Vaccine Info

Zostavax Shingles Vaccine

Authored by
Last reviewed
November 12, 2023
Fact checked by
Robert Carlson, MD

Zostavax Shingles Zoster Vaccine

Merck's Zostavax is a live, attenuated varicella-zoster virus (weakened chickenpox virus) vaccine. The U.S. CDC says the zoster vaccine can be administered concurrently with all other live and inactivated vaccines, including those routinely recommended for people 60 years of age or older, such as influenza and pneumococcal vaccines,

Zostavax works by helping immune systems protect people from getting shingles. Herpes zoster (HZ), also known as "shingles," is caused by reactivation and multiplication of the ubiquitous varicella-zoster virus (VZV) that remains latent in everyone's sensory neurons following varicella, or "chickenpox." Among individuals who live to age 85, the lifetime risk for HZ is 50%, and more than one in five individuals affected by zoster develops post-herpetic neuralgia, resulting in chronic pain. If you do get shingles even though you have been vaccinated, ZOSTAVAX may help prevent the nerve pain that can follow shingles in some people.

In 2011, the U.S. Food and Drug Administration expanded the age indication for Zostavax to include people 50 through 59 years old for preventing herpes zoster. This decision was based on aan extensive study showing that the vaccine initially reduced the risk of zoster by approximately 70%. On May 22, 2020, Merck issued a letter informing healthcare providers that it will no longer sell ZOSTAVAX in the USA, effective July 1, 2020. This decision is unrelated to product safety or manufacturing issues and only affects vaccine customers in the USA.

Merck is the producer of Zostavax. UNII: GPV39ZGD8C

Zostervax Vaccine Protection

The BMJ published a study on September 29, 2023, that concluded ZOSTAVAX™ effectiveness waned substantially after 10 years, with protection low against herpes zoster but higher against postherpetic neuralgia.

Zostavax Vaccine Indication

Healthcare providers considering the herpes zoster vaccine for certain ages should discuss the risks and benefits of vaccination with their patients.  Zostavax is indicated for adults 50 years of age or older and helps boost the immune system against herpes zoster virus and shingles, says the US CDC. When administering the zoster vaccine to people 60 yr older, there is no need to ask for a varicella history or conduct laboratory testing for serologic evidence of prior varicella-zoster virus infection. Almost all people 60 years or older born in the United States have had a previous infection with the varicella-zoster virus.

Persons who report not having varicella can still receive the zoster vaccine. Therefore, laboratory testing to determine if there is evidence of past infection with the varicella-zoster virus is unnecessary. However, the zoster vaccine should not be administered to anyone who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine, or someone who has a weakened immune system, says the CDC.

Zostavax Vaccine Dosage

Zostavax is given as a single dose by injection under the skin. Zostavax cannot be used to treat Shingles or the nerve pain that may follow Shingles once you have it.

Zostavax Vaccine News

December 7, 2022 - U.S. District Court Justice Harvey Bartle dismissed 1,189 lawsuits after the plaintiffs failed to produce evidence that their cases of shingles were caused by the vaccine and not by a reactivated shingles virus.

September 28, 2021 - The Annals of Internal Medicine published Original Research: The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy, A Randomized Controlled Phase 2 Trial. Suspected varicella infection or herpes zoster was clinically assessed using digital photographs and polymerase chain reaction on vesicular fluid. Between March 2015 and December 2018, 617 participants were randomly assigned in a 1:1 ratio to receive ZVL (n = 310) or placebo (n = 307) at 33 centers. The mean age was 62.7 years (SD, 7.5); 66.1% of participants were female, 90% were White, 8.2% were Black, and 5.9% were Hispanic. The most common TNFi indications were rheumatoid arthritis (57.6%) and psoriatic arthritis (24.1%); TNFi medications were adalimumab (32.7%), infliximab (31.3%), etanercept (21.2%), golimumab (9.1%), and certolizumab (5.7%). Concomitant therapies included methotrexate (48.0%) and oral glucocorticoids (10.5%). Through week 6, no cases of confirmed varicella infection were found; the cumulative incidence of varicella infection or shingles was 0.0% (95% CI, 0.0% to 1.2%). At six weeks, compared with baseline, the mean increases in geometric mean fold rise as measured by gpELISA and ELISpot were 1.33 percentage points (CI, 1.17 to 1.51 percentage points) and 1.39 percentage points (CI, 1.07 to 1.82 percentage points), respectively.

Zostavax Shingles Vaccine Clinical Trial

Post-Licensure Observational Study of the Long-term Effectiveness of ZOSTAVAX™. ZOSTAVAX™ (Zoster Vaccine Live) Long-term Effectiveness Study (V211-024).

Clinical Trial NCT03120364: Immunogenicity and Safety of NBP608 Compared to Zostavax in Healthy AAdultsAged 50 and Over. This is a phase 3 multicenter, randomized, double-blinded, parallel-group study to assess the Immunogenicity and safety of NBP608 compared to Zostavax, which is indicated for preventing herpes zoster.

Clinical Trials

No clinical trials found