Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
Can Shingles Be Prevented
Shingles can be prevented. Vaccine is available against varicella zoster virus to prevent chickenpox and shingles. According to the CDC , children are routinely recommended to take two doses of the vaccine, the first dose at the age of 12-15 months and the second between 4-6 years.
Two doses of the vaccine are recommended in children and adults who have never had chickenpox. One dose of the vaccine prevents 95% of moderate disease and 100% of severe disease. Two doses of the vaccine are more effective. It is not known how long the vaccine is effective, but studies have shown that the vaccine provides protection against the varicella zoster virus for 10-20 years following vaccination.
Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
Who Should Not Have The Shingles Vaccine
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
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How Is Chickenpox Treated
Specific treatment for chickenpox will be determined by your healthcare provider based on:
- Your overall health and medical history
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Treatment for chickenpox may include:
- Acetaminophen . Children with chickenpox should NEVER be given aspirin.
- Antiviral drugs
- Drinking plenty of fluids
- Cool baths with baking soda
Children should not scratch the blisters because it could lead to secondary bacterial infections. Keep fingernails short to decrease the likelihood of scratching.
Shingles Can Strike Twice Will The Shingles Vaccine Help
No one who has experienced the burning, stabbing, painful misery of shingles wants to think about it again. But they should. Why? Because shingles can strike twice, or rarely, even a third time. A shingles vaccine can reduce the chances of a recurrence.
Theres some disagreement about how often recurrence occurs. In one study, researchers examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of these patients were treated for a second episode within an average of eight years. Thats about as likely as getting shingles in the first place if youre age 60 or older. Other studies have shown the recurrence rate to be much lower.
But the bottom line is the same: having shingles once doesnt protect you from ever having it again.
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Can You Get Shingles More Than Once
Unfortunately, it is possible to get shingles twice .
In fact, of everyone who experiences shingles, people who have weakened immune systems or are over the age of 50 years are more likely to contract the virus than others. Additionally, the longer you experience severe pain after shingles , the higher your chances of a shingles recurrence.
Interestingly, if shingles comes back, it may recur on another side of your body. Suppose the rash first appeared on the left side of your torso, for example. In that case, its likely to come back on the right side, Nidhi Ghildayal, PhD, research associate specializing in environmental health at the Harvard T.H. Chan School of Public Health in Boston, told Health.
The reason for this is that once youve had chickenpox, the virus remains alive in your nerves, explained Dr. Ghildayal. When the virus reactivates, the infected nerves become inflamed.
The skin those nerves reach also becomes inflamed, noted Dr. Ghildayal. Those rashes are most likely on the torso or chest but can also occur on your arms, head, face, eyes, or ears. A rash on one of those places might be the first sign that you should seek help from a healthcare provider.
The good news: Its uncommon to get shingles again within three years since your immune system is more prepared for the virus. But the reason shingles can recur is apparent.
After the episode, the virus becomes inactive inside your nerves but is able to reactivate in the future, explained Dr. Ghildayal.
Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
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What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
Who Can Have The Shingles Vaccination
Shingles vaccination is available to everyone aged 70 to 79.
When you’re eligible, you can have the shingles vaccination at any time of year.
The shingles vaccine is not available on the NHS to anyone aged 80 or over because it seems to be less effective in this age group.
Read more about who can have the shingles vaccine.
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Vaccinate To Decrease Your Shingles Risk
Your chances of getting shingles increase as you get older. The U.S. Centers for Disease Control and Prevention recommends that adults age 50 and older get vaccinated against shingles.
Two vaccines, recombinant zoster vaccine and zoster vaccine live are available in the United States to prevent shingles. Shingrix is the preferred vaccine.
The CDC recommends Shingrix for adults 50 years and older, whether or not they have already had shingles or previously received the Zostavaxvaccine, which has been used since 2006. You should get two doses of Shingrix, two to six months apart. Two doses of Shingrix are more than 90% effective at preventing shingles. Shingrix is also 90% effective in helping to prevent PHN in those who get shingles despite being vaccinated.
While Zostavax is still available, studies show it is less effective than Shingrix.Zostavax may be used in some healthy adults 60 years and older, for example, in those who are allergic to Shingrix.
There is no specific time that you must wait after having shingles before receiving the shingles vaccine. But its probably best to hold off until the shingles rash has disappeared before getting vaccinated.
About the Author
Urmila Parlikar, Associate Director, Digital Health Products at Harvard Health Publishing
What Are The Symptoms Of Chickenpox
Symptoms are usually mild in children. But symptoms may be life-threatening to adults and people of any age with weak immune systems. However, each person may experience symptoms differently. Symptoms may include:
- Fatigue and irritability one to two days before the rash begins
- Itchy rash on the trunk, face, scalp, under the armpits, on the upper arms and legs, and inside the mouth. The rash appears in several crops. It starts as flat red spots and progresses to raised red bumps that then become blisters.
The initial symptoms of chickenpox may resemble other infections. Once the skin rash and blisters happen, it is usually obvious to a healthcare provider that it is chickenpox. If a person who has been vaccinated against the disease is exposed, he or she may get a milder illness with less severe rash and mild or no fever. Always talk with your healthcare provider for a diagnosis.
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How Does Shingles Rash Appear
The typical red shingles rash and blisters follow pain, itching and tingling. The rash is usually limited to one side of the face and body.
Shingles on the face, scalp, mouth and ear
- Rash and shingles blisters appear on one side of the face, extending to the scalp and ear.
- If the rash involves the ear, it can lead to hearing loss, imbalance and weakness of the facial muscles.
- Shingles rash on the scalp causes pain while combing and bald patches.
- Shingles can occur in the mouth, which is usually very painful, causing pain while eating and change in taste.
Shingles of the eye and forehead
- Rash and blisters appear around the eye, over the eyelids, once side of the forehead, extending to the tip of the nose.
- Patients complain of burning or throbbing in the eye, with watering of eyes, swelling and blurred vision.
- The pain may be present after the rash disappears due to nerve damage, but improves eventually. Without treatment, shingles of the eye and forehead can lead to corneal damage and vision loss.
Shingles on the waist and back
- Rashes and blistering appear over one side of the waist and the back in a stripe pattern, extending up to the lower back.
Shingles on the buttocks
- Shingles rash and blisters over the buttocks, usually on one side.
Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- Youve had shingles already.
- Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
- You dont know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.
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What Are The Complications Of Chickenpox
Complications can happen from chickenpox. They are more common in adults and people with weak immune systems. Complications may include:
- Secondary bacterial infections
- Cerebellar ataxia
- Transverse myelitis
- Reye syndrome. This is a serious condition marked by a group of symptoms that may affect all major systems or organs. Do not give aspirin to children with chickenpox. It increases the risk for Reye syndrome.
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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What Is The Outlook For People With Recurring Shingles
Shingles usually clears up within two to six weeks.
In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia . Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.
Recurring shingles isnt preventable. You can reduce your risk by getting the shingles vaccine, even after youve had shingles.
A showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.
People who received the shingles vaccine generally had less severe cases of shingles. They also had
Know Your Risk Of Getting Shingles And Complications
About 1 out of every 3 people in the United States will develop shingles during their lifetime.
If youve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they dont remember it.
Your risk of getting shingles and having serious complications increases as you get older.
About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.
Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.
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Know The Benefits And The Side Effects
Shingrix is more than 90% effective at preventing shingles and long-term nerve pain. You may experience some short-term side effects because Shingrix causes a strong response in your immune system.
After getting Shingrix:
- Most people had a sore arm.
- Many people had redness and swelling where they got the shot .
- Many felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea.
About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities like yardwork or swimming. Side effects usually go away after 2 to 3 days. Remember that the pain from shingles can last a lifetime, and these side effects should only last a few days.
Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
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When Should I See My Doctor
See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.
See your doctor straight away if you have symptoms of shingles and are experiencing the following:
- symptoms that affect your eye area
- a temperature of 38°C or higher
You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.