People aged ≥50 years who are immunocompetent are recommended to receive a zoster vaccine
All people aged ≥50 years who are immunocompetent should be offered zoster vaccine.
People who are immunocompetent are recommended to receive a 2-dose schedule of Shingrix, 2–6 months apart, for the prevention of herpes zoster and associated complications.
The optimal timing of receiving zoster vaccine depends on individual circumstances, including:
- Age-related risk of herpes zoster and its complications: Herpes zoster can occur at any age after primary infection with VZV, but the risk increases with age. The risk of herpes zoster in the general population increases from an estimated annual rate of 6 per 1000 in people aged 50–59 years to 15 per 1000 in people aged 70–79 years.1 The likelihood and severity of complications such as post-herpetic neuralgia also increases with age.
- Duration of protection: Shingrix has demonstrated high vaccine efficacy for at least 7 years after vaccination in people without immunocompromise,1 and immunogenicity data suggest that protection may persist for at least 10 years.1 A person vaccinated at a younger age such as 50 years may have reduced protection from vaccination as they age, when the risk of zoster is higher. There are no current recommendation for boosters for either zoster vaccine.
- Individual’s personal preferences: People’s desire to protect themselves from herpes zoster and related complications may vary, and this will influence decision-making on when they should receive zoster vaccination.
- NIP-funding for vaccination: An immunocompetent non-Indigenous adult will become eligible for Shingrix funded through the NIP from 65 years of age.
Shingrix is funded through the NIP for non-Indigenous people aged ≥65 years. Shingrix is funded through the NIP for Aboriginal and Torres Strait Islander peoples aged ≥50 years of age. For details see the National Immunisation Program Schedule.
A single dose of Zotavax may be used in people who are immunocompetent if Shingrix is not accessible. However, Shingrix is more efficacious,2 particularly in the elderly, and will likely offer longer-lasting protection against herpes zoster than Zostavax.3-8 Zostavax is no longer funded through the NIP. The person’s immune status should be carefully assessed before administering Zostavax, using the Live zoster vaccine (Zostavax) screening for contraindications tool, to confirm that they are not immunocompromised. See Contraindications and precautions. If the person’s immune status is uncertain, do not administer Zostavax, and consult the person’s specialist or an immunisation specialist before proceeding.
See Vaccine information.