Vaccine Pregnancy: There are no data from the use of Shingrix in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or post-natal development. As a precautionary measure, it is preferable to avoid the use of Shingrix during pregnancy. Breast-feeding: the effect on breast-fed infants of administration to their mothers has not been studied and it is unknown whether Shingrix is excreted in human milk.

Herpes-zoster vaccine (recombinant, adjuvanted)

Brand names: Shingrix

The recombinant adjuvanted herpes-zoster vaccine is a non-live vaccine used to prevent shingles and post-herpetic neuralgia in older adults and in eligible immunocompromised individuals.

Adult dose

Dose: Herpes zoster vaccination (adults) — primary vaccination schedule: two doses of 0.5 mL each, an initial dose followed by a second dose 2 months later. If flexibility in the vaccination schedule is necessary, the second dose can be administered between 2 and 6 months after the first dose. For subjects who are or might become immunodeficient or immunosuppressed due to disease or therapy, and who would benefit from a shorter vaccination schedule, the second dose can be given 1 to 2 months after the initial dose.

Route: IM — for intramuscular injection only, preferably in the deltoid muscle

Frequency: Two-dose primary course (see interval options in the dose)

Max: Two doses of 0.5 mL constitute the full primary course; the need for booster doses following the primary vaccination schedule has not been established.

Reconstituted from powder and suspension before administration. The need for booster doses following the primary vaccination schedule has not been established. Shingrix can be given with the same schedule in individuals previously vaccinated with live attenuated herpes-zoster vaccine. Shingrix is NOT indicated for prevention of primary varicella infection (chickenpox). The SPC sets the vaccine's schedule, not national programme eligibility (who is offered the vaccine, and at what age) — check the current UK immunisation schedule for that.

Paediatric dose

Route: N/A

Frequency: N/A

Max: Not established

UK SPC: the safety and efficacy of Shingrix in children and adolescents have not been established; no data are available. No paediatric dose is published here. Verify any off-label paediatric use against a children's formulary and specialist advice.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances or to any of the excipients

Side effects

Injection site reactions (such as pain, redness, swelling) — very common; pain at the injection site reported in 68.1% overall/dose (3.8% severe/dose) in adults aged 50 years and above
Myalgia — very common (32.9% overall/dose; 2.9% severe/dose)
Fatigue — very common (32.2% overall/dose; 3.0% severe/dose)
Headache — very common (26.3% overall/dose; 1.9% severe/dose)
Chills and fever — very common
Gastrointestinal symptoms including nausea, vomiting, diarrhoea and/or abdominal pain — very common
Injection site pruritus — common
Lymphadenopathy — uncommon; arthralgia — uncommon
Hypersensitivity reactions including rash, urticaria, angioedema — rare
Guillain-Barre syndrome — very rare
Most reactions were not long-lasting (median duration 2 to 3 days); reactions reported as severe lasted 1 to 2 days
NOTE: the SPC adverse-reaction table was truncated in this source capture — this list is not complete; consult the SPC

Clinical monograph

How it works

It combines a recombinant varicella-zoster virus glycoprotein E antigen with an adjuvant system to boost varicella-zoster-specific immunity that has waned with age or immunosuppression.

Prescribing in practice

Being non-live, it is suitable for immunocompromised patients in whom the live zoster vaccine is contraindicated.
It is given as a course of two doses, and completion is important for full protection.
Administer by intramuscular injection and follow the relevant Green Book chapter, the SPC and current prescribing references for eligible groups and timing.

Monitoring

Routine antibody monitoring is not required; observe after administration for hypersensitivity and ensure the second dose is given to complete the course.

Counselling the patient

Two doses are needed; attend for the second dose as scheduled to be fully protected.
Injection-site pain, muscle aches, tiredness and headache are common and usually settle within a few days.
This vaccine reduces, but does not entirely eliminate, the risk of shingles.

Evidence & guidelines

The recombinant adjuvanted zoster vaccine is recommended in UK immunisation guidance, including for eligible immunocompromised adults for whom the live vaccine is unsuitable.

Reference: UK Green Book; JCVI advice; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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