Shingles vaccines in US

This is from New England Journal of Medicine's Journal Watch.

https://blogs.jwatch.org/hiv-id-obs...he-shingles-vaccine-answered-here/2019/10/14/

October 14th, 2019
Common Questions About the Shingles Vaccine — Answered Here!

Here’s an interesting email from my friend and ID-colleague Dr. Carlos Del Rio (shared with his permission):

Went Tuesday to see my PCP for a routine visit and had my second dose of Shingrix that day. I had gotten my first dose about 3 months ago and had severe chills and even a fever of 38.5 after the first dose. With the second dose the response was not as severe but did have chills and rigors for about 18 hrs. Stupid of me, but the next day I went to get my labs checked, and everything was fine except my HS-CRP which was 14.72 (nl < 10 and in the past I had been < 1.0).

Anyway…..Shingrix is a good vaccine but it is a tough one to take and really gives you a nice TNF storm!

The rest is at the link.

 

Is there any suggestion whether the shingles vaccine is recommended for PWMECFS? My MECFS physician was not recommending this vaccine to their patients, but I do not know of any evidence that suggests that the new vaccine (or even the old one) is harmful to PWMECFS. Any thoughts about this?

 

I've been advised that it's fairly unlikely I'd get shingles a second time, so it's one vaccine choice I don't have to make (unless the advice has changed by the time I get to 70).

Mine only got diagnosed because I happened to have an appointment at the surgery to have stitches removed. There was a little rash going in a line across my back, which I realised was a bit tender when the nurse got the GP to examine it, but I had no other symptoms. I don't think I'd have known I'd had it otherwise.

The only difficult bit was when someone else developed it a few weeks later, and we had to try and convince two particular colleagues that shingles itself isn't transmissible. We'd both checked that people in our respective offices had definitely had chickenpox before continuing going in to work with it...we never quite convinced them that we weren't spreading a shingles epidemic, though!

 

In Canada SHINGRIX is a two-dose vaccine.

 

Shingrix is expensive (new, more effective than Zostavax) and because of its effectiveness (maybe because of the adjuvant?-- which is the chemical that prods your immune system into action) side effects of the vaccine can be strong: sore arm, muscle aches, fever, etc. This means the immune system is activated (a good thing).

Probably the UK will get on board with Shingrix when the price drops (generic comes out).