Is The Second Shingrix Shot The Same As The First?
In our latest question, the pharmacist discusses the Shingrix vaccine and how both doses contain the exact same ingredients.
Is the second shot different from the first or are the two shots the same, just given two months apart? In other words, could a person get the first shot twice by mistake?
Nov 27, 2022- Both doses of Shingrix contain exactly the same vaccine and ingredients, so there is no difference between the first and second shot.
- The two Shingrix doses should be given 2 to 6 months apart to help your body develop the best immune response against shingles.
- Shingrix is not labeled as dose one or dose two, so it's impossible to accidentally get them out of order or receive the first dose twice by mistake.
Answer
Shingrix is given as a two-shot series, separated by 2 to 6 months per CDC (Centers for Disease Control) recommendations as this elicits the optimal immune response against the varicella-zoster (i.e. shingles) virus.
The first and second doses of Shingrix are exactly the same. There is no difference between them. Therefore, it is impossible to get the first shot "twice" by mistake or to get them out of order.
In fact, Shingrix is only manufactured as one product. In other words, there is not any packaging or marking on the vials that refer to them as 'dose one' or 'dose two'.
The First And Second Dose Of Shingrix Are The Same And Contain The Same Ingredients
The Shingrix vaccine (both doses) comes in two vials that must be reconstituted by whoever is giving the vaccine prior to injection.
- One vial contains a single dose of the lyophilized varicella-zoster virus surface glycoprotein E (gE) antigen component (appears as a white powder).
- The other vial contains an adjuvant suspension (appears as an opalescent, colorless to pale brownish liquid). As a side note, an adjuvant is a component that enhances the immune response). The adjuvant in Shingrix is AS01B.
To reconstitute Shingrix, the adjuvant suspension component is transferred via a syringe into the lyophilized gE antigen component vial. The resulting reconstituted suspension contains the following components:
- Recombinant gE antigen
- MPL (3-O-desacyl-4’- monophosphoryl lipid A)
- QS-21 (saponin purified from plant extract Quillaja saponaria Molina)
- Sucrose (as a stabilizer)
- Sodium chloride
- DOPC (dioleoyl phosphatidylcholine)
- Potassium dihydrogen phosphate
- Cholesterol
- Sodium dihydrogen phosphate dihydrate
- Disodium phosphate anhydrous
- Dipotassium phosphate
- Polysorbate 80
Shingrix does not contain preservatives and the total volume injected intramuscularly is 0.5 mL.
As mentioned, Shingrix does not come labeled as 'dose one' or 'dose two'. There is only one Shingrix vaccine available and when you get two doses (separated by 2 to 6 months as recommended by the CDC), you are getting the same vaccine twice.
If you have any further questions about Shingrix, be sure to ask one of our pharmacists!
Final Words
I hope you found this helpful and gave you peace of mind.
Glossary — Terms in This Answer
- Varicella-zoster
- The virus that causes chickenpox and shingles.
- Immune response
- The body's defense system activation to fight off infection or recognize a vaccine.
- Lyophilized
- A powder form created by freeze-drying a liquid substance to preserve it.
- Antigen
- A substance that triggers the immune system to produce antibodies and protect against disease.
- Adjuvant
- A component added to a vaccine to strengthen and enhance the body's immune response.
- Reconstituted
- Mixed back together by combining separate components (powder and liquid) to create the final vaccine.
- Intramuscularly
- Injected directly into a muscle.
- Preservatives
- Chemicals added to medications to prevent growth of bacteria and maintain stability.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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