What Shingles Vaccines Are Available
According to the Centers for Disease Control and Prevention , there are 2 vaccines licensed and recommended to prevent shingles in the U.S.: Shingrix and Zostavax.2 The CDC recommends that healthy adults 50 years and older get 2 doses of Shingrix, separated by 2 to 6 months, to prevent shingles and the complications from the disease.3
What Are The Health Complications
The most common complication of shingles is postherpetic neuralgia . PHN causes severe pain even after the shingles rash clears.
People aged 60 years and older who dont seek treatment for shingles are more likely to develop PHN.
Shingles can also cause serious sight problems if it infects the structures of the eye.
Other rare complications include:
First Signs And Symptoms Of Shingles
Among the systemic symptoms that may appear in the first few days of the prodromal stage of shingles are:
- Pain in a specific, localized area of the body
- Sensitivity to light
The most telling first symptom of shingles typically is the pain. Often excruciating, the discomfort has been described as burning, stinging, tingly, prickly, itchy, numbing, achy, or shooting. It can be persistent or intermittent, but will always be limited to one side of the body.
Because the pain from shingles is localized, it can be mistaken for other conditions depending on where it’s focused.
For example, a stabbing or persistent pain on one side of the lower back may mistakenly be attributed to sciatica or a kidney problem. Shingles pain around the lips could suggest a cold sore coming on, while pain focused on the eye or ear might seem like the start of a migraine.
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Is There A Vaccine For Shingles
There are two shingles vaccines currently available, Shingrix and Zostavax. Shingrix vaccine, a newer vaccine, is preferred over Zostavax for the prevention of shingles and its complications. Two doses of Shingrix given 2 to 6 months apart are recommended for healthy adults 50 years of age and older. Shingrix is also recommended for adults who have previously received Zostavax. A single dose of Zostavax may still be used to prevent shingles in certain cases for healthy adults 60 years and older.
Urgent Advice: Get Advice From 111 As Soon As You Suspect Shingles
You might need medicine to help speed up your recovery and avoid longer-lasting problems.
This works best if taken within 3 days of your symptoms starting.
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or .
Get an urgent GP appointment
A GP may be able to treat you.
Ask your GP surgery for an urgent appointment.
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Shingles Symptoms Before Rash
Shingles develops in two stages. The first is called the prodromal period.
Shingles is a reactivation of the varicella virus, which is what causes chickenpox. After an initial infection, the virus lays dormant in the body. Once reactivated, which can happen years down the line, shingles results.
Often, the earliest signs this is occurring are similar to what you’d expect at the start of any infection. These symptoms sometimes occur at times when you’re feeling stressed or run down. They are also systemic, meaning they affect the whole body.
You may assume you’re just overtired or coming down with a cold when you actually have shingles.
The Stages Of Shingles Recovery
After the rash develops, which usually appears on only one side of the body, it forms blisters. You may feel like you have the flu or a mild fever. As you recover, you will typically go through these stages:
- Blisters begin to burst or weep about 5 days after they develop, and lasts from 7 to 10 days. You should take time off from work and other activities during this period, because you can spread the virus to others through the fluid in the blisters. Otherwise, you can return to work when you feel comfortable doing so.
- The blisters will scab over and begin to heal, which takes from 1 to 3 weeks, unless the rash is on your scalp in which case it can take several months.
- As they heal, the blisters become smaller and less painful, generally over a period of 3 to 5 weeks.
- About 10 to 15% of people with shingles will develop chronic nerve pain, which can be severe. Sensitivity to touch at the site of the rash is possible. The older you are, the more likely it is you will develop this disorder, called post-herpetic neuralgia, or PHN. The pain often lessens over time. Available treatments include anti-inflammatory injections, nerve blocks, certain tricyclic antidepressants, or capsaicin cream, which is made from chili peppers and can help ease nerve pain.
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Causes And Risk Factors Of Shingles
The varicella-zoster virus the virus that causes chicken pox and shingles is part of a group of viruses called herpes viruses. This group also includes the viruses that cause cold sores and genital herpes.
But the varicella-zoster virus is not the same virus that causes cold sores and genital herpes. The viruses that cause oral and genital herpes are herpes simplex 1 and herpes simplex 2.
If youve had chicken pox, you can get shingles. After the chicken pox is over, varicella-zoster lies inactive, mainly in spinal or cranial nerves. Sometimes the virus reactivates, and thats when it travels along the nerves to erupt as a rash on your skin, causing shingles.
Do You Need To Stay Away From Children People Who Are Pregnant Have Cancer Or Anyone With A Weak Immune System After You Get The Zostavax Vaccine
According to the CDC, its safe to be around babies and young children, pregnant women or anyone with a weakened immune system after you get the Zostavax vaccine. Even though the Zostavax vaccine contains a weakened live varicella-zoster virus, the CDC says theres no documented case of a person getting chickenpox from someone who has received the Zostavax vaccine. And remember: You cant get shingles unless youve already had chickenpox.
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Will Shingles Go Away Without Treatment
Shingles, or herpes zoster, is a painful rash caused by the varicella-zoster virus . This is the same virus that causes chickenpox.
This virus remains dormant in a part of your nervous system called the dorsal root ganglion. It can be reactivated during times of stress or illness, or when the immune system is weakened by an autoimmune disease or cancer.
The risk of developing shingles is relatively low for healthy young adults about 4 out of 1,000 people in the United States, according to the Centers for Disease Control and Prevention . Its much higher for those above age 60. Shingles affects about 1 out of 100 people in this older age group, the CDC says.
Generally, a case of shingles rash resolves within 3 to 4 weeks. It can resolve without treatment, but antiviral treatment can shorten both the duration and severity of the rash.
How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
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If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles
No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.
Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.
Is Shingles Vaccine Safe And Effective For People With Diabetes
Yes, the shingles vaccine is safe and effective for people with diabetes. Vaccines must pass rigorous development and testing procedures to demonstrate their safety for authorized use in the United States.
The Centers for Disease Control and Prevention recommends that adults age 50 and over get two doses of Shingrix as prescribed to help prevent shingles and its complications. The Advisory Committee on Immunization Practices specifically notes people with type 1 and type 2 diabetes should receive the Shingrix vaccine.
People 19 and older who are immunocompromised should also get the vaccine. This may include people living with diabetes. If you are younger than 50, talk with a healthcare provider about whether you should get the shingles vaccine.
In healthy people over age 50, the shingles vaccine is more than 90% effective at preventing shingles and postherpetic neuralgia. In immunocompromised individuals, a 2022 study found that Shingrix had a 64.1% effectiveness rate at preventing shingles.
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What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles.
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
Is Shingles Airborne
The varicella-zoster virus that causes shingles is not airborne. It cant be spread if someone with shingles coughs or sneezes near you or shares your drinking glass or eating utensils.
The only way the virus is contagious is if you come into direct contact with an oozing blister of someone who has shingles. You wont get shingles, but you may develop chickenpox if youve never had it before.
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How Does It Occur
If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.
What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.
When Should I Seek Emergency Care For A Shingles Rash
While most cases of shingles are mild, several potential complications may require emergent care:
- Facial rash. A shingles rash on the face is concerning because eye involvement can lead to blindness. This requires an urgent assessment from an ophthalmologist.
- Loss of hearing or facial movement. Rarely, shingles can lead to hearing loss or facial nerve paralysis.
- Disseminated herpes zoster. This widespread shingles rash can also affect your organs. It requires hospitalization with intravenous antiviral treatment.
- Fever. Shingles in addition to fever can be concerning. It may mean you have a superimposed bacterial infection, which could require antibiotics and close observation.
- Confusion or seizures. Shingles in addition to confusion or seizures could indicate brain inflammation, which requires hospitalization for IV antiviral treatment and close monitoring.
Dr. Megan Soliman is an ABMS board certified internal medicine physician whose main focus in her clinical practice is patient advocacy. Her research interests include adverse effects of medications and herbal supplements. Soliman is enthusiastic about bread and butter medicine, which includes treating patients with the most common diseases. She also has a passion for reaching underserved communities, including both U.S. and international rural communities.
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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.
Whos Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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Facial Pain And Eye Damage
Between 10% and 15% of the time, shingles affects the trigeminal gangliona triple-branched nerve that provides sensation to structures in the face. The medical term for head or facial pain due to shingles is “painful trigeminal neuropathy attributed to herpes zoster.”
Specifically, the trigeminal ganglion involves the eye the cheek and the mandibular branch . Of these, the ophthalmic branch is the one most commonly affected by herpes zoster.
According to the American Academy of Ophthalmology , 25% of the 300,000 to 500,000 cases of shingles that occur each year are herpes zoster ophthalmicus .
HZO can affect any part of the eye, from the optic nerve to the conjunctiva . Without antiviral treatment, almost half of people who have shingles near the eye will experience eye damage or even lose an eye, so it’s vital to see an ophthalmologist immediately.
Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
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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.
How Long Does A Shingles Outbreak Last
It can take three to five weeks from the time you begin to feel symptoms until the rash totally disappears.
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The Link Between Crohns Disease And Shingles
If you’ve never had chicken pox, as a child or as an adult, and you’re exposed to the virus let’s say you touch someone at the contagious, blister stage of shingles transmission could occur and you’d get chicken pox.
If you haven’t had chicken pox, you can’t get shingles. But someone who has never had chicken pox or been vaccinated for it can contract chicken pox through close contact with someone who has shingles.