- What Is
- Who Is a Candidate?
- How Often Do You Need?
- Vaccine Efficacy
- Vaccination Over 50 Years of Age
What is shingles?
Shingles, also called herpes zoster, is a painful rash forming along the path of one spinal or brain nerve. It can affect your trunk, limbs, or face. The disease itself is agonizing and can be contracted more than once.
Thankfully, safe and effective vaccines are available, but there's some confusion about who is a candidate for the shingles vaccine. Currently, only one vaccine is available in the USA: the recombinant zoster vaccine (RZV). This vaccine is sold under the brand name Shingrix and is typically recommended for people over 50 years old.
Shingles is a late-stage complication of chickenpox. It starts with some tingling in one part of the body that later becomes painful. You may have a headache and feel unwell. A rash may appear a few days later. It is most often located on the trunk but may also affect the limbs, genitals, or head.
The rash starts as a series of red patches and later becomes a cluster of small blisters. It can be intensely painful.
The rash typically crusts and disappears in 2 to 4 weeks. The pain also gradually subsides. Pain that persists for more than 90 days is considered postherpetic neuralgia (PHN), a complication of shingles that affects one in five people. This pain can be severe and last months to years.
Almost everyone above a certain age is at risk of contracting shingles. More than 99% of Americans born before 1980 have had chickenpox, though they may not remember it. That means they have the virus alive inside their body, persisting within the nervous system.
Conditions that reduce your immunity and could wake the virus, subsequently causing shingles, include:
Who is a candidate for the shingles vaccine?
The Centers for Disease Control and Prevention recommends that people over 50 receive two doses of the recombinant zoster vaccine (RZV). People over 19 with a weakened immune system should also get it.
Some conditions that weaken the immune system include:
- Cancer. Leukemia and lymphoma are especially dangerous
- Bone marrow or organ transplants. Recipients of these have to take immunosuppressive medicines for a long time.
- Treatment with immunosuppressive medicines like steroids and chemotherapy.
You should have this vaccine even if:
- You have had shingles before
- You received the earlier shingles vaccine, Zostavax
- You received the chickenpox (varicella) vaccine
There is no upper age limit for this vaccine.
You should not get this vaccine if you:
How often do you need the shingles vaccine?
Two doses of RZV are required. Once you take the first dose, your physician will call you for the second dose after 2 to 6 months. The vaccine is an injection and will be injected intramuscularly into your shoulder. You must take two doses even if you have received the varicella vaccine or Zostavax (the other shingles vaccine), or have had chickenpox before.
If you have weakened immunity, you are at risk for shingles at younger ages. Your physician may give you the second dose of shingles vaccine a month after the first dose to build your protection faster. They may also do this if you are going to be immune-suppressed because of chemotherapy or an organ transplant.
The earlier vaccine, Zostavax, was a live virus vaccine, and you only needed one dose. That vaccine has not been available in the USA since November 2020.
Shingles vaccine efficacy
The recombinant zoster vaccine, Shingrix, is highly effective. It provides 90% protection against shingles to people 50 years and older who have healthy immune systems. This protection remains for at least 7 years.
People with weakened immune systems are also protected. The vaccine is 68% to 91% effective at preventing shingles in those cases. This protection is valuable since people with weakened immunity are likely to have more severe shingles.
Risks of the shingles vaccine
The currently used vaccine, Shingrix, is generally a safe product. Possible adverse effects, though, include pain, redness, and swelling at the injection site. Others include body aches, tiredness, headache, shivering, and fever.
Why only get the shingles vaccine over age 50?
Shingles is uncommon in young people with a healthy immune system. The risk of shingles and its complications increase sharply after age 50, though. Older adults are more likely to have PHN and other complications necessitating hospitalization. Some serious complications of shingles include pneumonia, encephalitis (brain inflammation), and eye involvement that may cause blindness.
Since people over 50 are the most frequently affected, the vaccine trials were performed on this group. It is estimated that one case of shingles can be prevented by vaccinating 11 to 17 people over 50. For people younger than 50, the benefits from this vaccine are much lesser. The vaccine has excellent efficacy at this age, though, and will prevent shingles in midlife and beyond.
RZV (Shingrix) is a safe and effective vaccine for the prevention of shingles. People who have had chickenpox can also get shingles (that includes almost everyone born before 1980). If you are over 50, you should get this vaccine to keep yourself safe from shingles and its complications. People below 50 should only get this vaccine if they have weakened immunity that puts them at a higher risk of getting shingles at a younger age.
American Family Physician: "Herpes Zoster and Postherpetic Neuralgia: Prevention and Management."
Centers for Disease Control and Prevention: "About the Vaccine," "Clinical Overview," "Complications of Shingles," "Shingles Vaccination."
Morbidity and Mortality Weekly Record (MMWR): "Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines," "Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged =19 Years: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022."
National Health Service: "Shingles."
National Health Service Inform: "Shingles."
Top Have to Be Over 50 to Get the Shingles Vaccine Related Articles
Can You Get Shingles After Being Vaccinated?Shingles is a viral infection. It presents with a rash followed by an episode of intense pain in the infected area. This is caused by the virus called varicella zoster. This virus also causes chickenpox. If a child has had chickenpox, the virus may not completely go away, lie dormant in the body and come back years later as shingles. Older individuals and immunocompromised individuals are more likely to develop shingles.
How Long Is Shingles Contagious?Shingles is contagious from the time the blisters are oozing until the time the blisters have scabbed.
How Much Does a Shingles Shot Usually Cost?Depending on your medical insurance plan, the full price for two doses of the shingles vaccine could cost around $324 or less.
Is Shingles Contagious?Shingles is an infection caused by the varicella-zoster virus. Shingles symptoms and signs include skin burning, numbness, and tingling along with a painful red, blistering rash. Shingles is contagious until all of the blisters have crusted over.
Shingles (Herpes Zoster)Shingles, or herpes zoster, is a painful rash caused by the varicella zoster virus. Other shingles symptoms include headache, fever, nausea, and body aches. Treatment focuses on pain management and shortening the duration of the illness with antiviral medications.
Shingles QuizShingles falls within a well-known family of viruses that cause itching, burning, blisters, and pain. Take the Shingles Quiz to get the facts, causes, symptoms, and treatments for this itchy, painful condition.
Shingles PicturesAn acute infection caused by the herpes zoster virus, the same virus as causes chickenpox. See a picture of Shingles and learn more about the health topic.
What Is the Main Cause of Shingles Rash? Signs, Symptoms, VaccineShingles occurs when the varicella-zoster virus, the same virus that causes chickenpox, re-emerges due to a weakened immune system. Tingling may occur before herpes zoster blisters appear, usually on the side of the body. The shingles vaccine can boost the immune system to lower the risk of shingles outbreaks.
Myths and Facts About ShinglesThere are some common misconceptions about this viral illness and the uncomfortable rash it can cause. Here's a guide through the myths and facts of shingles.
What Does a Shingles Rash Look Like at First?The typical shingles red rash or blisters occur after pain, itching, and tingling. They are usually limited to one side of the face and body.
What Triggers a Shingles Outbreak?Shingles occur when the varicella-zoster virus, the same virus responsible for chickenpox, reactivates in the body, usually due to a weakened immune system. Learn about the symptoms of shingles and how you can treat them. The difference between chickenpox and shingles is that the first time you get infected with the varicella virus, you get chickenpox. Shingles is a condition you can develop if you've already had chickenpox. Learn about the differences between chickenpox and shingles and how these two diseases are connected.
Who Cannot Get Shingrix Vaccine?You cannot get Shingrix if you currently have an infection, had the chickenpox vaccine, are pregnant, or allergic to Shingrix vaccine.
Who Is Eligible for the Shingles Vaccine?Shingles is a reactivation of the varicella-zoster virus. People eligible for the shingles vaccine include those over the age of 50 and people over the age of 19 who have a weakened immune system.
Why You Shouldn't Get the Shingles VaccineShingles activates when your immunity is low, usually with advancing age. But not everyone who is a candidate for the shingles vaccine should take it.