrix. However, this side effect has been reported since the vaccine became available for use. Your risk of Guillain-Barré syndrome is highest in the first 6 weeks after you receive either dose of the vaccine.

Symptoms of Guillain-Barré syndrome can include:

• lack of coordination
• trouble chewing, swallowing, speaking, or walking
• vision problems
• trouble breathing

If you have symptoms of Guillain-Barré syndrome after receiving Shingrix, call 911 or your local emergency number right away. This condition can be life threatening if it isn’t treated.

To learn more about other possible side effects with Shingrix, see the “Shingrix: Side effects” section above.

Yes, Shingrix can be given with other vaccines, including the flu vaccine.

However, if you receive Shingrix and another vaccine on the same day, it may be best to have them injected into different sites. For example, you may want to receive each vaccine in a different arm.

To learn more about getting Shingrix along with other vaccines, talk with your doctor or pharmacist.

Yes, there is an age recommendation for receiving Shingrix. It’s approved for use in:

• adults ages 50 years and older
• adults ages 18 years and older, but only in certain situations

For more information about who can receive Shingrix, see the “Shingrix: Uses” section below.

The manufacturer of Shingrix hasn’t provided reviews from people who’ve received the vaccine.

In general, Shingrix is considered safe and effective for preventing shingles. This was shown in clinical studies of people who receive the vaccine. (See the “Shingrix: Uses” section below to learn more.)

To learn more about the safety of Shingrix in clinical studies, you can view the drug’s prescribing information. You can also see the “Shingrix: Side effects” section above to read about possible side effects of this vaccine.

If you have questions about what to expect with Shingrix, talk with your doctor or pharmacist.

Zostavax is no longer available in the United States. Like Shingrix, it was a vaccine used to prevent shingles. However, unlike Shingrix, Zostavax was given as a single dose.

If you received Zostavax in the past, you should still receive two doses of Shingrix. According to the Centers for Disease Control and Prevention (CDC), your first Shingrix dose can be given as early as 2 months after your Zostavax dose.

If you’ve already received the Zostavax vaccine, your doctor will recommend the Shingrix vaccine schedule that’s right for you.

No, Shingrix doesn’t contain neomycin.

Neomycin is an antibiotic. Some vaccines contain a small amount of neomycin to help prevent bacteria from growing in the vaccine during the manufacturing process.

Zostavax, a vaccine used in the past to prevent shingles, did contain small amounts of neomycin. In fact, people who were allergic to neomycin were advised not to receive Zostavax. However, Zostavax is no longer available in the United States.

For more information about Shingrix and Zostavax, see the question directly above.

Yes, most likely you can receive Shingrix if you have an allergy to eggs. The Shingrix vaccine is not made with eggs.

Keep in mind that some vaccines, such as certain flu vaccines, are made using eggs. And these vaccines do contain a small amount of egg proteins. In the past, people with egg allergies were advised to avoid flu vaccines that were made with eggs.

In more recent years, the CDC has changed this recommendation. According to the CDC, in most cases, it’s safe for people with egg allergies to receive flu vaccines made with eggs. However, before receiving any vaccine, talk with your doctor about any food or drug allergies you have.

If you’d like to know more about receiving Shingrix if you have an egg allergy, talk with your doctor.

Like other vaccinations, prices for Shingrix may vary. The vaccine’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage
• the facility where you receive Shingrix

Here’s a list of things to consider when looking into the cost of Shingrix.

• Need for prior authorization. Before insurance coverage for Shingrix is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Shingrix. Then the insurance company will decide whether the drug will be covered. To find out whether you need prior authorization for Shingrix, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Shingrix is available. GlaxoSmithKline Biologicals, the manufacturer of the vaccine, offers a program called GSK for You. To learn more and see whether you’re eligible for support, call 866-728-4368 or visit the manufacturer’s website.
• Availability of a generic or biosimilar form. Shingrix is a biologic drug. It doesn’t come in a biosimilar form. A biosimilar is like a generic drug, which is an exact copy of the active drug in the brand-name form. However, unlike nonbiologics, biologics can’t be copied exactly. So instead of generics, biologics have biosimilar forms. Biosimilars may cost less than brand-name drugs.

Shingrix is not a live vaccine. Live vaccines are made from a weakened form of the virus or bacteria the vaccine is meant to protect you from.

Shingrix is meant to help prevent shingles. However, it isn’t made from a live form of the shingles virus.

Instead, Shingrix is a recombinant vaccine. This means it’s made only from parts of the shingles virus. Specifically, Shingrix is made from a nonliving protein found on the shingles virus.

If you have additional questions about how Shingrix is different from live vaccines, talk with your doctor or pharmacist.

Your doctor or another healthcare professional will administer Shingrix. They’ll give you the vaccine as an intramuscular injection. It’s usually given in the upper arm.

Shingrix is given as two doses, with the second dose usually given 2 to 6 months after the first.

You won’t have to store the Shingrix vaccine at home because it’s given at a healthcare facility.

Below is a common question related to receiving Shingrix.

• When should I receive Shingrix? Shingrix is approved for use in adults ages 50 years and older as well as certain adults ages 18 years and older. For more information about who can receive Shingrix, see the “Shingrix: Uses” section below. Shingrix is given as two doses, with the second dose usually given 2 to 6 months after the first. To help avoid missing your second dose, you can sign up for reminders on the vaccine manufacturer’s website.

Vaccinations such as Shingrix are approved by the Food and Drug Administration (FDA) for certain conditions.

The FDA has approved Shingrix to help prevent shingles in certain people.

Specifically, Shingrix is approved for use in adults ages 50 years and older. It’s also approved for adults ages 18 years and older if they have certain conditions that increase their risk of shingles. This includes people who have weakened immune systems, such as those with HIV.

Shingles (sometimes called “herpes zoster”) is a viral infection. It usually causes a skin rash on one side of the body, such as on the chest, abdomen, back, or waist.

Other shingles symptoms can include:

• numbness, itching, pain, or tingling in the affected area
• fluid-filled blisters
• scabbing or scarring on the skin

If you’ve had chickenpox in the past, you could get shingles later in life. This is because chickenpox and shingles are caused by the same virus, varicella zoster. After you’ve had chickenpox, this virus can remain in your body for many years without being active. (When it’s active, it causes symptoms.) It isn’t known for sure what may cause the virus to become active again.

Keep in mind that Shingrix is not used to help prevent chickenpox. If you haven’t had chickenpox in the past, talk with your doctor before taking Shingrix. They may recommend you receive the chickenpox vaccine instead of Shingrix.

Doctors won’t recommend Shingrix for use in children. The vaccine is only approved for use in adults.

If you’re interested in receiving Shingrix, you can find a doctor who might prescribe it by searching here. You can also check out this appointment guide for ideas of what to ask your doctor about shingles.

There aren’t any known interactions between Shingrix and alcohol.

Talk with your doctor if you have questions about whether it’s safe for you to drink alcohol before or after getting the Shingrix vaccine.

Shingrix may interact with certain medications. However, it’s not known to interact with any herbs, supplements, or foods.

Different interactions can cause different effects. Some interactions can interfere with a vaccine’s effectiveness. Others can increase a vaccine’s side effects or cause them to be severe.

If any of the interactions listed below apply to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

• Shingrix and other medications. The following drugs may lessen the activity of your immune system, which could affect how your body responds to Shingrix. Before receiving Shingrix, tell your doctor if you take any drugs that affect your immune system. They’ll recommend whether you should receive Shingrix or not. Examples include:
  • prednisone (Rayos)
  • methotrexate (Trexall
  • azathioprine (Azasan, Imuran)
  • cyclosporine (Neoral, Sandimmune)
  • tacrolimus (Prograf)
• Shingrix and herbs and supplements. No herbs or supplements have been reported to interact with Shingrix. Before receiving Shingrix, tell your doctor or pharmacist about any herbs or supplements you take. They’ll recommend whether it’s safe for you to receive Shingrix.
• Shingrix and foods. Shingrix isn’t known to interact with any foods. If you have questions about eating certain foods when receiving Shingrix, talk with your doctor or pharmacist.

Shingrix is approved to help prevent shingles in certain people. To learn how Shingrix is used, see the “Shingrix: Uses” section above.

Shingrix is a vaccine that’s made from a protein found on the shingles virus. Shingrix works* by stimulating your body to make antibodies (immune proteins). These antibodies help fight off the shingles virus. This helps protect your body from a shingles infection.

To learn more about how Shingrix works, visit the drug manufacturer’s website. You can also talk with your doctor or pharmacist.

* The way a drug works in your body is called its “mechanism of action.”

Shingrix starts helping your body make antibodies after your first dose. However, it may take several weeks for your body to make enough antibodies to fully protect you against the shingles virus. Guidelines from the Centers for Disease Control and Prevention (CDC) recommend people receive two doses of Shingrix to be fully protected against shingles.

Doctors aren’t sure whether it’s safe to receive Shingrix during pregnancy. The vaccine hasn’t been studied in human pregnancies.

Animal studies haven’t shown any harm to offspring born to pregnant females who were given the vaccine. However, animal studies don’t always predict what could happen with humans.

The Centers for Disease Control and Prevention (CDC) recommend that you don’t receive Shingrix while you’re pregnant. Your doctor may suggest you wait to get the vaccine until after you’ve given birth.

If you’d like to know about birth control to help prevent pregnancy around the time of vaccination, talk with your doctor.

Doctors aren’t sure whether Shingrix can pass into breast milk during breastfeeding.

The Centers for Disease Control and Prevention (CDC) recommend that you don’t receive Shingrix while you’re breastfeeding. Your doctor may suggest you wait to get the vaccine until after you’ve finished breastfeeding.

Tell your doctor about your health history before starting treatment with Shingrix. Your doctor may not recommend this vaccine if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Allergic reaction. Your doctor likely will not recommend Shingrix if you’ve had an allergic reaction to it or other vaccines. To find out about other vaccine options, talk with your doctor.
• Pregnancy. Doctors aren’t sure whether it’s safe to receive Shingrix during pregnancy. If you’d like to learn more about receiving Shingrix while pregnant, view the “Shingrix and pregnancy” section above.
• Breastfeeding. Doctors aren’t sure whether Shingrix can pass into breast milk during breastfeeding. If you’d like to learn more about receiving Shingrix while breastfeeding, view the “Shingrix and breastfeeding” section above.

To learn more about the effects of Shingrix that could be harmful, see the “Shingrix: Side effects” section above.

If you have additional questions about receiving Shingrix, talk with your doctor. They can help advise on whether this vaccine is an option for you.

Here’s a list of questions you may want to ask your doctor:

• Can I receive Shingrix in combination with the COVID-19 vaccine?
• Do I have any health conditions that could increase my risk of shingles?
• Do I take any medications that could make Shingrix less effective?

Your doctor may also tell you about other options for vaccinations. You may find this article helpful in learning about the shingles vaccines.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.