Get a shingles vaccine after 50
A phase 3 trial found about 97% protection against shingles, similar across age groups. The drawback is the RMB 3,000–4,000 out-of-pocket price for two doses. What that buys is roughly a 97% reduction in incidence.
What it takes
In China, the two-dose recombinant vaccine costs roughly RMB 3,000–4,000 in total, paid entirely out of pocket.
What you may gain
A randomized phase 3 trial across 18 countries enrolled about 15,400 people and followed vaccine and placebo groups for an average of 3.2 years. Shingles occurred in 6 vaccine recipients and 210 placebo recipients: 0.3 versus 9.1 cases per 1,000 person-years, meaning cases during the equivalent of 1,000 people observed for one year. Overall vaccine efficacy was 97.2% (95% CI 93.7–99.0, P<0.001), ranging from 96.6% to 97.9% across age groups.
Context & considerations
Its high price puts it lower on the value-for-money list. Shingles rarely kills; the major concern is postherpetic neuralgia, which may cause pain for months or years. Injection-site pain and fever are fairly common. The most severe category reported, grade 3 symptoms, occurred in 17.0% versus 3.2%.
Research & references
Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. https://doi.org/10.1056/NEJMoa1501184