Should You Get the Shingles Vaccine?

The Centers for Disease Control and Prevention (CDC) recommends that healthy adults ages 50 and older get two doses of the shingles vaccine (Shingrix). The shingles vaccine can prevent both shingles and related complications.

This article will discuss the shingles vaccine, including frequency, effectiveness, side effects, and cost.

Shingles Facts

Shingles is a painful skin rash caused by the reactivation of the virus that causes chicken pox. If you have shingles, you can spread the varicella-zoster virus to others who have never had the infection or didn't get the chicken pox vaccine. 

Anyone who has ever had chicken pox is at risk for developing shingles. The virus that causes both diseases remains dormant in the nerve cells and can eventually be reactivated. Many people who had chicken pox as children don’t know they contracted it.

Prevalence

According to the CDC, nearly 1 in 3 people in the United States will develop shingles in their lifetime. About 1 million people in the United States get shingles every year. About 1%–4% of people who get shingles will need to be hospitalized.

Symptoms

The first symptoms of shingles are tingling and itching sensations on the skin, as well as stabbing, burning pains. 

Several days later, a painful rash develops—typically in a band on one side of the waistline, torso, face, or other parts of the body. After developing into a patch of fluid-filled blisters, the rash usually crusts over and dries out.

Other shingles symptoms may include:

• Chills
• Fever
• Nausea
• Headache

For most people, the symptoms of shingles resolve within two to four weeks. For others, the intense, burning pain in the area of the rash may continue for weeks, months, or even years. This condition, known as postherpetic neuralgia (PHN), is the most common complication of shingles. About 10%–13% of people 60 years or older with shingles develop PHN.

Other potential shingles complications include: 

• Vision problems, including blindness
• Hearing problems
• Pneumonia (inflammation of the lungs)
• Encephalitis (brain inflammation)
• Death, although very rarely

Risk Factors

Anyone who has ever had chicken pox can develop shingles. However, it’s most common in adults over age 50. 

According to the National Institute on Aging, about half of all shingles cases in the United States are in adults 60 and older. Older adults are also significantly more likely to be hospitalized for shingles-related complications. 

Anything that weakens the immune system and the body’s ability to fight infections is a risk factor for developing shingles. These may include:

• Stress
• Other illnesses, such as colds or flu
• Human immunodeficiency virus (HIV)
• Cancer, especially lymphoma or leukemia
• Using certain medications, such as chemotherapy drugs or steroids like prednisone
• Having an organ transplant

Shingles Vaccine (Shingrix)

Shingrix is recommended for all adults age 50 and older to prevent shingles. It is also recommended for people ages 19 and over who have or will have a weakened immune system due to disease or therapy. Shingrix, or the recombinant zoster vaccine (RZV), is delivered via injection, usually in the upper arm.

The CDC recommends that you get Shingrix even if you’ve had shingles before or if you’re not sure if you had chicken pox in the past.

Frequency

Adults age 50 and older should get two doses of the shingles vaccine, separated by an interval of two to six months. If you recently had shingles, you should wait to make sure the rash has fully resolved before getting the vaccine.

People ages 19 and over who have or will have a weakened immune system due to disease or therapy, the doses can be given just one to two months apart.

Booster shots have not been approved for the Shingrix vaccine, so after receiving the two doses, your vaccination is complete.

Efficacy

Shingrix is highly effective in preventing both shingles and shingles-related complications, such as hospitalization and PHN. 

Two doses of the Shingrix vaccine prevents shingles and PHN approximately 90% of the time, and the protection stays strong for at least seven years. In adults who have weakened immune systems, the vaccine can be less effective, in the range of 68%–91%, depending on their underlying condition.

Zostavax, a single-shot live-virus shingles vaccine, was less effective and only reduced shingles by 51% and the risk of postherpetic neuralgia by 67% in people ages 60 and over. It was discontinued in 2020.

Cost

The cost of RZV varies widely, depending on whether you use Medicare, Medicaid, or a private health insurance plan. 

Some insurers (such as Medicare Part D plans) cover the vaccine, but you may still have a copay. However, most patients pay less than $50 out of pocket for the shingles vaccine. Around 90% of patients with private insurance plans pay less than $5 for each dose of Shingrix.

Side Effects

Shingrix has been shown to be safe and effective. However, some people may experience side effects from the shingles vaccine, including:

• Soreness, redness, or swelling at the site of injection
• Fatigue
• Muscle pain
• Headache
• Fever
• Nausea
• Stomach pain
• Shivering

Due to a stronger immune response, younger people are more likely to experience side effects after the shingles vaccine. Some people have side effects that interfere with their daily activities. Most of these symptoms resolve on their own within two to three days.

In very rare cases, RZV may cause a serious allergic reaction. Seek urgent medical help if you have any of the following symptoms of an allergic reaction:

• Hives (itchy, raised welts)
• Swelling, especially in the face or throat
• Dizziness
• Muscle weakness
• Difficulty breathing
• Rapid heart rate

These symptoms usually appear just minutes or hours after vaccination.

Who Should Not Get the Vaccine

Shingrix is safe and effective for most adults. There is no upper age limit for the vaccine. However, you should not get the shingles vaccine if you:

• Are pregnant
• Currently have shingles
• Have had a severe allergic reaction to Shingrix or any of its ingredients in the past
• Have a moderate or severe illness

Talk to Your Healthcare Provider

Talk to your doctor about whether or not you should receive RZV or if you should get it on an altered vaccine schedule if you:

• Have recently had or are soon going to have an organ transplant or stem cell transplant
• Are taking immunosuppressive medications or chemotherapy drugs
• Have cancer
• Have an autoimmune or inflammatory disorder
• Have HIV

Summary

Shingles is a painful skin rash that can cause intense itching and burning sensations. It is caused by a reactivation of the varicella-zoster virus (VZV), which also causes chicken pox. Anyone who has had chicken pox can get shingles later in life.

People who are over age 50 or who are immunocompromised are especially at risk of developing shingles. The most common shingles complication is postherpetic neuralgia (PHN), which causes intense, ongoing pain in the area of the rash.

The shingles vaccine, Shingrix, is safe and highly effective in preventing both shingles and PHN. The CDC recommends that all healthy adults ages 50 and older get two doses of the shingles vaccine, separated by two to six months. 

Side effects from the shingles vaccine can include pain and redness at the injection site, as well as muscle pain, headache, nausea, stomach pain, shivering, fatigue, and fever. Allergic reactions to Shingrix are very rare.

People who currently have shingles, are pregnant, have ever had an allergic reaction to the vaccine, or currently have a moderate to severe illness should not get the vaccine. 

A Word From Verywell

The shingles vaccine is safe and effective in preventing both shingles and related complications, such as PHN. Talk to your healthcare provider about getting the shingles vaccine, especially if you are 50 years old or over or are immunocompromised.