Who should get the Shingrix vaccine?

Dear Dr. Roach: My son is a kidney transplant recipient. Is it safe for transplant recipients to get the new Shingrix vaccine? — J.O.

Because the Shingrix vaccine is not a live vaccine, it is thought to be safe. It is licensed for immunocompromised people, like your son, but transplant recipients were not included in the published trials. As such, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has not made an official endorsement as of this writing.

However, many experts do recommend the vaccine for people on the kind of immune-suppression drugs used for solid-organ transplant recipients.

Studies are ongoing, and the ACIP and other advisory groups will make new recommendations as data become available. Until then, your son should talk with his transplant doctors about the vaccine.

Dear Dr. Roach: I am a 58-year-old male who has never had chickenpox.

Should I consider getting the Shingrix vaccine? I am HIV positive for 22 years with no symptoms or opportunistic infections. — B.D.

Unfortunately, people who have not had chickenpox but who have had the varicella vaccine (the live vaccine usually given to children to prevent chickenpox) still may get shingles.

You definitely should consider the Shingrix vaccine. It reduces your risk of shingles from fairly small to very small. You, personally, have possibly less risk because you had the weakened vaccine strain of chickenpox, but then you have a slightly higher risk due to your HIV infection. The downside of getting it is a sore arm (less likely is a more severe reaction) and some money. The upside is that you’d have a lower risk of getting shingles, which is painful and unpleasant, and which in the rare case can cause serious disease.