Can this shingles vaccine make you younger?

A vaccine that protects elderly people from shingles and contains dramatic anti-ageing properties is due in South Africa later this year.

Shingrix was registered by the South African Health Products Regulatory Authority (Sahpra) for prescribed local use seven months ago. It is due to land in the second half of the year, after which it must be cleared by the National Control Laboratory (NCL) in Bloemfontein, a process that can take several weeks.

Until then, say pharmacists who spoke to the FM, it can only be prescribed via a special permit issued by the regulator. Sahpra CEO Dr Boitumelo Semete says GlaxoSmithKline (GSK), which manufactures and distributes the vaccine, will need to submit the anti-ageing data for review before any indication can be included on the Shingrix label. Until that happens, doctors will need to take “full responsibility” for prescribing off-label use, she cautions.

Prof Hannelie Meyer, head of the South African Vaccination & Immunisation Centre at Sefako Makgatho Health Sciences University, says all human vaccines need to be assessed independently by the NCL before being released to market. She says adult vaccination is gaining more attention, given the importance of “healthy ageing” and the World Health Organisation’s agenda on life-course vaccination.

Shingrix is a newer version of Zostavax, a drug used to vaccinate against shingles — and far more effective. Single-trial findings of its anti-ageing effects could result in it reaching sales levels of Ozempic, the blockbuster diabetes drug that also reduces weight.

“I can see a run on it when this gets known and it is locally available,” a pharmacist tells the FM.

Shingrix costs about R15,600 in the private sector for a two-dose inoculation and is not yet covered by local medical aids. GSK referred the FM to the national department of health on questions regarding cost, but department spokesperson Foster Mohale says he is unaware of any public sector Shingrix consignment. “If it’s coming, it’s not us.”

Shingrix is wonderful, but we need to keep perspective

—   India Butler

A decade-long study of 3,800 Californians, all older than 70, shows that Shingrix may keep people biologically younger. Researchers comparing vaccinated and unvaccinated groups said the DNA of those who had the jab looked “younger” at a molecular level. They also had less inflammation while reducing the risk of heart disease, cancer and Alzheimer’s, according to the study by the University of California.

Prof Rayne Stroebel, a gerontologist at North-West University, focuses on improving care and quality of life for old people, particularly around dementia, long-term care and relationship-centred support. He says: “Shingles is an inflammatory condition that is hugely underacknowledged in South Africa. Most GPs do not even know that shingles is preventable.” The incidence of shingles in old-age facilities he visits “is alarmingly high and mostly stress-related”, he says.

“Doctors assume it’s just part of old age, but it is terrible to experience and avoidable. People usually get it around the waist, but it can also occur in the groin, midriff or face and neck. People feel like death warmed up and when the rash comes out it can be unsightly,” he says.

Stroebel says elderly people and their caregivers now have an added incentive to get the vaccine.

Prof Eric Decloedt, head of pharmacology at Stellenbosch University, says because Shingrix is not a live vaccine it is suitable for people with a weakened immune system. “It’s a real bonus if it slows biological ageing as well.”

Prof Wolfgang Preiser, head of medical virology at Stellenbosch University, says there have been several studies over the past year or two showing nonspecific beneficial effects. “At just over 60, I’d very much like to get it just to prevent the very unpleasant shingles.”

He said he found the study “rather convincing.””It falls within a rapidly growing line of studies that demonstrate significant positive non-specific (aka heterologous or off-target) effects of shingles vaccines."

However, he calls the price “a joke”, saying he would rather take high-dose acyclovir (an antiviral medication used to treat infections caused by the herpes virus family) “very early” to avoid shingles complications and ease any associated pain.

Prof India Butler, a geriatrician and former vice-president of the South African Geriatrics Society, says the rollout of lifesaving adult vaccines (shingles is not life-threatening) in South Africa is “dismal”.

“The flu shot, which costs nothing in the public sector and about R50 over the counter without prescription, has been shown to be 24% effective against all-cause mortality, including respiratory infections, diabetes complications, cardiovascular events and even functional decline among geriatrics. It reduces hospitalisation, mortality and frailty, and saves the health-care system millions. We should be offering flu shots at all community points, hospitals on the day of discharge, and clinics. We need to step this up to Covid levels,” she says. “Shingrix is wonderful, but we need to keep perspective.”