Ask AI
Back Back
Optimizing Shingles Vaccine Uptake

CE / CME

Optimizing Shingles Vaccination: Current Trends and Expert Strategies for Improving Uptake and Series Completion

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit™

Nurse Practitioners/Nurses: 1.00 Nursing contact hour

Released: January 30, 2026

Expiration: January 29, 2027

Jacinda (JAM) Abdul-Mutakabbir
Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH
Ruth Carrico
Ruth Carrico, PhD, DNP, FNP-C, FAAN
Dalilah Restrepo
Dalilah Restrepo, MD
CME/CE Information

Activity

Progress
1 2 3
Course Completed

How many people 50 years of age or older with immune compromise do you provide care for in a typical week?​

For those who practice in academic or community settings, please indicate your practice setting

Epidemiology of Shingles

Dalilah Restrepo, MD:
Shingles is a vaccine-preventable illness caused by reactivation of latent varicella-zoster virus. You can see its impact in this slide.1-3

Download

Potential Complications of Shingles

Dalilah Restrepo, MD:
Shingles can cause significant morbidity. It is more than just a vesicle; it is more than just a rash. There are potentially serious complications.3 The one we talk most about is postherpetic neuralgia (PHN) because this can be significantly debilitating. PHN is a nerve pain that is very difficult to control. It does not disappear after the vesicles are gone; it lasts at least 3 months after the rash is resolved. This is highly debilitating and is more common in older people.3

Download

The Disease Burden of Shingles

Dalilah Restrepo, MD:
Shingles is an all-encompassing infection that can affect morbidity, but it is preventable with the RZV. Prevention also yields significant downstream benefits2-4

Download

CDC Guidelines for RZV: Older Adults

Dalilah Restrepo, MD:
The CDC has guidelines for the RZV in older adults because we want to vaccinate the people who are most likely to have more severe disease.5-7 So, in 2017 the FDA approved and ACIP recommended that people 50 years of age or older be vaccinated against varicella zoster virus.

The ACIP considers anyone born before 1980 as having natural varicella zoster virus immunity via childhood exposure. So it is not necessary to ask whether someone has had chickenpox to vaccinate them against shingles.

Even if someone previously received the zoster vaccine live or the varicella vaccine, they can still receive the RZV, and should receive it if they meet any of the criteria for recommendation (50 years of age or older or with immunocompromise).5-7

The second RZV dose should be given 2-6 months after the first in this population. If dose 2 is given sooner than this, it should be repeated at least 1 month after the early dose. If it has been more than 6 months since the first dose, the vaccine series should not be restarted.6,7

Download

CDC Guidelines for RZV: People With Immunocompromise

Dalilah Restrepo, MD:
The recombinant vaccine really changed the way we see shingles and vaccinate against it. This is because we could not vaccinate people with immunocompromise with the live vaccine. Yet the recombinant vaccine is safe to use in those with immunocompromise.5-8 The FDA approved it in people older than 18 years of age with immunocompromise in 2021, and the ACIP followed in recommending it for people older than 19 years of age with immunocompromise the same year.

Of note, immunocompromise encompasses diseases that are very common as well as immunosuppressing therapies—a person with RA receiving hydroxychloroquine, for example. If you anticipate a patient will become immunocompromised, it is a perfect time to start the vaccination process. This will allow the patient to mount a better immune response before they become more heavily immunosuppressed.5-8

This may seem counterintuitive because when someone is newly diagnosed with cancer or an immunocompromising condition, they may feel too frail to receive the shingles vaccine. But that is the perfect time to receive it because we want patients to enter immunosuppression with immunity already developed.5-8

In people with immunocompromise, the timing of the second dose can be shortened from 2-6 months to 1-2 months.5-8

Download

RZV New Formulation

Dalilah Restrepo, MD:
A prefilled syringe formulation of RZV was approved by the FDA in July 2025. This allows greater convenience for HCPs, who previously had to manually mix the antigen and adjuvant before filling a syringe for administration.8

Uptake of Shingles Vaccine in US Adults

Dalilah Restrepo, MD:
One of the barriers to shingles vaccination is that we do not raise enough awareness about how debilitating shingles can be. Many people know someone who had shingles, but their experience really does not seep in as much.

The uptake of the shingles vaccine in the US is not as high as it should be because we, HCPs, are falling short of vaccinating everyone who is eligible. In addition, there is inequity in who is vaccinated. Those who are more susceptible to complications and who would benefit the most from vaccination are less likely to be vaccinated. We can do better.9,10

Download

3 Major Areas of Emphasis for Shingles Vaccination

Dalilah Restrepo, MD:
The 3 major areas of improvement for shingles vaccination are:

  1. Increasing the coordination between primary and specialty care in vaccinating and in raising awareness of how important singles is—awareness of the burden it carries, especially among older adults, and how safe and preventable it truly is
  2. Ensuring series completion because immunity will wane with only 1 dose and lasting immunity is really conferred with that second dose; that is why it is important to ensure patients receive the second dose
  3. Addressing disparities in access to the vaccine, patient acceptance, and administration of the vaccine in conjunction with community programs

Download
BACK | NEXT