2nd Dose of Shingrix - How Long After Rituximab?

[Investigator1]

Hi everybody as mentioned in an earlier post I had my 1st Shingrix Vaccine yesterday, no worries my Consultant told me no closer than a month before my Rituximab, that’s due end of November so job done. When I asked about when I could have the 2nd dose after Rituximab I didn’t get a definitive answer. The nurse said yesterday “see you in two months” don’t know on this one. Any advice greatly accepted as usual.

[PMRpro]

The spacing is 2 to 6 months between the first and second jabs. I assume rituximab is 6 monthly so a month before the next rituximab is also ideal.

[Investigator1 in reply to PMRpro]

Hi PMRpro, thanks for that but this is my last Rituximab treatment for a while, I have seen some US guidance that says the second Shingrix jab should be given no earlier than 3 months after the Rituximab infusion but I don’t know if that’s a trustworthy source, if it is that would mean my Shingrix jabs would be 4 months apart if three months was the minimum after Rituximab.

[PMRpro in reply to Investigator1]

That's fine - the spacing is broad enough to accommodate that. But the longer you can leave it after the rituximab, the better the development of the immune response will be.

Even if you exceed the 6 months they suggest you don't need to start again - there is something in the rubics for the Shingrix about that. Two to 6 months is the ideal.

[Investigator1]

Yes that’s good advice, the GP Practice who administered the Shingrix won’t have considered the Rituximab situation so I will need to point them in the right direction. I can see it now “well we didn’t know about that!” That was the same response I got when they were planning the flu jabs.