Funding and expanded eligibility for free Shingrix under the National Immunisation Program (NIP) has led to the highest number of shingles vaccinations on record, new data from the National Centre for Immunisation Research and Surveillance (NCIRS) has revealed. 

On 1 November 2023, Shingrix replaced Zostavax as the only NIP-funded vaccine for the prevention of shingles in Australia. Shingrix had previously only been available – from 2021 – for purchase on the private market.

Since this change, there has been rapid uptake of Shingrix vaccination in Australia. Nearly 1 in 5 eligible adults aged 65 years and over received at least one dose of Shingrix vaccine in the first six months of the new program (to 30 April 2024) – with approximately 1.25 million Shingrix doses administered over this period. 

Associate Professor Frank Beard – Associate Director, Surveillance, Coverage, Evaluation and Social Science, NCIRS – stated, ‘This rapid uptake is likely due to Shingrix being available to more people under expanded NIP eligibility – and better, longer-lasting effectiveness compared to Zostavax.’

Previously, eligibility for free Zostavax under the NIP was limited to adults aged 70–79 years. When Shingrix was added to the NIP, free shingles vaccination expanded to all adults aged 65 years and over; Aboriginal and Torres Strait Islander people aged 50 years and over; and selected groups aged 18 years and over with weakened immunity (immunocompromise) – which means more people at risk of severe disease can now be protected.

Assoc. Prof. Beard said, ‘Shingrix is more than 90% protective over a 3-year period in people aged 50 years and over. Zostavax is 70% protective in people aged 50–59 years but only 41% protective in those aged 70–79 and 18% protective in those aged 80 and over. The effectiveness also lasts longer with Shingrix – with more than 80% protection after 8 years compared to 30% for Zostavax.’

‘Another key benefit of Shingrix is that it can be used safely in both healthy and immunocompromised people – unlike Zostavax, which should not be given to immunocompromised people due to serious and potentially life-threatening risks,’ Assoc. Prof. Beard added.

‘While minor side effects are a bit more common with Shingrix than Zostavax, Shingrix is safer overall and more effective – and the rapid uptake of the vaccine shows Australians and healthcare professionals are confident in its value.’ 

Safety data published by AusVaxSafety show that more than half of Shingrix vaccine recipients (52.3%) experienced no side effects in the first three days following vaccination. 

Among those who did experience a side effect, local reaction (mainly pain, swelling and redness at the injection site) was the most common, followed by fatigue, muscle/joint pain and headache. These reactions are generally short-lived and go away without treatment, with most resolving within a couple of days.

Shingles presents as a painful rash of fluid-filled blisters on one side of the face or body – often in a strip or band-like pattern. It is caused by reactivation of the virus that causes chickenpox (varicella-zoster virus) in nerve cells. 

People who live to 80 have an approximately 50% chance of developing shingles during their lifetime. The risk is higher for those who are immunocompromised.

Although shingles is most often a self-limiting illness, it can lead to serious complications, including postherpetic neuralgia (PHN), which occurs where the shingles rash was located. PHN is an extremely painful condition that can last for months or years after the rash goes away, negatively impacting quality of life. It is estimated up to 30% of people who have shingles also experience PHN, with the risk of this serious complication increasing with age.  

People with immunocompromise are more likely to experience complications from shingles and to have a severe, long-lasting rash.  

NCIRS will continue to monitor and report Shingrix vaccination uptake and safety data and is developing a plan to evaluate the long-term impact of these changes to the NIP. Key measures for the evaluation will include Shingrix vaccine effectiveness and impact on shingles disease rates and severity.

More information on shingles disease and vaccination recommendations is available in the shingles chapter of the Australian Immunisation Handbook.