New shingles vaccine available in Vancouver

Clinical trials show Shingrix 97 per cent effective in most older adults

The medical director of Vancouver Coastal Health’s travel clinic says a new shingles vaccine recently approved in Canada offers more benefits than Zostavax, the drug approved more than a decade ago.

“You can give Shingrix to people who are immune compromised because it’s a killed vaccine, not a live one,” says Dr. Suni Boraston.

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That means the vaccine is safe for people living with cancer, who have taken high doses of Prednisone or who’ve had a kidney transplant.

Shingles, also known as herpes zoster, is caused by a re-activation of chicken pox. So anyone who’s had that childhood disease is in danger of contracting the virus again, but this time with a vengeance. The chicken pox virus can lay dormant for years, but typically returns in people 50 and older. More than 130,000 Canadians are diagnosed with shingles each year and the majority of them are seniors.

For the lucky ones, shingles symptoms can be as minor as a rash and slight pain, but for others the results can be devastating and debilitating. Severe complications of shingles can include blisters and extreme nerve pain even after those sores have healed, vision loss, flesh-eating disease and neurological problems. Shingles can also increase the risk of heart attack and stroke.

Boraston says the current vaccine Zostavax is about 54 per cent effective against shingles and 67 per cent against the pain, while Shingrix is 97 per cent effective for many older adults. She adds it’s also thought Shingrix will provide life-long immunity, but since the new vaccine has only been around for four years, that’s yet to be confirmed — Zostavax offers about five years of protection. Shingrix was approved in Canada in October 2017 for use in adults aged 50 years and older.

But, Boraston says, there’s no need to run out and get Shingrix if you’ve recently had the Zostavax vaccine.

“Don’t waste your money,” says Boraston, who has had the Zostavax vaccine. “Zostavax is good for five years.”

Neither of the vaccines are cheap. At the Vancouver Coastal Health travel clinic, Shingrix is $300 for the two-part vaccine — the doses are given two to six months apart for $150 a visit. Meanwhile Zostavax, which can be administered at a pharmacy within B.C., costs between $200 and $240 including tax and dispensing fees. Boraston says anyone who has recently received Zostavax, but is still eager to have the Shingrix vaccine, should wait at least eight weeks.

According to GSK Vaccines, the creators of Shingrix, the approval was based on three clinical trials evaluating the drug’s efficacy, safety and immunogenicity involving more than 37,000 participants at 31 trial sites — more than 2,100 of the trial volunteers were from across Canada. The results of the trial showed that in healthy adults between the ages of 50 and 69, Shingrix reduced the likelihood of shingles by 97 per cent, compared with 70 per cent for Zostavax. In the 70 to 79 age group, the vaccine was 91 per cent effective compared to 41 per cent for Zostavax, and in the 80 and older group, the drug was 91 per cent effective versus 18 per cent for Zostavax. Boraston says a common side effect of Shingrix is pain at the injection site.

At this time the only province that provides Zostavax at no charge to seniors aged 65 to 70 is Ontario. In response to questions from the Courier about funding the drug, the B.C. Ministry of Health said once Health Canada has approved a vaccine, there are other levels of review that must take place before a vaccine is included in B.C.’s public immunization program. Once a vaccine is available in Canada, the National Advisory Committee on Immunization reviews it and makes recommendations to the provinces and territories. When the committee has reviewed and made recommendations and supply and pricing information has been attained, B.C.'s own Communicable Disease Policy Advisory Committee, led by the Office of the Provincial Health Officer, will make its recommendations to the government for a decision to include or exclude this vaccine from the provincial immunization program.

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