8 March 2021

New shingles vaccine more effective

Clinical Dermatology PBS Vaccination

A recombinant vaccine for the prevention of herpes zoster and postherpetic neuralgia, the most common complication of shingles, will be available on the private market in the coming months.

The Shingrix vaccine has been shown to be more effective than the live, attenuated vaccine that is currently listed on the National Immunisation Program for the prevention of shingles in people aged 70 to 79 years.

Shingrix, according to a study funded by the vaccine’s manufacturer, offers 97% protection against herpes zoster for 50–59-year-olds, and 91% for those over 70. It also offers similar levels of protection against postherpetic neuralgia, over more than three years.

Shingrix may also be safer for patients who are immunocompromised, although it can’t be recommended for this patient group yet because there is not enough evidence, according to the CDC.

Zostavax on the other hand, only provides 51% protection against shingles and 67% against postherpetic neuralgia over three years.

It’s also contraindicated in patients who have compromised immune function, with the vaccine carrying a risk of varicella zoster infection even in patients who are only on low-dose immunosuppressants.

But Australians are expected to pay handsomely for the more efficacious vaccine, with the two-dose course of Shingrix likely to cost $450-550.

The vaccine’s sponsor GlaxoSmithKline told TMR it was following a global pricing model for Shingrix, meaning that older adults can expect to pay the same amount, regardless of where they live.

“We have a robust supply plan for the private market, and we anticipate thousands of older Australians will benefit from access to Shingrix from the middle of this year,” said a GSK representative. “But realistically, we know that broader access to Shingrix – and therefore broader supply – will not come until Shingrix is recommended for inclusion on the NIP.”

The non-live shingles vaccine, Shingrix, was first approved by the TGA in July 2018 for people aged 50 years and above but was refused PBAC approval that same year.

GSK was critical of the PBAC process, saying: “the assessment processes for valuing new vaccines were flawed and often result in delayed, limited [access] – or in some cases a lack of access altogether – to new vaccines”.

“In Australia, we’ve faced setbacks in securing NIP access to our new vaccines including Shingrix because of how our health system undervalues prevention,” GSK told TMR.

GSK said while it plans to return to the PBAC at some stage, it doesn’t expect Shingrix to make it onto the NIP before 2024.

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