What Antibiotics Are In The Shingles Vaccines?
In our latest question and answer, the pharmacist discusses whether or not antibiotics are contained in the shingles vaccines Shingrix and Zostavax.
I have had shingles several times. My doctor says that I am allergic to the vaccine for shingles. What are the ingredients in Shingrix vaccine? I do have a list of all the antibiotics I am allergic to...
There are currently two FDA-approved vaccines for the prevention of herpes zoster, also known as shingles:
- Shingrix (manufactured by GSK)
- Zostavax (manufactured by Merck)
The recommended vaccine by the Advisory Committee on Immunization Practices (ACIP) is Shingrix. Studies have shown that Shingrix is more effective in preventing episodes of shingles than Zostavax.
We've written a number of articles regarding the differences between Shingrix and Zostavax, one of which can be found here:
Even though Zostavax isn't the recommended vaccine, it is still available and is an option for those that may be allergic to any component of Shingrix...which brings us to your question regarding antibiotics in these vaccines.
Zostavax does contain the antibiotic neomycin. Shingrix does not contain neomycin. In fact, it doesn't contain any antibiotics.
Antibiotics In Shingles Vaccines
As stated, Zostavax contains neomycin.
The prescribing information for the drug even warns against the use of the vaccine in those with a known anaphylactic reaction history to neomycin:
Do not administer ZOSTAVAX to individuals with a history of anaphylactic/anaphylactoid reaction to gelatin, neomycin or any other component of the vaccine.
As the excerpt above states, Zostavax also contains gelatin.
The full ingredient list for Zostavax is as follows:
- Oka/Merck strain of VZV [varicella zoster virus]
- Hydrolyzed porcine gelatin
- Sodium chloride
- Monosodium L-glutamate
- Sodium phosphate dibasic
- Potassium phosphate monobasic
- Potassium chloride
- Residual components of MRC-5 cells including DNA and protein
- Bovine calf serum
Shingrix, on the other hand, does not contain neomycin and actually contains no antibiotics. The full ingredient list of Shingrix is as follows:
- Recombinant gE antigen
- Monophosphoryl lipid A
- QS-21 (saponin purified from plant extract Quillaja saponaria)
- Sodium chloride
- DOPC (dioleoyl phosphatidylcholine)
- Potassium dihydrogen phosphate
- Sodium dihydrogen
- Phosphate dihydrate
- Disodium phosphate anhydrous
- Dipotassium phosphate
- Polysorbate 80
- Residual amounts of host cell proteins (≤3.0%) and DNA (≤2.1 picograms) from the manufacturing process.
Since Shingrix does not contain neomycin or any other antibiotic for that matter, it is considered safe for those who have a neomycin allergy.
The prescribing information doesn't list any specific ingredient in its 'Contraindications' section, which is the section that lists individuals or situations where the vaccine should not be administered. All it states is the following:
History of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine or after a previous dose of SHINGRIX.
If your doctor is stating that you are allergic to Shingrix, they must have an allergy listed in your medical record to something other than an antibiotic, since Shingrix doesn't contain any.
Be sure to ask them exactly what component of Shingrix they have you being allergic to and whether or not there are any alternative options.
SummaryShingrix, the recommended vaccine for the prevention of shingles, does not contain any antibiotics. Zostavax, on the other hand, contains neomycin.