Preventing Shingles: Raising Awareness and Promoting Vaccination

Antiviral treatment should be started as soon as possible and is most effective when started within 72 hours of rash onset (Table).4 Shingles Prevention During COVID-19 According to the Centers for Disease Control and Prevention (CDC), HZ vaccination is an essential preventive care service for older adults that should not be delayed or discontinued during the COVID-19 pandemic unless a patient is suspected or confirmed to have COVID-19.5 Only 1 Food and Drug Administration (FDA)-approved vaccine for the prevention of HZ is available: recombinant zoster vaccine (RZV, Shingrix). According to the Advisory Committee on Immunization Practices (ACIP), RZV is recommended for the prevention ofHZ and related complications for adults 50 years and older and is preferred over zoster vaccine live (ZVL, Zostavax), which was approved in 2006 and removed from the market in November 2020 because of the superior efficacy of RZV6,7 RZV is recommended for the prevention of HZ and related complications for immunocompetent adults who previously received ZVL.6 The vaccination consists of 2 doses (0.5 mL each) administered intramuscularly 2 to 6 months apart.6,7 Two doses of RZV are more than 90% effective at preventing HZ and PHN. [...]as was seen in clinical trials, local and systemic reactions can occur including pain, swelling, and redness at the injection site as well as fever, chills, and body aches.7 Counseling patients about potential side effects is especially important during the COVID-19 pandemic because some side effects of shingles vaccination may be similar to symptoms of COVID-19.5 These reactions are self-limited and resolve in a few days.8 Because the shingles vaccine stimulates the immune system, patients can expect such reactions to occur. [...]adults with incomes below the federal poverty level ($12,760 for an individual) were only half as likely to get immunized as adults with annual incomes of more than $25,000.9 These findings are consistent with disparities seen with other adult vaccines.10 The cost of RZV can have a negative impact on vaccination rates, especially among patients of low socioeconomic status, many of whom do not have health insurance.