When Is The Best Time To Get The Second Shingrix Shot?
In our latest question and answer, the pharmacist discusses the best time to get your second shot of Shingrix.
After your first Shingrix shot I understand that the second dose should be 2-6 months later. My question is, in order to be the most effective what month after the first shot was given is the most effective? In other words, is exactly 2 months after too soon? Would waiting for month 3 or 4 be better?
Aug 05, 2022- The second Shingrix dose should be given 2 to 6 months after the first dose, with no single month being better than the others within that window.
- You can safely receive your second dose at exactly 2 months after your first dose if that timing works best for you.
- The absolute minimum interval between doses is 4 weeks, though the 2 to 6-month schedule is recommended whenever possible.
Answer
The dosing recommendation for Shingrix is as follows:
- Healthy adults 50 years and older should get two doses of Shingrix, 2 to 6 months apart.
In regard to the second dose, there is no "ideal" month during the two to six-month time frame. According to the prescribing information for Shingrix, there is no significant difference in efficacy or adverse effects, regardless of the month the second dose is given (as long as it is 2 to 6 months after the first dose):
"The safety profile of SHINGRIX was similar when administered according to a 0- and 2-month or 0- and 6-month schedule."
You can feel comfortable getting your second dose anytime during the 2-6 month window, including at exactly two months since your first dose.
Is There A Minimum Interval?
The Immunization Action Coalition states that the absolute minimum interval between the first and second dose is 4 weeks, but it is still highly recommended to stick to the 2 to 6-month interval if possible. One exception for giving a dose sooner could be for someone undergoing chemotherapy.
The 'Ask The Experts' feature on Immunize.org states the following:
Q: I have an oncology patient age 35 years who had chickenpox as a child and is going to be initiating chemotherapy soon. What are the guidelines in such a situation?
A: The risk for zoster and its severe morbidity and mortality is much greater for immunosuppressed people. A 2-dose series of Shingrix should be administered as soon as possible while the person's immune system is intact. In cases such as this, depending upon the timing of chemotherapy initiation, you may wish to consider a shorter interval of at least 4 weeks (1 month) in order to complete the series as soon as possible.
If the second dose of Shingrix is given earlier than 4 weeks after the first dose, the second dose needs to be regiven.
Final Words
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References & sources
- Shingrix Prescribing Information — FDA
- Shingles (Zoster): Ask The Experts — Immunize.Org
Glossary — Terms in This Answer
- Efficacy
- How well a medication or vaccine works to produce the desired effect.
- Adverse effects
- Unwanted or harmful reactions that occur after taking a medication or receiving a vaccine.
- Prescribing information
- Official documentation that describes how a drug or vaccine should be used, including dosage and safety details.
- Immunosuppressed
- Having a weakened immune system that cannot fight off infections as effectively as normal.
- Chemotherapy
- Strong cancer-fighting drugs that can damage the immune system as a side effect.
- Zoster
- The medical name for shingles, a painful viral infection that reactivates in people who previously had chickenpox.
- Morbidity
- The rate of disease or illness in a population.
- Interval
- The length of time between two doses of a vaccine.
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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