New shingles vaccine Skyzoster available in Thailand

[Arkady]

For some unknown Thailand continues to drag its heels on approving and importing Shingrix and most hospitals only provide Zostavax which seems to be largely discredited in the West as, not only  being not very effective at preventing shingles but also actually causing shingles. 

 

Skyzoster has been developed by SK Biosciences of Korea and Thailand was the first country outside Korea to applrove in May 2020.  Malaysia has just appoved it this month as the second country outside Korea to do so. It now has a market share in S Korea of 56%

 

I have just seen it on the price list of Mahidol U's Travel Clinic near Victory Monument but I haven't seen other Thai hospitals offering it. https://www.thaitravelclinic.com/cost.html

 

Does anyone have any information or opinions on this new vaccine? I would like to get a shingles vaccination, preferably Shingrix, but have no interest in Zostavax.

[Gaccha]

Not exactly glowing recommendations:

 

"A recent Phase III clinical trial showed that SKYZoster is non-inferior compared to the control vaccine (Zostavax)."

 

Looks like Shingrix is considerably superior since although "Sky Zoster won’t lose its competitive edge because it is much cheaper and convenient with one dose. Still the newcomer may quickly penetrate into the market despite its high price due to stronger effectiveness."

 

Best wait for Shingrix.

[Dogmatix]

3 minutes ago, Gaccha said:

Not exactly glowing recommendations:

 

"A recent Phase III clinical trial showed that SKYZoster is non-inferior compared to the control vaccine (Zostavax)."

 

Looks like Shingrix is considerably superior since although "Sky Zoster won’t lose its competitive edge because it is much cheaper and convenient with one dose. Still the newcomer may quickly penetrate into the market despite its high price due to stronger effectiveness."

 

Best wait for Shingrix.

 

Unfortunately most of the information about it is from the manufacturer. 

[HuskerDo2]

Stick with the big pharma companies that have rigorous testing and procedures and decades of experience (Pfizer, Moderna, J&J). Other newbie companies with low standards will likely cause you more problems than benefits with their so-called vaccines. They can only truly be called vaccines IF they work. Zostavax appears to fail in this regard.

[Lorry]

3 hours ago, Arkady said:

For some unknown

Sheryl has explained several times that there just isn't enough Shingrix around in the world.

There are several rich countries where it is not available at all or hard to get.

Thailand would be a small market,  so the manufacturer didn't even apply for approval here.

 

[bluejets]

Friend of ours recently had shingles vaccination........had alergic reaction (apparently)

 

Now deaf.......

[internationalism]

I had zostavax in May 2021 at that mahidol clinic, it was 4800b.

 

looks like skyzoster available in siriraj hospital on thonburi since December 2021, no price given. Probably at the same time available at the mentioned travel clinic near Victory.

https://www2.si.mahidol.ac.th/km/cop/clinical/medicationsafety/18601/

 

available at

https://www.vibhavadi.com/Package/P0000190 for 4700b (special price till end of January)

[Sheryl]

12 hours ago, Lorry said:

Sheryl has explained several times that there just isn't enough Shingrix around in the world.

There are several rich countries where it is not available at all or hard to get.

Thailand would be a small market,  so the manufacturer didn't even apply for approval here.

 

As above.

 

People seem to think that a drugs are automatically available unless the government has banned it or witheld approval.

 

Quite the contrary. A manuacturer must take the initiative to apply for registration which is a time- consuming and costly process. Often they do not bother especially if the projected market is comparatively small.

 

Zostavax is not ineffective or worthless. It is less effective, certainly, but does reduce risk of getting Shinghlles by about 50%. It also reduces severity if you do get it.

 

I developed shingles about 3 years after getting Zostavax and compared to the usual course it was pretty mild. Uncomfortable but I only needed paracetemol to get through the day.  Nothing like what unvaccinated people report. 

 

Getting Zostavax does not preclude later getting Shingrix when/if it becomes available. 

 

As for Sky Zoster vs Zostavax, pretty much same.

 

[internationalism]

as zostavax lasts some 3-5-7 years (depending on source), what about getting skyzoster sometimes after 3 years?

And later even going for shingrix (is already available in Singapore for some $420).

Having zostavax in 2021 I have tried to get varicella vax in 2022 - I was told to do antibody test (some 300b) which confirmed strong immunity.

What about having zostavax booster sometimes after 3 years - first checking for antibody? In my vax book they put no booster needed.

 

Skyzoster is only in 3rd phase now. So looks like Thailand, and now Malaysia, are just testing fields for the 4th phase. I would rather avoid it for now, before phase 4th is known.

In Korea skyzoster has only just half of the market. A few months ago Korea even approved shingrix. So they don't trust their own developed vax. Looks, like they are going to mix and match those 3.

 

[Lorry]

13 minutes ago, internationalism said:

as zostavax lasts some 3-5-7 years (depending on source), what about getting skyzoster sometimes after 3 years?

And later even going for shingrix (is already available in Singapore for some $420).

Having zostavax in 2021 I have tried to get varicella vax in 2022 - I was told to do antibody test (some 300b) which confirmed strong immunity.

What about having zostavax booster sometimes after 3 years - first checking for antibody? In my vax book they put no booster needed.

 

Skyzoster is only in 3rd phase now. So looks like Thailand, and now Malaysia, are just testing fields for the 4th phase. I would rather avoid it for now, before phase 4th is known.

In Korea skyzoster has only just half of the market. A few months ago Korea even approved shingrix. So they don't trust their own developed vax. Looks, like they are going to mix and match those 3.

 

I would skip all these experimental vaccination schedules. In 3-5-7 years you can most probably get subsidized Shingrix in many European countries, not subsidized one in HK and Singapore.

I have no idea whether and when it will be available in Thailand. 

[Sheryl]

51 minutes ago, internationalism said:

as zostavax lasts some 3-5-7 years (depending on source), what about getting skyzoster sometimes after 3 years?

And later even going for shingrix (is already available in Singapore for some $420).

Having zostavax in 2021 I have tried to get varicella vax in 2022 - I was told to do antibody test (some 300b) which confirmed strong immunity.

What about having zostavax booster sometimes after 3 years - first checking for antibody? In my vax book they put no booster needed.

 

Skyzoster is only in 3rd phase now. So looks like Thailand, and now Malaysia, are just testing fields for the 4th phase. I would rather avoid it for now, before phase 4th is known.

In Korea skyzoster has only just half of the market. A few months ago Korea even approved shingrix. So they don't trust their own developed vax. Looks, like they are going to mix and match those 3.

 

There is no data available on use of Zostavax boosters.

 

And no reason I can see for choosing Sky Zoster over Zostavax. Both are attenuated live vaccines. 

 

I too want Shingrix but even though I go to the US annually I  have had to wait (2 monthly dose schedule plus very expensive in US.)

 

 

Edited January 14, 2023 by Sheryl
said Shingrix when I meant Zostavax booster

[internationalism]

in my home country in the EU, even zostavax was never available.

Possibly, in a few years, they would have zostavax, but I would rather opt for 4th phase skyzoster, than zostavax booster

And later, in some 10 years, shingrix in thailand or neighbourhood.

I would do yearly varicella tests, which are cheap and harmless.

 

Looks, like those 3 vax, are still being investigated for how long they protect and if they will need bosters. 

If zostavax lasts only 3 years (per wikipedia) or some 5 or 7 years (by the other sources), surely there is a need for a booster or for the other vaxes. I will ask doctors for the updates each time when going for a seasonal flu, covid or other shots.

 

I would rather overvax than undervax, even if I would have to lie to doctor. I did already lie before getting prevnar 13, and that probably saved me from longer hospital stay for pneumonia.

I have red on AN several threads about herpex zoster prevention in thailand, looks like some doctors prever to use aciclovir and other, instead of recommending zostavax. As if they preferred their patients getting sick

[Sheryl]

7 minutes ago, internationalism said:

If zostavax lasts only 3 years (per wikipedia) or some 5 or 7 years (by the other sources), surely there is a need for a booster or for the other vaxes. I will ask doctors for the updates each time when going for a seasonal flu, covid or other shots.

 

 Wikipedia is nto a very good source for mnedical information.

 

"Zoster vaccine efficacy wanes within the first 5 years after vaccination, and protection beyond 5 years is uncertain.

Studies are ongoing to assess the duration of protection from one dose of zoster vaccine and the need, if any, for booster doses."

https://www.cdc.gov/vaccines/vpd/shingles/hcp/zostavax/hcp-vax-recs.html

 

"wane" does not mean gone, it means starts to decrease

 

I think you will see Shingrix available in the Eu in much less than 10 years. My guess would be in the next few (2-3) years as the stock situation is starting to improve and EU is a large market.

[internationalism]

if "wanes within the first 5 years after vaccination, and protection beyond 5 years is uncertain" so it would be wise to check sometimes before year 5th for antibodies.

Wikipedia can be a good reference source, as they have to quote research papers. Other sources, like press articles, don't have to. 

Sometimes inventors and manufacturers deliberately misinform. For example skyzoster claims, that they are the second invented vax for shingles, but they are the 3th one  

https://www.biospectrumasia.com/news/37/21755/worlds-second-developed-shingles-vaccine-receives-biologics-license-application-approval-in-malaysia.html

That is one of the reasons I would wait for, at least, the 4th phase, before contemplating them at all. 

[Sheryl]

38 minutes ago, internationalism said:

if "wanes within the first 5 years after vaccination, and protection beyond 5 years is uncertain" so it would be wise to check sometimes before year 5th for antibodies.

Wikipedia can be a good reference source, as they have to quote research papers. Other sources, like press articles, don't have to. 

Sometimes inventors and manufacturers deliberately misinform. For example skyzoster claims, that they are the second invented vax for shingles, but they are the 3th one  

https://www.biospectrumasia.com/news/37/21755/worlds-second-developed-shingles-vaccine-receives-biologics-license-application-approval-in-malaysia.html

That is one of the reasons I would wait for, at least, the 4th phase, before contemplating them at all. 

Antibodies are not the only indication of immune response.

 

Antibody levels can become undetectable yet cell-mediated immunity remain.

 

In vitro tests of cell-mediated immune response are difficult to do which is why the preferred approach is controlled trials looking at actual disease incidence and severity.

[Dogmatix]

11 hours ago, bluejets said:

Friend of ours recently had shingles vaccination........had alergic reaction (apparently)

 

Now deaf.......

That is tragic.  Which vaccine was that?  Zostovax or Shingrix.

[Arkady]

Thanks for all responses.  I am wondering whether to get Zostavax, while waiting patiently for Shingrix, after reading Sheryl's comments.  But there are some suggestions online that it can cause shingles and that the US FDA cancelled its approval which is worrisome, if correct.

 

I had chicken pox as a kid and had a nasty dose of shingles around my eye and forehead in my 40s.  So the virus is definitely resident in my body and could come out at any moment, the risk increasing with age. My mother had a horrific dose of shingles in her 80s and I certainly don't want to go through that, if it can be avoided.

[TallGuyJohninBKK]

fyi...

 

"United States

Zostavax was developed by Merck & Co. and approved and licensed by the U.S. Food and Drug Administration (FDA) in May 2006,^[19] In 2011, the FDA approved the live vaccine for use in individuals 50 to 59 years of age.^[3][42]

...

Shingrix, which provides strong protection against shingles and PHN, was preferred over Zostavax before Zostavax was discontinued.^[44]

In June 2020, Merck discontinued the sale of Zostavax in the U.S.

 

The U.S. Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get two doses of Shingrix, at least two months apart."

 

https://en.wikipedia.org/wiki/Zoster_vaccine#United_States

 

 

[TallGuyJohninBKK]

Merck escapes nearly 1,200 Zostavax shingles vaccine lawsuits as plaintiffs' testimony falls short

 

Dec 8, 2022

 

Following a court judgment in its favor last year, Merck & Co. is formally bidding adieu to more than 1,000 lawsuits alleging its shingles vaccine Zostavax caused patients to develop the disease.

 

Tuesday, a Pennsylvania federal judge threw out exactly 1,189 cases against Merck in the four-year-long group of cases.

...

The plaintiffs in the now-dismissed clutch of lawsuits argued Zostavax caused their shingles. But the medical expert attempting to back up that claim failed to consider whether the plaintiffs’ disease occurred naturally because they’d had chickenpox as kids, according to court filings published this week.

 

(more)

 

https://www.fiercepharma.com/pharma/merck-dodges-nearly-1200-zostavax-shingles-vaccine-lawsuits-after-plaintiffs-expert

 

 

[TallGuyJohninBKK]

"A shingles vaccine called zoster vaccine live (Zostavax) is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix.

 

"Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia (PHN), the most common complication from shingles."

 

"In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles; in adults 70 years and older, Shingrix was 91% effective.

In adults 50 years and older, Shingrix was 91% effective in preventing PHN; in adults 70 years and older, Shingrix was 89% effective."

 

https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

 

 

 

[internationalism]

zostavax is the oldest, since 2006 probably hundreds of millions doses. It was withdrawn in the USA, because they have a better one, shingrix, when they had already reasonable stock.

The rest of the world doesn't have much choice, yet. A few richest countries (some EU - but not all, UK, China, Singapore, Korea) got them.

shingrix is since 2017 and mainly the USA, so maybe low tens of millions. Less data on long term safety.

 

You can always get shingrix after zostavax, but maybe the other way round is not recommended. 

 

I think thatland is switching to skyzoster, because it's cheaper (3200b in comparison to 4800b zostavax) - partly because it's still phase 3. So market for it would be larger, simply that 1600b is 20% and makes difference for thai pensioner.

Second reason might be short expiry date for zostavax and risk of losing stock when outdated. I have got my zostavax within just 1 year of expiry. But many other vaxes which I got in 2021 were just months within expiry. Thai medical tourism has collapsed during covid and hospitals had to dispose surplus.

Skyzoster is fresh made with long expiry, and possibly longer expiry, than zostavax.

 

thare is also varicella vax for the same virus, just 900b, but I think less potent, Can be boosted by the second dose

Edited January 14, 2023 by internationalism

[TallGuyJohninBKK]

The legal claims against Merck that Zostavax caused some vaccine recipients to later develop shingles apparently were never successfully proven. (See the Fierce Pharma article I linked to above).

 

But the main reason to prefer Shingrix over Zostavax appears to be the issue of their relative effectiveness in preventing shingles and PHN:

 

"Studies presented to the committee show that Zostavax is 51% effective against shingles and 67% effective against postherpetic neuralgia.

 

In contrast, Shingrix is 97% effective against shingles for people between the ages of 50 and 69 and 91% effective for people 70 or older. It is 91% effective against postherpetic neuralgia for people 50 and older. These rates are based on evidence presented to the committee from clinical trials with over 38,000 total participants.

 

Both vaccines wane in effectiveness over time. Zostavax diminishes in effectiveness by 15% to 25% after the first year and shows no significant protection by the ninth year, according to research presented to the committee. Shingrix remained at or above 85% effectiveness up to four years after vaccination; longer-term effectiveness is unknown."

 

https://www.cnn.com/2017/10/25/health/cdc-new-shingles-vaccine/index.html

 

 

[unblocktheplanet]

13 hours ago, bluejets said:

Friend of ours recently had shingles vaccination........had alergic reaction (apparently)

 

Now deaf.......

Crikey! Would like to hear more about this terrible tale. What vax? One ear, or both? Percent of hearing loss?

[internationalism]

anaphylaxis can happen to any vaccination. That's why there is always doctor's consultation about any previous reactions to vax.

After jab 30 minutes observation.

Such serious reaction is rare. Possible reversible.

Shingles can cause deafness as well - but only to one ear, on side of facial paralysis, it's called Ramsay Hunt syndrome (herpes zoster oticus) 

[YaiJung]

I had a bad case of shingles on my head/face 3 months ago and now dealing with post herpetic neuralgia.  Every morning when I wake up it feels like somebody was kicking me in the face the day before.  Not fun. I'm in my late 40s and wasn't able to get the vaccine, nor did I really know how severe shingles can be.  If I had known then what I know now, I would have traveled around the world and paid many thousands of dollars plus my left nut for the vaccine. 

[SunsetT]

Get a vaccine if you can! I am 70 and fit but have shingles on my left chest and back right now; excruciatingly painful and worst at night when you are trying to sleep. Been using ibuprofen, paracetamol and gabapentin + anti-virals to dampen down the pain. The 2 latter drugs dampened down the internal pain to bearable almost immediately but now the rash is dry and healing it is mostly surface pain. Anti-virals and gababentin now now finished. Not sure if I need to get some stronger painkillers because the pain relief with para. and ibu. doesnt seem to be as effective now.

[Arkady]

A troll post was deleted.

[internationalism]

Aciclovir is OTC, the strongest 800mg. But you can divide, to lessen potiential side effects. 
that medicine gave me serious diarhea. 
there also migh be creams with aciclovir

[Arkady]

1 hour ago, internationalism said:

Aciclovir is OTC, the strongest 800mg. But you can divide, to lessen potiential side effects. 
that medicine gave me serious diarhea. 
there also migh be creams with aciclovir

Aciclovir cream applied within a couple of days of the outbreak around my eye lessened the severity for me. It was still under patent under the name of Zovirax at that time and very expensive. A doctor at BNH prescribed it for me in a tiny tube and I bought more tubes for half that price but still very expensive at a pharmacy.  Fortunately the patent expired some time in the 90s and aciclovir is now readily available as a low cost generic. There must have been thousands of shingles and herpes sufferers who couldn't get access to the medication while it was still under patent.

[Kaoboi Bebobp]

Canada approved Shingrix in October, 2017, just before the US. I got my first of 2 doses in April 2018. I think it was CA$165/dose, 2-6 months apart. In my case, 6 months.

 

I just missed out in getting free doses as Shingrix was going to be added to the vaccine no-fee schedule for us old goats, the pharmacist told me. 

Edited January 16, 2023 by Kaoboi Bebobp
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