Latest news with #Shingrix
Edmonton Journal
2 days ago
- Health
- Edmonton Journal
Experts call on Alberta to make shingles vaccine more easily accessible for seniors
Article content As Alberta's senior population continues to grow, experts are asking the province to lower the barrier to receive shingles vaccinations. 'It's a kick-you-while-you're-down disease,' said Anjli Acharya, a pharmacist who specializes in vaccines and immunizations. Shingles is a viral infection that can cause painful rashes with blisters on an area of the body. It is caused by the same virus as the chicken pox, which can lie dormant inside anybody who contracted it in the past. Article content The dormant virus can reactivate when someone's immune system becomes compromised due to age, stress, or illness. 'The shingles virus can reactivate because it is sitting on the nerve ending of any of us that have had chicken pox in the past,' Acharya said. One in four people will likely contract the virus once they reach 50. By the age of 80, the risk increases to a one-in-two chance. This inflammatory infection can also exacerbate conditions including diabetes, kidney disease, cardiovascular disease, and heart disease. Shingles vaccinations like Shingrix help prevent complications that stem from contracting the virus. This includes post-hepatic neuralgia, a nerve condition that can occur following a shingles infection. In Alberta, the vaccine is not covered for seniors. Two doses of Shingrix in Alberta would cost $360 for the full series of treatment separated over six months. Article content Acharya has never heard why the provincial government will not cover the vaccine, which is often a challenge for the subset of individuals who cannot afford it. 'From a socioeconomic perspective, a vaccine at this cost will often put individuals that have other determinants of health at higher risk,' she said. 'From a clinical perspective, I would really prefer that everyone have shingles vaccine coverage because those patients, who are more vulnerable, higher risk, have chronic disease, or are living on a fixed income are less likely to afford the shingles vaccine.' President of CanAge, Laura Tamblyn Watts, said with increased costs of living and many seniors on fixed living, the cost of Shingrix is more than what people can afford. 'We know the single biggest deterrent for getting a vaccine like Shingrix is simply the cost,' Watts said. Article content If the shingles vaccine becomes easily available in the province, Watts said this can prevent seniors from making trips to the hospital due to the virus. Currently, it is estimated around 60 per cent of Alberta's senior population has not been inoculated. 'Across the country, we're having more older people, so even if that percentage stayed the same, the real number of people we have to treat with shingles is going to rise,' Watts said. From working with seniors, community groups, and health-care organizations, Watts said the people need to convey their need for the vaccine to elected officials. 'It is important that you write to your local representative, and it's important that you tell the premier, that this is a priority,' she said. The shingles vaccine is funded in Alberta for adults who are pre- or post-solid organ transplant or post-stem cell transplant, since they are at higher risk for complications. Article content 'Alberta Primary and Preventative Health Services considers several factors when determining vaccine funding, including a disease's epidemiology, vaccine effectiveness for specific age groups, cost, and the resources needed for an immunization program,' Maddison McKee of the office of the Minister of Primary and Preventative Health Services. While the vaccine is safe and effective, shingles itself is not highly contagious like measles or influenza, as it does not spread from person to person. 'Most provinces do not cover it at present; a few cover it for specific age groups or others. Instead, many jurisdictions focus on funding the vaccine for high-risk populations,' McKee said. More information on the shingles vaccine can be found online by visiting Latest National Stories
Calgary Herald
2 days ago
- Health
- Calgary Herald
Experts call on Alberta to make shingles vaccine more easily accessible for seniors
As Alberta's senior population continues to grow, experts are asking the province to lower the barrier to receive shingles vaccinations. Article content 'It's a kick-you-while-you're-down disease,' said Anjli Acharya, a pharmacist who specializes in vaccines and immunizations. Article content Article content Shingles is a viral infection that can cause painful rashes with blisters on an area of the body. It is caused by the same virus as the chicken pox, which can lie dormant inside anybody who contracted it in the past. Article content Article content The dormant virus can reactivate when someone's immune system becomes compromised due to age, stress, or illness. Article content Article content 'The shingles virus can reactivate because it is sitting on the nerve ending of any of us that have had chicken pox in the past,' Acharya said. Article content One in four people will likely contract the virus once they reach 50. By the age of 80, the risk increases to a one-in-two chance. Article content Shingles vaccinations like Shingrix help prevent complications that stem from contracting the virus. This includes post-hepatic neuralgia, a nerve condition that can occur following a shingles infection. Article content Two doses of Shingrix in Alberta would cost $360 for the full series of treatment separated over six months. Article content Article content Article content Acharya has never heard why the provincial government will not cover the vaccine, which is often a challenge for the subset of individuals who cannot afford it. Article content 'From a socioeconomic perspective, a vaccine at this cost will often put individuals that have other determinants of health at higher risk,' she said. 'From a clinical perspective, I would really prefer that everyone have shingles vaccine coverage because those patients, who are more vulnerable, higher risk, have chronic disease, or are living on a fixed income are less likely to afford the shingles vaccine.'
Sydney Morning Herald
7 days ago
- Health
- Sydney Morning Herald
Shingles vaccine may increase mild shingles risk for a few weeks, new data shows
The company said many of the cases might be rashes that were misdiagnosed by GPs as shingles; rashes are a noted side effect of the vaccine. But the researchers – which includes the head of signal reporting at Victoria's Vaccine Safety Service – are confident about their data. Australia's drug regulator, the Therapeutic Drugs Administration, confirmed it too had 'found evidence of a possible temporal association' between the vaccine and shingles and was investigating. The new data shows a 16-times increased risk of developing shingles in the three weeks following the first dose of Shingrix, compared to the period before vaccination. Loading The risk only effects people aged over 65. After three weeks, the vaccine's protection kicks in and the risk of developing shingles drops dramatically. The researchers do not yet have absolute risk figures. But other studies suggest that for every 1000 unvaccinated people aged between 60 and 69, there will be about 150 new cases a year. Shingrix cuts cases of shingles by 97.4 per cent in that age group, according to a large clinical trial. 'It does not change the overall benefit this vaccine has been proven to have. It's more about letting people know it is possible,' said Professor Jim Buttery, head of epidemiology and signal detection at the Victorian government's Immunisation Safety Service. 'There is a very short-term increased risk, followed by a much longer period of increased protection.' The data is not yet conclusive and has not shown up in vaccine surveillance programs in other countries rolling out Shingrix. 'I find that data very strange, and biologically difficult to understand,' said Professor Tony Cunningham, director of the Centre for Virus Research at The Westmead Institute for Medical Research. 'It does not quite fit with the trials or the effectiveness studies.' Cunningham led the global clinical trials that showed Shingrix was safe and effective; they did not find any evidence of shingles reactivation following vaccination. The Victorian researchers used two datasets for their study, a database of GP visits from Outcome Health and a second dataset drawn from hospital presentations and lab-confirmed cases of shingles. The increased risk showed up strongly in the GP dataset, but only slightly in the hospital dataset. The researchers believe this means nearly all the vaccine-related cases are mild, as the patients are going to GPs rather than to hospital. They did not see any increased risk for postherpetic neuralgia, a nasty chronic pain that often is a complication of severe shingles. 'We still believe the true effect possibly lies between the two datasets, but we believe the primary care dataset is the most important to explore this,' said Shetty. The mildness of the cases may also explain why other countries have not recorded similar increases in shingles. Because people are not turning up to hospital, they might have been missed by data-collectors. Most countries don't monitor GP visits – Australia's database is brand new. That's a strength of the study, but it could also be a flaw. Cunningham said many doctors misdiagnosed a rash or other symptoms as shingles. Following the vaccine's 2018 rollout in Germany, some patients reported shingles-like rashes following the jab. But a later investigation revealed half those cases were misdiagnosed. However, Buttery pointed to a 2007 study showing GPs had a 90 per cent accuracy rate diagnosing shingles. The signal in his data is so strong it would still stand even if many cases were misdiagnosed, he said. It remains unclear what might be causing the increased risk of shingles following the vaccine. 'The answer is, we essentially don't know. The immunologists we've worked with have theories, but no one knows,' said Buttery. GSK, the manufacturer of Shingrix, said there was 'currently no established biological mechanism through which Shingrix, a non-live vaccine, would cause shingles'. The team's hypothesis focuses on age and the design of the vaccine. Shingles is caused by a reactivation of the Varicella-Zoster virus. We first encounter VZV as children, when the virus causes chickenpox. The nasty red rash fades, but the virus hangs around – slinking off into our nerve cells, where it is out of the reaches of our immune system. Loading As we age, our immune systems naturally lose their punch – a phenomenon known as immunosenescence. Eventually, our immune system might weaken so much VZV is able to reactivate, causing shingles. Why would the vaccine cause reactivation? One possibility: the vaccine's adjuvant may weaken cellular immunity for a small time period. In people who already have weakened immunity, that short period could allow the virus, in rare cases, to reactivate. In a time when vaccine misinformation is rampant, the researchers said the close tracking and disclosure of possible side effects was evidence of the safeguards built into Australia's vaccine system. 'Work like ours is very important to maintain vaccine confidence and vaccine trust, and help patients make informed decisions,' said Shetty.
The Age
7 days ago
- Health
- The Age
Shingles vaccine may increase mild shingles risk for a few weeks, new data shows
The company said many of the cases might be rashes that were misdiagnosed by GPs as shingles; rashes are a noted side effect of the vaccine. But the researchers – which includes the head of signal reporting at Victoria's Vaccine Safety Service – are confident about their data. Australia's drug regulator, the Therapeutic Drugs Administration, confirmed it too had 'found evidence of a possible temporal association' between the vaccine and shingles and was investigating. The new data shows a 16-times increased risk of developing shingles in the three weeks following the first dose of Shingrix, compared to the period before vaccination. Loading The risk only effects people aged over 65. After three weeks, the vaccine's protection kicks in and the risk of developing shingles drops dramatically. The researchers do not yet have absolute risk figures. But other studies suggest that for every 1000 unvaccinated people aged between 60 and 69, there will be about 150 new cases a year. Shingrix cuts cases of shingles by 97.4 per cent in that age group, according to a large clinical trial. 'It does not change the overall benefit this vaccine has been proven to have. It's more about letting people know it is possible,' said Professor Jim Buttery, head of epidemiology and signal detection at the Victorian government's Immunisation Safety Service. 'There is a very short-term increased risk, followed by a much longer period of increased protection.' The data is not yet conclusive and has not shown up in vaccine surveillance programs in other countries rolling out Shingrix. 'I find that data very strange, and biologically difficult to understand,' said Professor Tony Cunningham, director of the Centre for Virus Research at The Westmead Institute for Medical Research. 'It does not quite fit with the trials or the effectiveness studies.' Cunningham led the global clinical trials that showed Shingrix was safe and effective; they did not find any evidence of shingles reactivation following vaccination. The Victorian researchers used two datasets for their study, a database of GP visits from Outcome Health and a second dataset drawn from hospital presentations and lab-confirmed cases of shingles. The increased risk showed up strongly in the GP dataset, but only slightly in the hospital dataset. The researchers believe this means nearly all the vaccine-related cases are mild, as the patients are going to GPs rather than to hospital. They did not see any increased risk for postherpetic neuralgia, a nasty chronic pain that often is a complication of severe shingles. 'We still believe the true effect possibly lies between the two datasets, but we believe the primary care dataset is the most important to explore this,' said Shetty. The mildness of the cases may also explain why other countries have not recorded similar increases in shingles. Because people are not turning up to hospital, they might have been missed by data-collectors. Most countries don't monitor GP visits – Australia's database is brand new. That's a strength of the study, but it could also be a flaw. Cunningham said many doctors misdiagnosed a rash or other symptoms as shingles. Following the vaccine's 2018 rollout in Germany, some patients reported shingles-like rashes following the jab. But a later investigation revealed half those cases were misdiagnosed. However, Buttery pointed to a 2007 study showing GPs had a 90 per cent accuracy rate diagnosing shingles. The signal in his data is so strong it would still stand even if many cases were misdiagnosed, he said. It remains unclear what might be causing the increased risk of shingles following the vaccine. 'The answer is, we essentially don't know. The immunologists we've worked with have theories, but no one knows,' said Buttery. GSK, the manufacturer of Shingrix, said there was 'currently no established biological mechanism through which Shingrix, a non-live vaccine, would cause shingles'. The team's hypothesis focuses on age and the design of the vaccine. Shingles is caused by a reactivation of the Varicella-Zoster virus. We first encounter VZV as children, when the virus causes chickenpox. The nasty red rash fades, but the virus hangs around – slinking off into our nerve cells, where it is out of the reaches of our immune system. Loading As we age, our immune systems naturally lose their punch – a phenomenon known as immunosenescence. Eventually, our immune system might weaken so much VZV is able to reactivate, causing shingles. Why would the vaccine cause reactivation? One possibility: the vaccine's adjuvant may weaken cellular immunity for a small time period. In people who already have weakened immunity, that short period could allow the virus, in rare cases, to reactivate. In a time when vaccine misinformation is rampant, the researchers said the close tracking and disclosure of possible side effects was evidence of the safeguards built into Australia's vaccine system. 'Work like ours is very important to maintain vaccine confidence and vaccine trust, and help patients make informed decisions,' said Shetty.
Daily Maverick
30-05-2025
- Health
- Daily Maverick
Understanding shingles: Risks, vaccination gaps, and the quest for better health solutions
The only shingles vaccine on the market in South Africa was discontinued in 2024. A newer and better vaccine is being used in some other countries, but has not yet been registered in South Africa, though it can be obtained by those with money who are willing to jump through some hoops. Shingles is a common and painful condition that mostly affects the elderly and people with weakened immune systems. It generally appears with a telltale red rash and cluster of red blisters on one side of the body, often in a band-like pattern. 'Shingles is pretty awful to get – it's extremely painful, and some people can get strokes, vision loss, deafness and other horrible manifestations as complications,' said infectious disease specialist, Professor Jeremy Nel. 'Shingles really is something to avoid, if at all possible.' One way to prevent the viral infection is to get vaccinated. But while two vaccines against shingles have been developed and broadly used in the developed world, neither is available in South Africa. Two vaccines Zostavax, from the pharmaceutical company MSD, was the first vaccine introduced to prevent shingles. It was approved for use in the US in 2006 and in South Africa in 2011. It is 51% effective against shingles in adults over 60. A more effective vaccine, Shingrix, which is more than 90% effective in preventing shingles, was introduced by GlaxoSmithKline (GSK) in the US in 2016. It is not yet authorised for use in South Africa, but GSK has submitted paperwork for approval with the South African Health Products Regulatory Authority (Sahpra), said company spokesperson Kamil Saytkulov. The superior protection offered by Shingrix compared with Zostavax quickly made it the dominant shingles vaccine on the market. As a result, MSD discontinued the production and marketing of Zostavax. MSD spokesperson Cheryl Reddy said Zostavax was discontinued globally in March 2024. Before then, the vaccine was sold in South Africa's private healthcare system for about R2,300, but it was never widely available in government clinics or hospitals. No registered and available vaccine Since Zostavax has been discontinued and Shingrix remains unregistered, the only way to access a vaccine against shingles in South Africa is by going through the onerous process of applying to Sahpra for a Section 21 authorisation – a legal mechanism that allows the importation of unregistered medicines when there is an unmet medical need. 'Access will only be available to those who are able to get Section 21 approval' and 'this is a costly and time-consuming process, requiring motivation by a doctor,' said Dr Leon Geffen, director of the Samson Institute for Ageing Research. The cost of the two-dose Shingrix vaccine imported through Section 21 authorisations is currently about R15,600, said Dr Albie de Frey, CEO of the Travel Doctor Corporate. People who seek Section 21 authorisation typically have to pay for this out of their own pockets. 'Shingrix is not covered [by Discovery Health] as it is unregistered in South Africa and is therefore considered to be a General Scheme Exclusion,' Dr Noluthando Nematswerani, chief clinical officer at Discovery Health, told Spotlight. The Department of Health did not respond to queries about whether Section 21 processes are being pursued for priority patients in the public sector or whether there has been any engagement with GSK on the price of this product. People who receive organ transplants, for example, should be prioritised to receive the shingles vaccine since the medications they are given to suppress their immune system puts them at high risk of developing shingles. Why is the price of Shingrix so high? Unlike South Africa, where companies must sell pharmaceutical products at a single, transparent price in the private sector, the US has no such requirement. Even so, the US Centers for Disease Control and Prevention (CDC) pays $250 (R4,600) for the two-dose Shingrix vaccine through CDC contracts. This is less than a third of the charge when Shingrix is imported to South Africa. Equity Pharmaceuticals, based in Centurion, Gauteng, is importing GSK's Shingrix for patients who receive Section 21 authorisations to use the unregistered vaccine. It is unclear what price Equity Pharmaceuticals is paying GSK for Shingrix to be imported under Section 21 approvals, or what its mark-up on the medicine is. Asked about the price of Shingrix in South Africa, Saytkulov told Spotlight: 'Equity Pharmaceuticals is not affiliated with GSK, nor is it a business partner or agent of GSK. Therefore we cannot provide any comments with regards to pricing of a non-licensed product, which has been authorised for importation through Section 21.' Equity Pharmaceuticals also said it was difficult to comment on the price. 'The price of a Section 21 product depends on a number of fair considerations, including the forex rate, the quantity, transportation requirements, and the country of importation. Once the price and lead time are defined for an order, the information is shared with the healthcare provider to discuss with their patient and the medical aid,' the company's spokesperson, Carel Bouwer, said. Nematswerani pointed out that 'Section 21 pricing is not regulated' and that the price can change due to many factors including supplier costs, product availability and inflation. What causes shingles? Shingles is caused by the same highly infectious virus that causes chickenpox. Most people are infected with the varicella-zoster virus (VZV) during childhood. Chickenpox occurs when a person is first infected by VZV. When a person recovers from chickenpox, the VZV virus remains dormant in their body but can reactivate later in life as the immune system weakens. This secondary infection that occurs, typically in old age when the dormant virus reactivates, is called shingles. People who were naturally infected with chickenpox, as well as those vaccinated against chickenpox with a vaccine containing a weakened form of the VZV virus, can get shingles later in life. But, people who were vaccinated against chickenpox have a significantly lower risk of developing shingles later in life compared with those who naturally contracted chickenpox, according to the World Health Organization (WHO). The chickenpox vaccine is available in South Africa's private sector but is not provided in the public sector as part of the government's expanded programme on immunisation. Chickenpox is usually mild in most children, but those with weakened immune systems at risk of severe or complicated chickenpox should be vaccinated against it, said Professor James Nuttall, a paediatric infectious diseases sub-specialist at the Red Cross War Memorial Children's Hospital and the University of Cape Town. Who should be vaccinated against shingles? South Africa does not have guidelines for who should receive the shingles vaccine and when. The US CDC recommends that all adults older than 50 receive the two-dose Shingrix vaccine. It also recommends that people whose immune systems can't defend their body as effectively as they should, like those living with HIV, should get the vaccine starting from age 19. While Shingrix works better than Zostavax at preventing shingles, it has other advantages that make it a safer and better option for people with weak immune systems. The Zostavax vaccine contains a weakened live form of the VZV virus and thus poses a risk of complications in people with severely weakened immune systems. 'In the profoundly immunosuppressed, the immune system might not control the replication of this weakened virus,' explained Nel. The Shingrix vaccine does not contain any live virus and therefore does not present this risk. In March 2025, the WHO recommended that countries where shingles is an important public health problem consider the two-dose shingles vaccine for older adults and people with chronic conditions. '[T]he vaccine is highly effective and licensed for adults aged 50 and older, even if they've had shingles before,' according to the WHO. It advised countries to weigh up how much the vaccine costs with the benefits before deciding to use it. The cost of not vaccinating against shingles The cost of not vaccinating against shingles is high for people who develop the condition, as well as the health system. '[T]he risk of getting shingles in your lifetime is about 20 to 30%… by the age of 80 years, the prevalence is almost 50%,' said Geffen. 'Shingles is often a painful, debilitating condition, with significant morbidity. It can result in chronic debilitating pain which affects sleep, mood and overall function,' he added. Beyond preventing shingles and its complications, new evidence suggests that getting the vaccine may also reduce the risk of developing dementia and heart disease. In April, a large Welsh study published in Nature reported that people who received the Zostavax vaccine against shingles were 20% less likely to develop dementia seven years after receiving it compared with those who were not vaccinated. In May, a South Korean study published in the European Heart Journal reported that people vaccinated against shingles had a 23% lower risk of cardiovascular events, such as stroke or heart disease, for up to eight years after vaccination. DM
