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December 2018

Here’s what you need to know about administering the Shingrix® shingles vaccine

Blue Cross Blue Shield of Michigan and Blue Care Network cover Shingrix at zero cost share for most commercial (non-Medicare) members age 50 and older.

Shingrix prevents shingles and its complications and is administered as two injections. The second injection should be administered at least 60 days up to six months after the first injection.

The Centers for Disease Control and Prevention released a monitoring report** in May 2018 indicating that providers may be confusing Shingrix with Zostavax®. The CDC found that from October 2017 to February 2018, the Vaccine Adverse Events Reporting System received 155 reports regarding Shingrix. Of these, 13, or 8 percent, were attributed to administration error.

These errors include:

  • Subcutaneous administration rather than intramuscular administration
  • Inappropriate age
  • Wrong vaccine information statement
  • No instructions to return for the second dose
  • Administering the wrong vaccine
  • Administering without reconstitution of the vaccine

The CDC recommends that healthy adults age 50 and older get Shingrix, even if in the past they:

  • Had shingles
  • Received Zostavax
  • Are not sure if they had chickenpox

Blue Cross and BCN also cover the shingles vaccine Zostavax at zero cost share for most commercial (non-Medicare) members age 60 and older. Shingrix should not be administered less than two months after Zostavax was administered.

Shingrix versus Zostavax

Shingrix®

Zostavax®

Manufacturer

GSK

Merck

Type

Recombinant adjuvanted

Live-attenuated virus

Storage

Refrigerator (do not freeze)

Freezer

Dosage

0.5 mL IM x 2 doses
(2-6 months apart)

0.65 mL SC x 1 dose

Supply and administration

Two components:

  • Vial one: Single-dose vial of adjuvant suspension component (blue-green cap)
  • Vial two: Single-dose vial of lyophilized gE antigen component (brown cap)

Contents in vial one (adjuvant) should be withdrawn and transferred in entirety to vial two (antigen).

Gently shake until powder is completely dissolved. Withdraw 0.5 mL from vial two and administer intramuscularly.

Single-dose vial of lyophilized vaccine and a vial of sterile water diluent

ACIP recommendation

Immunocompetent adults 50 years and older, including those who previously received Zostavax. Shingrix is preferred over Zostavax.

Immunocompetent adults aged 60 years and older

Read the Shingrix prescribing information here.

**Blue Cross Blue Shield of Michigan doesn't own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.