When Should You Get Vaccinated Against Shingles
Most people should be vaccinated against shingles at ages 50 and over. People ages 18 and over who have health conditions or take medications that can weaken the immune system should consider getting the shingles vaccine before age 50.
For people receiving the vaccine at ages 50 and over, there is no particular time and no maximum age when you should be vaccinated.
Vaccination against shingles can be done on its own or alongside other vaccinations, like for the flu or pneumonia. Generally, the vaccine is given in two doses, with the second dose given 2 to 6 months after the first dose.
For people who are receiving the shingles vaccine because of an immune deficiency, the second dose can be given sooner: 1 to 2 months after the first dose.
In this case, if possible, shingles vaccination should be timed with your immune response. This could mean waiting until after a flare-up of your condition has subsided or getting the vaccine before you receive certain immune-suppressing medications.
7 years and remains effective afterward.
Speak with a doctor about how often you should be vaccinated for shingles based on your specific immune system and health concerns.
The shingles vaccine that is currently available in the United States was introduced in 2017, so you may have questions about it. Below are answers to some of the most common questions.
A Look Back At Varicella
Even though chickenpox and shingles are caused by the same virus, the conditions have different vaccines. The chickenpox vaccine made its debut in 1995, but a shingles vaccine didnt hit the market until about a decade later. The first shingles vaccine was Zostavax in 2006. However, this vaccine was taken off the market in 2020, following the release of another vaccine, called Shingrix, in 2017. The Centers for Disease Control and Prevention now recommends that anyone who received Zostavax be revaccinated with Shingrix.
Three groups of people absolutely should not receive the shingles vaccine. These are people who:
- currently have shingles
- previously had an allergic reaction to any components of the Shingrix vaccine
If you are pregnant or currently have shingles, its best to wait to get vaccinated until you are no longer pregnant or your shingles case clears up.
It may be difficult to know if you are allergic to any part of the vaccine, so speak with a doctor about any medication allergies you may have or previous reactions you experienced after vaccinations.
Most of the side effects of the shingles vaccine are limited and short-acting. Side effects usually appear in the first few days after your first or second dose of the vaccine and disappear within a few days.
Common side effects include things like:
- arm soreness or pain where the vaccine was injected
- swelling or redness at the injection site
Who Should Not Get Zostavax
Some people should not get shingles vaccine :
The Shingles Prevention Study involved individuals age 60 years and older and found that Zostavax significantly reduced disease in this age group. The vaccine is currently recommended for persons 60 years of age and older.
- A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine. Tell your doctor if you have any severe allergies.
- A person who has a weakened immune system because of:
- HIV/AIDS or another disease that affects the immune system,
- treatment with drugs that affect the immune system, such as steroids,
- cancer treatment such as radiation or chemotherapy, or
- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
This information was taken from the Shingles Vaccine Information Statement dated 10/06/2009.
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A Closer Look At The Safety Data
Both Shingrix and Zostavax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.
Shingrix
In 8 clinical trials of more than 10,000 participants:
- Grade 3 reactions were common after patients received Shingrix.
- About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling.
- About 1 out of 10 reported grade 3 systemic reactions such as myalgia , fatigue , headache, shivering, fever, and gastrointestinal illness.
- Most people who got Shingrix reported at least some pain at the injection site.
Zostavax
- A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. See Safety of zoster vaccine in elderly adults following documented herpes zoster.
Are There Any Restrictions After A Shingles Shot
You should not receive the shingles vaccine if you are pregnant, if you have an active shingles infection, or if you previously had an allergic reaction to any component of the vaccine. If youre eligible for the vaccine and receive the vaccination, there are no restrictions afterward and you can leave the doctors office or pharmacy as soon as the shot is complete.
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Mild Side Effects Of Shingles Vaccine:
- Redness, soreness, swelling, or itching at the site of the injection .
It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. There is no documentation of a person getting chickenpox from someone who has received the shingles vaccine .
Some people who get the shingles vaccine will develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.
Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems by CDC and FDA.
Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination. If you have a severe allergic reaction or other emergency that cant wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.
Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS website, or by calling 1-800-822-7967.
The shingles vaccine does not contain thimerosal .
This information was taken directly from the Shingles Vaccine Information Statement dated 10/06/2009.
For more information on possible side effects from vaccination, visit CDCs Possible Side Effects from Vaccines page.
Uncommon Rare And Very Rare Adverse Events
Uncommon adverse events occur in 0.1% to less than 1% of vaccinees. Rare and very rare adverse events occur, respectively, in 0.01% to less than 0.1% and less than 0.01% of vaccinees.
Both HZ vaccines are safe with serious adverse events reported very rarely in immunocompetent individuals.
Recurrence or exacerbation of herpes zoster ophthalmicus following LZV vaccination has been reported very rarely, involving several cases world-wide following LZV immunization. Following a causality assessment of seven cases of HZO which were temporally associated with the administration of LZV, NACI concluded that there was insufficient evidence to recommend for or against the administration of LZV in individuals with a history of HZO. More evidence is required for further assessment of risk related to HZO recurrence in LZV recipients. At this time, there is insufficient evidence to assess the risk related to HZO recurrence following RZV recipients.
See Contraindications and Precautions if considering vaccinating a person with previous HZO.
For more information, refer to Adverse Events Following Immunization in Part 2 and the product monograph in Health Canada’s Drug Product Database.
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What Are The Main Differences Between Shingrix And Zostavax
Shingrix is a recombinant, adjuvanted zoster vaccine that was first FDA-approved in 2017. It uses the varicella-zoster glycoprotein E antigen to produce an immune response in the body. An adjuvant, or added ingredient, helps boost the bodys immune response to the virus. Because Shingrix is an inactivated vaccine, it can be used in immunocompromised patients or those with a weakened immune system.
Shingrix is administered as an injection into the muscle . It is given in two separate doses with a period of two to six months in between. The second dose is necessary to ensure long-term effectiveness.
Zostavax, approved in 2006, is a live attenuated herpes zoster vaccine. In other words, Zostavax contains a weakened version of the actual virus to produce an immune response. For this reason, it is not recommended for those who are immunocompromised. Or else, the vaccine itself could cause an infection.
Zostavax is administered as a single injection underneath the skin . It comes in a frozen version and a refrigerator-stable version. The frozen version must be kept frozen during transport and storage to ensure its effectiveness while the refrigerator-stable Zostavax can be kept in a refrigerator until it needs to be used.
How Does The Shingles Vaccine Work
The vaccine recommended for most people is a live vaccine called Zostavax. It contains a weakened chickenpox virus . It’s similar, but not identical, to the chickenpox vaccine.
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
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Available Vaccines And Vaccination Campaigns
Since 2008, the U.S. Advisory Committee on Immunization Practices has recommended most Americans aged 60 and older get the shingles vaccine. A newer recommendation was issued in 2018 with the licensure of a new vaccine: .
In adults 50-69 years old, Shingrix reduces the risk of shingles by more than 96%. For those 70 and older, the vaccine is 91.3% effective at preventing shingles. It similarly reduces the risk of post-herpetic neuralgia. Modeling studies project that protection will wane to 0 by 19 years after immunization. Study of the expected duration of protection is ongoing.
The antigen in Shingrix is a surface protein of the varicella zoster virus produced by culturing genetically engineered Chinese hamster ovary cells. Vaccination consists of two doses of vaccine, given at months 0 and 2-6.
The older shingles vaccine is a live, attenuated vaccine. It was licensed in 2006. The generic name of the vaccine is Zoster Vaccine, Live . It is still available, although Shingrix is recommended over Zostavax because of its superior effectiveness and duration of protection.
People who have previously been vaccinated with Zostavax are recommended to vaccinate with Shingrix.
Most Medicare drug plans cover the cost of the shingle vaccine and its administration, minus any copayments, for people 65 and older. Most private insurance plans provide coverage for the vaccination for people 50 and older.
Simultaneous Administration With Other Vaccines
RZV and LZV may be administered concomitantly with other live vaccines given by the parenteral, oral, or intranasal routes. For concomitant parenteral injections, different injection sites and separate needles and syringes should be used.
In general, inactivated vaccines including RZV may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease.
LZV may be given at any time before or after live oral or intranasal vaccines. If two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.
Concomitant administration of pneumococcal 23-valent polysaccharide vaccine and LZV has not resulted in decreased efficacy and so the two vaccines can be given concomitantly.
For more information, refer to Timing of Vaccine Administration in Part 1.
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Do I Need To Pay For Shingles Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
When To See A Doctor For The Possible Side Effects Of A Shingle Vaccine
Most side effects of the shingles vaccine will resolve on their own within a few days of vaccination or can be treated with over-the-counter medications like acetaminophen or ibuprofen.
In the rare case that you develop a more serious reaction after vaccination, you should call a doctor or go to a health clinic.
Medical emergency
Its rare but possible to have a serious allergic reaction to a shingles vaccine. Call emergency services or go to the nearest emergency room if you experience the following symptoms after a vaccination:
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How Well Does Zostavax Work
Zostavax®, the shingles vaccine, reduced the risk of shingles by 51% and the risk of post-herpetic neuralgia by 67% based on a large study of more than 38,000 adults aged 60 years or older. Protection from shingles vaccine lasts about 5 years.
While the vaccine was most effective in people 60 through 69 years old, it also provides some protection for people 70 years old and older.
Adults vaccinated before age 60 years might not be protected later in life when the risk for shingles and its complications are greatest.
Does The Vaccine Work
In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England . This showed that the shingles vaccine was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia in this period. Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period.
In the early 2000s researchers carried out a very large study of Zostavax, the shingles vaccine used in the UK, involving over 38,000 adults aged 60 or older. The results showed that:
- In adults aged between 60 and 70, the vaccine reduced the number of cases of shingles by 51.3%
- In adults aged over 70, the vaccine reduced the number of cases of shingles by 38%
- The vaccine reduced the incidence of post-herpetic neuralgia by over 66% in all age groups
- For those who did get shingles, the vaccine reduced the severity of the disease.
Read the abstract of this study , published in 2005 by Oxman et al.
Adults aged 80 or over are not offered the shingles vaccine. This is because the effectiveness of the vaccine declines with age in older age groups.
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Who Is A Candidate For The Shingles Vaccine
Adults 50 years and older. Immunocompetent adults 50 years and older should get two doses of Shingrix, 2 to 6 months apart.
Adults 19 years and older with weakened immunity. Immunity could be reduced by diseases like HIV, leukemia, or lymphoma. The immunosuppressive medicines given with organ transplants, and chemotherapy for cancer, also weaken immunity. The vaccine is safe and effective in people with multiple myeloma and other blood cancers, solid organ cancer, people with HIV, and renal transplant recipients.
People who have had shingles. Unlike chickenpox, shingles can happen again. The shingles vaccine works well if you’ve had shingles before. You will have stronger immunity against further attacks of shingles.
People who took Zostavax. This shingles vaccine is no longer in use in the US. People who took it should take two doses of RZV.
Do your age or health situation make you eligible for the vaccine? Weighing the benefits and potential dangers will let you make the best decision for yourself.
Can I Get The Shingles Vaccine If I Am Under Age 50
Shingrix is not recommended for adults under age 50 who have a healthy immune system.
It is recommended for adults ages 19 or over who are immunocompromised, such as people with an immune-related health condition or who are receiving immunosuppressive agents, which are medications that reduce the bodys immune response. These medications may help prevent organ rejection after an organ transplant and treat other medical conditions.
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Why You Shouldn’t Get The Shingles Vaccine
- Medical Reviewer: Dany Paul Baby, MD
Medically Reviewed on 5/24/2022
Shingles is a disease that usually presents with a painful rash that affects one in three people in their lifetime. It is caused by the same virus that causes chickenpox the herpes virus varicella-zoster. More than 99% of people born before 1980 have had chickenpox and have this virus dormant in the brain or spinal cord.
Shingles activates when your immunity is low, usually with advancing age. The currently used recombinant zoster vaccine is safe and effective. But not everyone who is a candidate for the shingles vaccine should take it. Like all vaccines, the shingles vaccine has benefits and harms. You should know about both and make an informed decision about taking it.