Shingles Prevention

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It's important to do all you can to prevent shingles. Your strategy will depend on your age and stage of life. If you're an older adult who had chickenpox as a child, the only way to avoid getting shingles is to get the vaccine, which is approved for people 50 and older. Stress can trigger the dormant varicella virus to become active, so for people who do not get the vaccine avoiding stress can be an important approach to keeping the virus under wraps.

If you're under 50 and have never had chickenpox, talk to your doctor about getting the chickenpox vaccine. At the very least, steer clear of anyone who you know to be ill with chickenpox—even if it's your favorite niece or nephew. You won't get shingles from someone who has chickenpox, but you may become infected with the virus.

Finally, if you're a parent, you have it in your power to protect your kids from getting shingles later in life—and from getting chickenpox while young—by having them vaccinated against the varicella virus as part of their routine childhood vaccinations.

Chickenpox often is relatively mild in children, typically involving a week's worth of mild fever, general fatigue, and an itchy rash that can be fairly easily soothed. But these symptoms can be more severe if you're not infected until you're an adult. And a flare-up of varicella that causes shingles is an entirely different experience that includes extreme pain in a localized area of the body and an unsightly rash that can last for two to four weeks or longer. After the rash heals, there can be a range of long-term complications from shingles ranging from an excruciating condition called postherpetic neuralgia (PHN) to skin or brain infections to permanent eye damage if the virus affects the face.

Avoidance

If you have not had chickenpox or its vaccine, you should steer clear of someone who has shingles. While you don't risk getting shingles itself, which cannot be spread through contact with the rash, you can come down with chickenpox.

This is true for adults and children; remember that the virus can "hide" in the nervous system for years, even decades, and reactivate, meaning a child could contract the virus at a young age and only develop shingles as an adult. This advice holds true for children who haven't yet received the varicella vaccine, too.

The Centers for Disease Control and Prevention (CDC) recommends that children get the first dose of chickenpox vaccine, which is part of the regular schedule of childhood vaccinations, at 12 to 15 months, and the second shot between 4 and 6 years. Unvaccinated teens and adults also are advised to get two doses of the varicella vaccine, four to six weeks apart.

Remember, the virus that causes chickenpox moves in for good once it infects the body, so by allowing it in, you put yourself at risk of shingles at some point in your life. This is why exposing children to chickenpox so they can "get it over with" rather than have them vaccinated is such a risky idea. The chickenpox vaccine is perfectly safe—and certainly safer than shingles.

Vaccination

There are two vaccines for shingles. One, called Zostavax (zoster vaccine live), was licensed by the U.S. Food and Drug Administration (FDA) in 2006. The other shingles vaccine, Shingrix (zoster vaccine—recombinant, adjuvanted) debuted in 2017. Both vaccines also protect against PHN and typically are covered by health insurance or Medicare. However, for a variety of reasons Shingrix is regarded by the CDC as preferable to Zostavax for most people.

Here's how the two vaccines compare:

  • Type of vaccine: Zostavax is a live attenuated virus, meaning it contains a weakened version of live varicella to stimulate the immune system to produce antibodies against the virus. Shingrix, on the other hand, is a non-live vaccine known that are made from a part of the virus. This makes it safer for people with immune-system weakness. 
  • The number of doses: Zostavax is a one-shot vaccine; Shingrix is given in two doses, two to six months apart.
  • Effectiveness: The CDC says that Zostavax reduces the risk of shingles by 51 percent and lowers the risk of PHN by 67 percent. Shingrix, on the other hand, provides considerably more protection: Two doses are more than 90 percent effective at preventing shingles and PHN. What's more, for at least four years after receiving Shingrix, protection against both conditions stays above 85 percent. 
  • Recommended age for vaccination: Zostavax is recommended by the CDC for people 60 and older, but the agency does not have a recommendation for people between 50 and 59. This is because the vaccine provides protection for only about five years, so getting it before age 60 can put a person at risk of no longer being protected when the risk of shingles is highest. Shingrix, on the other hand, provides adequate protection against shingles and PHN starting at age 50. 
  • Side effects: Both shingles vaccines are safe, though they have side effects—redness, soreness, swelling, or itching of the skin where the shot was given, in particular. Some people may also experience muscle pain, headache, fatigue, shivering, low-grade fever, or an upset stomach after receiving either vaccine. Both carry a very low risk of triggering a severe allergic reaction, which would involve symptoms such as hives, swelling of the throat, difficulty breathing, a racing heart, dizziness, and weakness that require immediate attention from a doctor. 

Stress Relief

There's evidence the varicella virus sometimes re-emerges in response to stress or some sort of emotional upheaval. While there's little you can do to prevent the unexpected negative turns life can throw at you, such as the loss of a job or a loved one's severe illness, there are plenty of strategies for protecting yourself from general stress and anxiety. 

The obvious ones are general lifestyle habits that can help you stay strong and healthy both physically and mentally. These include sticking to a nutrient-rich diet; including plenty of movement throughout your day and getting adequate sleep. If you smoke, kicking the habit will most certainly shore up your overall health. The same is true if you drink alcohol excessively. 

Most important to keeping the varicella virus from waking up is managing stress. There are lots of proven ways to do this, which means there are plenty of options to try until you find the strategies that offer the most calming benefits to you. Yoga, meditation, a hobby or other activity that you find relaxing are just a few of the possibilities.

Tai Chi may be especially helpful. There's preliminary evidence that this gentle form of exercise, which began as a martial art in China, may improve immune function and health in older adults at risk for shingles. In a 2003 study, for example, 36 men and women age 60 and over did three 45-minute Tai Chi classes per week for 15 weeks. At the end of this time, they had an increase in immunity to the varicella-zoster virus. A control group that did not do Tai Chi did not have a bump in VZV immunity.

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