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New shingles (Varicella zoster) vaccine: Shingrix

by Multibilly on Wed Aug 09, 2017 12:42 pm

As only a slightly immuno­com­pro­mised smoldering patient, I've been debating getting the current Merck shingles vaccine (which is a live vaccine and is therefore technically contraindicated for immuno­com­pro­mised patients). If you are immuno­com­pro­mised and have a bad reaction to the current shingles vaccine, you can develop "disseminating disease", which is not at all pleasant and may even be worse than getting shingles itself - at least according to my doctor.

The good news is that I met with my oncologist today and he thought that there may be a new shingles vaccine on the horizon that may be used by immuno­com­pro­mised patients such as myself. After the appointment, I did a little research and he was indeed spot on. The vaccine is known as Shingrix and it may receive FDA approval as soon as late October this year. Unlike Merck's current shingles vaccine, Shingrix is not a live vaccine, and it appears to be more efficacious in preventing shingles than the current Merck vaccine. This may be great news for us myeloma patients who don't want to pro­phylaptically take acyclovir every day to fend off shingles, or who are simply on a fearful watch for any signs of developing shingles.

Here's an article with more information:

http://www.fiercepharma.com/vaccines/eager-for-marketing-approval-gsk-s-shingrix-passes-revaccination-test

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Arizonan on Wed Aug 09, 2017 4:50 pm

Thanks. That's great news.

Arizonan
Name: Arizonan
Who do you know with myeloma?: Self
When were you/they diagnosed?: April 2010
Age at diagnosis: 54

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Ian on Fri Sep 15, 2017 2:53 am

A quick update on this:

A U.S. Food and Drug Administration advisory committee has unanimously recommended that Shingrix be approved by the FDA for marketing as a new shingles vaccine:

"'Impressed' FDA panel unanimously recommends GSK shingles vaccine," Reuters, Sep 13, 2017 (link to full text of article)

A few excerpts from the article:

"A U.S. Food and Drug Administration advisory panel on Wednesday voted 11-0 that the safety and efficacy of GlaxoSmithKline’s Shingrix shingles vaccine warrants approval for its use in adults aged 50 and over.

Panel members said they were “very impressed” by efficacy data from Shingrix clinical trials, and that it represents an improvement over Zostavax, the only marketed shingles prevention vaccine from Merck & Co.

While the FDA is not required to follow recommendations of its advisory panels, the enthusiasm expressed would seem to indicate that approval is a virtual certainty in coming weeks ...

In clinical trials, Shingrix has shown greater protection against shingles among older recipients than that demonstrated by Zostavax. Four years after injection, the GSK vaccine remained about 90 percent effective in people over age 70, while the efficacy of Zostavax declines noticeably over time ...

Shingrix, given in two doses two months apart, also reduces incidence of nerve pain following a shingles outbreak known as postherpetic neuralgia.

In two pivotal Phase III studies involving more than 29,000 subjects, serious side effects were similar for Shingrix and a placebo. Panelists had questions about a small but greater incidence of certain reported adverse health issues among Shingrix recipients, including gout and stroke."


Cheers!

Ian

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Multibilly on Fri Sep 15, 2017 9:03 am

This is fantastic news Ian! Many thanks for posting the update. I wonder how long it will take for the vaccine to make it into the doctor's offices in the US and elsewhere, once officially approved by the FDA and other regulatory bodies throughout the world?

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: New shingles (Varicella zoster) vaccine: Shingrix

by NStewart on Sun Sep 17, 2017 4:05 pm

This is still a live vaccine. So I would ask your oncologist / myeloma specialist if it's ok for you to have the shingles vaccine. Even a little immune compromised can be the difference between being protected and getting a very bad reaction to the shot.

Nancy in Phila

NStewart
Name: Nancy Stewart
Who do you know with myeloma?: self
When were you/they diagnosed?: 3/08
Age at diagnosis: 60

Re: New shingles (Varicella zoster) vaccine: Shingrix

by moonscape on Sun Sep 17, 2017 4:32 pm

I wonder if acyclovir would be needed still on top of this? Hopefully not.

Nancy, great news in that it seems this is not a live vaccine:

"Furthermore, Shingrix is a recombinant sub-unit vaccine rather than a live, attenuated virus like Zostavax. Live virus vaccines can't be used in immune-compromised patients, whereas Shingrix should have no problem getting approval for those situations." (source)

Also:

"Shingrix is a non-live, recombinant vaccine that combines glycoprotein E, a protein found on the varicella zoster virus (VZV), with an adjuvant system, AS01B, which is intended to enhance the immunological response to the antigen. " (source)

moonscape
Who do you know with myeloma?: me
When were you/they diagnosed?: 11/2015

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Ian on Mon Oct 23, 2017 5:25 am

The U.S. Food and Drug Administration went along with its advisory committee recommendation and has approved Shingrix, the new "non-live" shingles vaccine. Here is a Reuters article about the approval:

"GlaxoSmithKline adult shingles vaccine wins U.S. approval," Reuters, Oct 20, 2017 (full text of article)

Some key points:

  • The company said it expects Shingrix 'will be available shortly.'"
  • "Shingrix has shown greater protection against shingles among older recipients than Zostavax. Four years after injection, the Glaxo vaccine remained about 90 percent effective in people over age 70, while the efficacy of Zostavax declines noticeably over time."
  • "Given in two doses two months apart, Shingrix also reduces incidence of nerve pain following a shingles outbreak."
Also, here is a link to the press release from the GlaxoSmithKline (GSK), the company that will market the vaccine, announcing the FDA approval.

The press release says that "the US Food and Drug Administration (FDA) has approved Shingrix (Zoster Vaccine Recombinant, Adjuvanted) for the prevention of shingles (herpes zoster) in adults aged 50 years and older. Shingrix is a non-live, recombinant subunit vaccine given intramuscularly in two doses."

Interestingly, the FDA approval of the vaccine was not the first. About a week earlier, Singrix was approved in Canada. Here's a link to the GSK press release announcing the Canadian approval. It says that Shingrix "has been approved in Canada for the prevention of shingles (herpes zoster) in people aged 50 years or older." It goes on to say that Shingrix "is a non-live, recombinant subunit adjuvanted vaccine given intramuscularly in two doses and is expected to be available through physicians’ offices and pharmacies in early 2018."

The press release about the Canadian approval also explains how Shingrix works. It says that the vaccine combines "a non-live antigen, to trigger a targeted immune response, with a specifically designed adjuvant to enhance this response and help address the natural age-related decline of the immune system."

Cheers!

Ian

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Multibilly on Mon Oct 23, 2017 9:52 am

This is very good news! Thanks again Ian. I will be asking my GP's office to place an order for the vaccine.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: New shingles (Varicella zoster) vaccine: Shingrix

by NStewart on Tue Oct 24, 2017 4:04 pm

Good news about this being a non-live vaccine. I'll ask my oncologist about it when I see him next week. The center where I am treated participated in a clinical trial for a non-live vaccine. I don't know if Shingrix is the vaccine that was being tested in the trial that they were part of.

Nancy in Phila

NStewart
Name: Nancy Stewart
Who do you know with myeloma?: self
When were you/they diagnosed?: 3/08
Age at diagnosis: 60

Re: New shingles (Varicella zoster) vaccine: Shingrix

by Nancy Shamanna on Sat Oct 28, 2017 11:17 pm

I echo the above comments about a non-live shingles vaccine being a good development! I hope to get it next year also.

Just had the flu shot and also the pneumococcal vaccine. Here in Alberta the pneumococcal vaccine is just given free once to healthy people over age 65, but for me this was a five year repeat of the vaccine, since I had all my (childhood and other) vaccines again after my stem cell transplant. I also had that vaccine before my stem cell transplant, when I was initially diagnosed and going through induction chemotherapy, due to being immune-compromised.

I understood at the time of all my childhood re-vaccinations that the varicella vaccine (for chickenpox) can help to prevent shingles, since the two viruses are in the same family. It will be nice to get a vaccine meant just for shingles though, hopefully!

Nancy Shamanna
Name: Nancy Shamanna
Who do you know with myeloma?: Self and others too
When were you/they diagnosed?: July 2009

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