Shots, Shots, Shots! Updates for Hepatitis B, Pneumonia, and the Zoster Vaccines.

Shots, Shots, Shots! Updates for Hepatitis B, Pneumonia, and the Zoster Vaccines.
Makoto Hang, PharmD, Minnesota Community Care

In a recent update from the Center for Disease Control and Prevention (CDC), new vaccination protocols and recommendations are being provided for the shingles and hepatitis B vaccinations. Previously, the CDC recommended the shingles recombinant zoster vaccine (RZV) to all adults aged 50 and older. However, in July 2021, the Food and Drug Administration (FDA) expanded the recommendation to include adults 19-49 years old who are or will be at increased risk of infection because of high level immunosuppression from drug therapy or diseases. Both the CDC and the Advisory Committee on Immunization Practices (ACIP) recommended two doses of the vaccine to prevent shingles in adults aged 19 and older. The schedule and timing of the doses remain the same as previous recommendations. After receiving one dose of the RZV, the second dose should be administered within two to six months. For patients who are or expect to be immunodeficient or immunocompromised, it is reasonable to administer the second dose at least four weeks after receiving the first dose.

Previous guidance by the CDC and ACIP for hepatitis B vaccinations were recommended for adults with diseases such as chronic liver disease or HIV. Moving forward, it is now recommended that all adult patients aged 19 through 59 receive the vaccination if they previously were unvaccinated. The CDC reports increasing rates of hepatitis B infection despite vaccinations following childbirth. The rationale of this recommendation is to reduce the rate of hepatitis B infections and mortality by providing universal injections to all age groups.

Patients who were previously unvaccinated or have received Pneumovax 23 (PPSV23) without Prevnar 13 (PCV13) are recommended to receive either Prevnar 20 (PCV20) or Vaxneuvance (PCV15). Conversely, patients who received PCV13 without PPSV23, or have received both, should follow the usual schedule for PPSV23 if they have not previously received PPSV23 or are due for the next dose.


  1. Therapeutic Research Center. Expect to vaccinate more adults against shingles and hep B. Published April 2022. Accessed May 15, 2022.
  2. Centers for Disease Control and Prevention. Clinical considerations for use of recombinant zosver vaccine (RZV, Shingrix) in immunocompromised adults aged > 19 years. Published January 20, 2022. Accessed May 15, 2022.
  3. Centers for Disease Control and Prevention. Hepatitis B vaccination of adults. Published April 1, 2022. Accessed on May 15, 2022.
  4. Therapeutic Research Center. Pneumococcal vaccination in adults. Published March 2022. Accessed May 15, 2022.