Herpes Zoster vaccination OK for me?

[AliDeJ]

Hello. I'm about to start Tocilizumab injections for GCA. I've been on high doses of steroids since February (60mg). Now down to 17.5 mg. I've been recommended by the health board to have the Herpes Zoster vaccination prior to starting the biologic jabs. I recall that Zostavax , because it is a live vaccine, is not recommended, but Shingrix is OK. Is Zostavax the same as the Herpes Zoster? I would be grateful for advice. Thank you.

[PMRpro Ambassador]

It is against herpes zoster yes. However - I'm surprised you are being offered a shingles vaccine since they have been adamant it is only for over 70s whatever the medical history,

[AliDeJ in reply to PMRpro]

Thank you!

[Sharitone in reply to PMRpro]

I have seen a notice recently saying that the age for pneumococcal and shingles vaccines is coming down to 65 this Autumn, and lower still (50?) for the immunosuppressed.

You will be given all sort of advice about avoiding infection whilst on TCZ, and I can only recommend that you take this very seriously. But wort it considering that you will get down to a lower dose of pred!

[Bluey-1 in reply to Sharitone]

Where did you see the notice? I have had the vaccination for pneumonia but was told shingles was for 70+

[Sharitone in reply to Bluey-1]

There was a notice on the wall when I had my latest covid vaccine last week. It is hard to find online, but here it is at

england.nhs.uk/wp-content/u...

31.From 1 September 2023 changes to the Shingles Programme to implement the JCVI recommendations will be as follows:

• replacement of Zostavax with the 2-dose Shingrix vaccine as Zostavax goes out of production.

• 2-dose Shingrix vaccine for the current 70-79-year-old cohort with a period of 26 weeks to 52 weeks between doses following the depletion of Zostavax.

• expansion of the immunocompromised cohort to offer 2-dose Shingrix to

individuals aged 50 years and over with a period between doses of 8 weeks to 26 weeks.

• expansion of the immunocompetent cohort to offer 2-dose Shingrix routinely to individuals aged 60 years and over with a period between

doses of 26 weeks to 52 weeks, remaining an opportunistic offer up to and including 79 years of age.

32.The expansion of the immunocompetent cohort will be implemented over two five year stages as follows:

• first five-year stage (1 September 2023 to 31 August 2028): Shingrix will be offered to those turning 70 and those turning 65 years of age in each of the five years as they become eligible.

• second five-year stage (1 September 2028 to 31 August 2033): Shingrix will be offered to those turning 65 and those turning 60 years of age in each of the five years as they become eligible.

[AliDeJ in reply to Sharitone]

Thank you for your helpful reply.

[Bluey-1 in reply to Sharitone]

Really helpful. Thank you so much. I’ll follow up in August. Two people I know younger than 70 have had shingles in the eye / face / head. One is still in excruciating pain several months later.

[PMRpro Ambassador in reply to Sharitone]

Thank you - very useful! I assumed it would be only a matter of time since the USA removed Zostavax from sale some time ago and they would have needed that market to make production worth it.

[PMRpro Ambassador in reply to Sharitone]

No-one has told me to avoid living - and in the year I have been on TCZ I haven't had any more infections than in the previous 13 years on pred. I was checked for Hep B and TB before starting it,

[Sharitone in reply to PMRpro]

No, I don't think I was told to avoid living, just infection. And maybe if people only have it for 1 year their chances are good. I did not have any problems for the first year. Since then, I have had two bouts of neutropenia. The first one allowed covid to sneak in. This wasn't a problem because of the antivirals. However, two months ago it happened again and I have been struggling with pneumonia ever since - no fun at all! And of course I can't have TCZ at the moment, so goodness knows what my arteries are up to. So I thought I would just mention to Ali that it is as well to follow the advice. But on the whole it is a great drug and I'm really glad for her that she is getting it.

[AliDeJ in reply to Sharitone]

Sorry to hear you are struggling with pneumonia. I do wish you well, and thank you for the advice. Would you fly while on TCZB?

[Sharitone in reply to AliDeJ]

I can't go anywhere at the moment, but if I got miraculously better 🤣, then, yes, I would fly. Maybe not long haul, but some people have managed it. It is much easier now they have said the syringes do not have to go back in a refrigerator within a few hours.

Shame about the camp, but probably worth the sacrifice, and maybe next year?

[AliDeJ in reply to PMRpro]

I was told I must not help at a camp for teens this summer. Shame, because I go as Nanny for my son's children while he and my daughter in law are busy leading the camp. Too risky, too wide a mix of unfamiliar germs, shared toilet facilities, muggy marquees in wet weather. Great to hear you have been fairly well on Tczb so far.

[Myfoe]

Every friend that suffered through shingles was under the age of 70 when they had their first outbreak all we’re in their 60s… To date I have been advised to not get vaccinated I also have peripheral neuropathy PMR I have not worried about it until the last few years my wife and I are about to retire 🥰.. the idea of wasting months to shingles is disturbing

[PMRpro Ambassador in reply to Myfoe]

"To date I have been advised to not get vaccinated"

Why? Because the Zostavax is a live vaccine? It is no longer used in the USA - but the Shingrix vaccine is which is not live and OK for us.

[perceptual63]

I'm in the US and was 57 when I got the Shingrix series vaccines.

If I remember correctly, my mother got shingles when she was 63 on one side of her torso and from what I recall she said it was extremely painful.