A 60-year-old patient was inadvertently given varicella vaccine instead of recombinant zoster vaccine, Shingrix. Should the patient still be given Shingrix? If so, how long an interval should occur between the 2 doses?

CDC recommends that if a provider mistakenly administers varicella vaccine to a person for whom recombinant zoster vaccine (RZV, Shingrix, GSK) is indicated, no specific safety concerns exist, but the dose should not be considered valid. You should administer a dose of Shingrix to the patient during that same visit (same day). If the error is not detected and corrected on the same day, Shingrix should be administered at least 8 weeks after receipt of the varicella vaccine. However, if Shingrix is inadvertently administered less than 8 weeks after the varicella vaccine, CDC experts state that the Shingrix dose does not need to be repeated if given at least 4 weeks (28 days) after the varicella vaccine. A second dose of Shingrix should be given 2–6 months after the first dose of Shingrix to complete the series.

These events should be documented and procedures put in place, such as checking the vial label 3 times to be sure you are administering the product you intend, to prevent this from happening again.