Zoster vaccine recombinant (Shingrix®)

OFFICE ADMINISTRATION

The CDC recommends Shingrix as preferred over Zostavax for the prevention of herpes Zoster (shingles) and related complications

Indications for Prior Authorization:

  • Indicated for the prevention of herpes zoster (shingles) in adults

Prior Authorization Criteria:

  • Recommended in patients 50 years of age or older:
    • Whether or not they report a prior episode of herpes zoster
    • Whether or not they report a prior dose of Zostavax (Shingrix should not be administered less than 2 months after a patient received Zostavax)
    • Who have chronic medical conditions (e.g., chronic renal failure, diabetes mellitus, rheumatoid arthritis, chronic pulmonary disease), unless a contraindication or precaution exists.  Similar to Zostavax, Shingrix may be used for adults who are
      • are taking low-dose immunosuprressive therapy
      • are anticipating immunosuppression
      • have recovered from an immunocompromising illness
    • Who are getting other adult vaccines in the same doctor's visit, including those routinely recommended for adults age 50 years and older, such as influenza and pneumococcal vaccines.  The safety and efficacy of concomitant administration of two adjuvanted vaccines, such as Shingrix and Fluad, have not been evaluated
    • It is not necessary to screen, either verbally or by laboratory serology, for evidence of prior varicella infection
  • Patient does not have a history of a severe allergic reaction (e.g. anaphylaxis) to any component of the vaccine or after a previous dose of Shingrix

Dosing:

  • 0.5 mL administered as a 2-dose series, the second injection should be administered 2-6 months after the initial vaccination

Approval:

  • 2 doses

Last review date: April 23, 2019