Shingles Prevention: Who Should Get the Vaccine?

In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine known as Zostavax is approved for use in adults ages 50 and over who have had chickenpox. The U.S. Centers for Disease Control and Prevention recommends the vaccine for people 60 years of age and over who have had chickenpox. It is a onetime injection (shot) that does not need to be repeated. The shingles vaccine contains a booster dose of the chickenpox vaccine usually given to children. Tests over an initial four-year period showed that the vaccine significantly reduced the incidence of shingles in these older adults. The single-dose vaccine was shown to be more than 60% effective in reducing shingles symptoms, and it reduced the incidence of postherpetic neuralgia (PHN, see above) by at least two-thirds. Studies are ongoing to evaluate the effectiveness of the vaccine over a longer term. Even if you already have had shingles, you can still have the vaccine to help prevent future outbreaks.

There are certain contraindications to receiving the shingles vaccine. People with weakened immune systems due to immune-suppressing medications, cancer treatment, HIV disease, or organ transplants should not receive the shingles vaccine because it contains live, weakened viral particles. Zostavax has been shown to be beneficial in people younger than 60 years of age (50-59). However, there is less of a cost benefit due to the lower incidence of shingles in this population, unless there is anticipation of upcoming immunosuppression. Pregnant women should not receive the shingles vaccine.

The shingles vaccine has not been shown to cause any serious side effects or health consequences. Minor side effects include redness, soreness, swelling, or itching at the shot site, and headache. It is safe for those who have received the shingles vaccine to be around babies or those with weakened immune systems. It has not been demonstrated that a person can develop chickenpox from getting the shingles vaccine, although some people who receive the vaccine may develop a mild chickenpox-like rash near the injection site. This rash should be kept covered and will disappear on its own.

Because the chickenpox vaccine is now recommended for children, the incidence of chickenpox has been reduced. This is also expected to reduce the incidence of shingles in adults in the future as these vaccinated children age.