Shingrix, the two-dose vaccine approved in 2017 to prevent shingles and its blistery skin rash, continues to be in short supply.
"There is still a shortage; demand continues to outpace supply," says Kathleen Dooling, M.D., M.P.H., a medical officer in the division of viral diseases at the Centers for Disease Control and Prevention. "But the plan is to have more and higher-volume shipments [throughout] 2019, so we expect there will be a greater number of doses distributed in 2019 compared to 2018."
In 2018, GlaxoSmithKline (GSK), the manufacturer of the vaccine, delivered about 3 million doses in the first half of the year and 5.3 million in the last 6 months of the year, according to company representatives.
GSK is currently sending out shipments twice a month—more frequently, overall, than in 2018—and will distribute "significantly more" of the vaccine throughout the year than it did last year, according to Sean Clements, a spokesman. He declined to say how much more but noted that GSK is keeping government agencies up-to-date on supplies.
The Food and Drug Administration also recently approved a GSK facility in France for Shingrix production, which will help the pharma company ramp up manufacturing, Clements notes.
What's unclear is whether these steps will be sufficient to meet the public's need, says Dooling. "It’s very difficult to say at this point," she notes. "We know we’re still catching up on people who need their second dose. We anticipate there’s a lot of pent-up demand for people to start the series as well. We’ll be watching closely as to whether there will be enough."
Difficulty getting the vaccine is bad news for those who want to protect themselves against shingles, which can cause two to four weeks of painful skin eruptions and, in 20 percent of cases, lingering nerve pain known as post-herpetic neuralgia (PHN).
Shingles occurs when the chickenpox virus, dormant in those who once had the illness, reawakens years later. It strikes about 1 in 3 people at some point, and the older you are, the higher your risk.
The effectiveness of Shingrix probably explains the high interest. In clinical trials, the vaccine, which is approved for most people 50 and older, provides up to 90 percent protection against shingles and 86 percent protection against PHN.
That makes it far more effective than Zostavax, the single-dose shingles vaccine that has been available since 2006. It cuts shingles risk by 51 percent and PHN risk by 67 percent. The CDC considers Shingrix the preferred vaccine over Zostavax but says, “Zostavax may still be used to prevent shingles in healthy adults 60 years and older.”
Here’s what else you need to know about Shingrix availability and the steps to take to protect yourself from shingles.
What Can You Do to Find Shingrix?
If you’re eligible for Shingrix (50 or older, and not immunocompromised or taking moderate to high doses of drugs that suppress immunity), you can start by asking whether your pharmacist or doctor currently has the vaccine, suggests the American Pharmacists Association (APhA).
If Shingrix isn't in stock, ask when they expect more and whether you can be put on a waiting list. (Some pharmacies and other providers may be keeping these.) Ask whether they’ll contact you or whether you should call them periodically about restocking, and whether they know of another provider who may have Shingrix.
You might also want to contact other pharmacies in your area. The CDC’s Vaccine Finder and GSK’s Shingle Vaccine Locator may be useful, but it’s wise to phone ahead before trekking to a far-flung pharmacy.
“The websites are not up-to-the-minute, so what’s showing in the vaccine finder may reflect yesterday or last week’s information,” Dooling says. You can put your name on more than one waiting list, she adds.
How Can You Get Your Second Dose?
As soon as you get your first dose, make an appointment for the second dose two months later, Dooling says. Ask whether the vaccine provider is keeping a list of people who need the second dose, because they should receive priority, according to the CDC.
“Find out if they have a recall and reminder system for people who’ve had their first dose,” Dooling suggests.
Once you receive notification that your second dose is available, call the day before you’re scheduled to receive it to confirm, the APhA says.
Don’t skip that second shot. The two-dose recommendation is based on research, and we don’t have any evidence on how well just one dose might protect against shingles.
“You obviously get some immune response, but exactly how strong it is and how long the protection lasts is not known,” says William Schaffner, M.D., a professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tenn.
And If You Can't Find That Second Shot?
The CDC’s recommendation, based on evidence from clinical trials, is to get your second dose of Shingrix two to six months after the first.
But if it takes longer than that to find a second dose, don’t worry, Schaffner says. The CDC advises getting that second dose as soon as you can find it—and no, you don’t have to start the series over.
“The timing is not critical,” Schaffner notes. “You just don’t want to get it sooner than recommended because then the body’s immunity is still working on the first dose, so you don’t get the full benefit of the second.”
It’s also fine to get your second dose from a different pharmacy or doctor than your first. “But let your home-base provider know you’ve gotten it,” Schaffner says. “As soon as I got my second dose, I sent my physician an email so he could put it in my medical record.”
What If You Can't Get a First Dose Anywhere?
A reasonable option, if you’re eligible, is to have the Zostavax vaccine in the interim, Dooling and Schaffner say. But if you do, you'll need to wait at least eight weeks before getting the newer vaccine.
(The CDC recommends that anyone who has had Zostavax also get Shingrix, and says that Zostavax can’t be used as a substitute for a second dose of Shingrix.)
And last, “keep looking and be patient,” Dooling says. “It is worth the wait, and we anticipate that supply will catch up with demand.”