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 would you respond to a 58-year-old patient who reports fever, myalgia, and significant fatigue after the RZV first dose and says, “I’m not doing that again.”

Need for Second Dose: Real-world Efficacy of RZV Vaccination After 1 and 2 Doses

Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH:
Regarding the shingles vaccine in particular, pharmacists should promote the vaccine series in completion. Because it is 2 doses, we must ensure patients receive both doses.

Dalilah Restrepo, MD:
This has been studied quite carefully, and the second dose is critical. Yes, RZV is effective after 1 dose, and we see a 70% efficacy after 1 year. But that efficacy wanes as time goes on. If patients only receive the first dose, protection against shingles wanes approximately 20%.

By contrast, receiving the second dose of the RZV will allow that initial efficacy to be maintained. There are data for 3 years showing 73% efficacy with 2 doses of RZV.19

In addition, other studies are looking at longer-term data, showing maintained efficacy.20

So although 1 dose is still good, it is short lived. The second dose will really give patients the lasting immunity they need.

Download

Questions to Ask About Series Completion

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
Here are some questions to ask yourself. How do you discuss the data behind the timing of the second dose with patients? And how can you ensure patients return for their second dose?

How do you communicate with patients to ensure they know what to expect after vaccination? You should tell them that they may experience adverse events (AEs)/reactions beyond local pain, such as fever, back pain, myalgias, or gastrointestinal-related symptoms—all of which are anticipated immune responses to the shingles vaccine.21 We must have these conversations with patients, so they do not think, "Oh my gosh, something went wrong."

Next, can patients call or get in touch with you if they are worried?

Finally, since we treasure the completion of the vaccine series, how are you measuring that? How well are you doing? Is your office or clinic using the results of that measurement to inform improvement processes?

Download

Patient Counseling on RZV Safety and Adverse Events

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
Dr Restrepo, how should we educate patients on the safety of these vaccines?

Dalilah Restrepo, MD:
First, upfront education is the way to go. I think patients are more open to hearing what to expect when the message comes from us. When they are prepared and provided with a game plan, it is much better received and less scary for them. Therefore, it is best practice to discuss these things upfront.

One of the most common AEs with shingles vaccination is local injection-site pain with redness and swelling, in addition to myalgias, fatigue, and headache. These AEs are often short-lived and can be relieved with over-the-counter analgesics.21,22 I advise my patients to drink plenty of water, refrain from vigorous exercise, and rest for the day following vaccination. I also counsel them to wait until Friday to receive their vaccine if they have Saturday off, in case they experience AEs.

I then encourage patients to receive their second dose even if they experienced AEs with the first dose. Encouraging a second dose is sometimes a little more difficult, especially if patients have had a serious reaction to the first dose. This also can be true for patients who experienced a mild fever, myalgias, or just did not feel well 24 hours after the first dose. It is sometimes harder to get patients to buy into that second dose. It is important to point out that AEs are not necessarily going to be repeated at dose 2 because they had a reaction with dose 1.

Again, coaching them will encourage patients to complete the vaccine series. Despite the pain of dose 1, we want to make sure patients have lasting immunity, which is the selling point here.

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
Yes, just because someone had an AE or felt poorly following the first dose, that does not necessarily mean that it is how they will feel after the second dose. I think that that is an important reminder for patients.

Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH:
I agree with what Dr Restrepo said. Many times, HCPs will get nervous about discussing the full scope of AEs associated with a vaccine, but I tell my patients everything. You want to ensure that you give patients all the information they need to make an informed decision. That is a starting point for me, as a pharmacist, when thinking about how to best counsel points.

Download

Patient Counseling on RZV Benefits: Talking Points

Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH:
HCPs should inform their patients on how effective the vaccine is in preventing disease reactivation. A lot of times, I will talk with patients who say, "I've already had shingles before. Why do I need to be vaccinated?" Well, the vaccine can help prevent reactivation as well as reduce disease severity should they have a reactivation.

We are also seeing an increase in the literature regarding the benefits the RZV can have, especially for people 60 years of age or older. There is a reduction in the incidence of dementia associated with Alzheimer's disease among those who have received the shingles vaccine. So this is another big conversation point for our older adults. There is also a reduction in major adverse cardiovascular events, such as stroke, with RZV.23

So although we have to talk about risks associated with RZV, we can also illustrate to patients the benefits and how these outweigh the risks.

Download
BACK | NEXT