Should You Get the Shingles Vaccine?
By: Andrea Romeo, RN BN
Updated October 2023
If you’ve heard of Shingles vaccines like Shingrix, you may be wondering if you need this vaccine. Or, you may be wondering if you should be concerned about shingles at all. For such a common condition, many people are confused about shingles and whether they are at risk.
The truth is, almost everyone is at risk. If you have ever had chickenpox or the chickenpox vaccine — you can get shingles. One in three people will be affected in their lifetime. Read on to find out more about why you should be concerned about shingles and whether the vaccine is right for you.
What is Shingles?
Shingles, also known as herpes zoster, is caused by the varicella zoster virus — the same virus that causes chicken pox. Once you have had chicken pox, or the chickenpox vaccine, the virus remains dormant (inactive) in your body for life. With normal aging, or if your immune system becomes weakened for any reason, the dormant virus can reactivate and cause shingles.
As the virus reactivates, it spreads along the nerve fibers that lead from your spinal cord to your skin. The first sign is often pain, itching or tingling of the skin along the nerve path. This is soon followed by a painful rash of tiny, red, fluid-filled blisters, usually on one side of the face or torso.
Some people believe that shingles is a disease of old age. It’s true that your chance of getting shingles increases as you age, but the number of cases is actually greatest among people in their 50s. Another common misconception is that only people with severely compromised immune systems, such as cancer patients, can get shingles. This is not necessarily true. While these individuals are at increased risk, and tend to get worse cases of shingles, over 90% of people who get shingles have normal immune systems.
It’s important to know that you can’t catch shingles from someone who has shingles. Shingles is only caused by the virus you already have becoming reactivated by factors in your immune system. The fluid in shingles blisters can, however, spread chickenpox to people who have not already had it. For this reason, pregnant women and people with no history of chickenpox should avoid contact with anyone who has shingles until the rash has healed.
How Serious Is Shingles?
There is a lot more to shingles than just a rash — ask anyone who’s had it. Because it affects the nerves that carry pain signals, shingles pain can be debilitating and last for months or even years after the rash has healed. Nerve pain is notoriously difficult to treat, even with strong opioid pain medications like morphine. The aftermath of shingles can greatly reduce your quality of life, causing sleep disturbances, depression, and in some cases — irreversible loss of independence.
As if that wasn’t bad enough, about 10–20% of shingles cases affect nerves on the face. This can spread to the eyes and cause permanent blindness and life-threatening stroke, although this is rare. Clearly, the consequences of shingles can be very serious and should not be taken lightly.
Who Should Get the Shingles Vaccine?
Anyone with a history of chickenpox, or who has had the chickenpox vaccine is at risk for shingles — that’s over 99% of the US population. Even if your immune system is healthy now, stressful life events or an unexpected illness can put you at risk.
Some people are more likely to get shingles than others. Women are twice as likely. People with a history of depression, asthma, kidney disease, diabetes, and chronic obstructive pulmonary disease (COPD) are also at a significantly higher risk. There are some recent studies showing that taking a statin medication can also be a risk factor for shingles.
People with autoimmune diseases like lupus, rheumatoid arthritis, and inflammatory bowel disease are also at high risk. It is recommended that people with these conditions get the shingles vaccine before starting any therapy that suppresses the immune system to make sure the body has time to build up immunity from the vaccine.
The CDC recommends two doses of Shingrix for adults 50 years and older. Shingrix is also recommended for adults 18 years and over with weakened immune systems due to disease or therapy. You should get the shingles vaccine even if you have had the chickenpox vaccine, and even if you have had shingles in the past, because, unlike chickenpox, shingles can recur.
Who Should Not Get the Shingles Vaccine?
Most people are eligible to receive Shingrix. The only people who should not get the shingles vaccine are:
- People who have had a severe allergic reaction to any component of the vaccine
- People who currently have shingles
- People who are currently pregnant — they should wait to get the vaccine
The vast majority of people in the US and Canada have been exposed to chickenpox, even if they don’t remember. If you suspect you have not, a blood test can be done to determine whether you have a history of chickenpox. In the rare case that an adult over 50 is not immune to chickenpox, they should be vaccinated for chickenpox, not shingles.
If you have an immune disease like cancer or HIV, or are taking immunosuppressant medication like chemotherapy, you should talk to your doctor before getting any vaccine, including Shingrix.
Facts About the Shingles Vaccine
The Shingles vaccine is safe and effective. Shingrix was approved by the FDA in 2021 for adults over 18 years and is currently recommended by the CDC. Studies have shown it is more than 90% effective at preventing shingles and immunity stays strong for at least 7 years after vaccination. In adults with weakened immune systems, the vaccine is 68–91% effective in preventing shingles, depending on the condition that affects the immune system.
Side effects are mild with injection site reactions (pain, redness, swelling), body aches and fatigue being the most frequent adverse events. And unlike the pain of shingles, these side-effects are short-lived.
Talk to Your Prescriber
Shingles can be a devastating disease with potentially life-altering complications. It’s also very preventable. For the vast majority of people, the risk of getting shingles can be almost completely eliminated with a safe and effective vaccine. Talk to your doctor or prescriber about the shingles vaccine, and if you have relatives over 50 — encourage them to do the same. There is no reason to let shingles impact your quality of life.
Andrea Romeo is a freelance health writer with a Bachelor’s Degree in nursing. Based in Manitoba, Canada, she has over 20 years of experience in various areas of nursing including Emergency and Intensive Care, and has worked as a clinical instructor for nursing students. You can find her website at: www.aromeowrites.com
DISCLAIMER: THIS ARTICLE DOES NOT PROVIDE MEDICAL ADVICE
The information, including but not limited to, text, graphics, images and other material contained in this article are for informational purposes only and are not intended to be a substitute for professional medical advice.. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this article.
Author Statement: The author has no affiliation with any drug or vaccine producer and has no conflicts of interest to declare for this work.
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References:
Centers for Disease Control and Prevention (2022). Shingles (herpes zoster). https://www.cdc.gov/shingles/index.html
Cohen, E. J., & Jeng, B. H. (2021). Herpes Zoster: A Brief Definitive Review. Cornea, 40(8), 943–949. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249351
Harbecke, R., Cohen, J. I., & Oxman, M. N. (2021). Herpes Zoster Vaccines. The Journal of infectious diseases, 224(12 Suppl 2), S429–S442. https://doi.org/10.1093/infdis/jiab387
