What's Important to Know About the Shingles Vaccine?

Staff WriterLast Updated Jun 24, 2020 7:00:45 PM ET
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Shingles is a condition that you can develop if you’ve had chickenpox before. In recent years, pharmaceutical companies have formulated vaccines for shingles that can help you avoid coming down with this painful rash. Learn more about these vaccines, including how they work and whom they're for, to determine whether they may be an appropriate preventative treatment for you to get.

What Is Shingles?

Did you have chickenpox as a child? If so, you have the varicella-zoster virus in your body. Once your case of chickenpox ran its course, your body likely built up an immunity to the virus keep you from getting this illness again. However, the virus remained in your system, but it went dormant, staying in nerves near your brain and spine. Sometimes, the virus can re-activate due to stress or your immune system weakening as you age. When this happens, instead of reappearing as chickenpox, the virus appears in a much more painful form called shingles. If you haven’t had chickenpox before, you cannot develop shingles.

While chickenpox causes itchy red welts to appear all over your body and usually creates flu-like symptoms, shingles is a little different. Shingles begins with nerve-related pain and sensations that include itching, burning and tingling as the virus travels down your nerves to reach your skin. It can also cause numbness or sharp, shooting pains. These sensations may last for a few days or about a week before shingles erupts on your skin as a spreading, red rash.

Although there’s a chance that you may not develop the rash, if it does appear, it’ll likely show up on just one side of your body — usually on your torso, shoulder, scalp or face, but not all over your body like chickenpox welts. The shingles rash can also move into one of your eyes. As the red rash grows, it begins forming clusters of fluid-filled blisters in addition to the intense, shooting pain that’s typical of this disease. After a few days in this stage, the blisters pop and scab over. The pain may continue until the rash fades and can sometimes linger for months or years afterwards. When this happens, it's a condition called postherpetic neuralgia.

What Is the Shingles Vaccine?

A vaccine is a preventative treatment that’s meant to keep your body from becoming infected with a disease. Vaccines present your immune system with substances that it interprets as different viruses, toxins and bacteria, depending on the vaccine you’re getting. These substances are usually some form of germs that cause disease, but the germs have been weakened or diluted to the point that they won’t get you sick. The germs may have also been killed so that they’re inactive and can’t infect you. Or, a vaccine may only contain one part of the germ, not the full pathogen. The presence of these substances stimulates your immune system to start producing antibodies to whatever disease the vaccine is formulated to prevent.

Your body recognizes the substances, called antigens, as disease-causing agents, and your immune system responds by developing immunity to them — all without the need to make you get sick from the disease in the first place. Vaccines effectively “train” your immune system to recognize antigens as harmful so that if you do get exposed to complete, living forms of a pathogen later on, your immune system knows to fight them immediately. Your immunity from the vaccine then helps your body resist the infection without causing you to get sick.

The shingles vaccine contains a live form of the varicella-zoster virus that has been attenuated, meaning it’s been weakened but is still a live strain. Enough of the live virus is present in the vaccine to stimulate your immune system, but there isn’t enough of the virus to make you come down with shingles.

Vaccine Options

There are two vaccines that have been approved for preventing shingles: Zostavax and Shingrix. Zostavax has been around longer than Shingrix and is intended for adults over age 60, although it’s approved for use in adults over age 50. Because the risk of developing shingles is highest for people around age 60, it’s recommended to get the vaccine closer to that age. Zostavax is given as one shot. The Centers for Disease Control and Prevention (CDC) notes that this vaccine reduces the risk of developing shingles by 51% and postherpetic neuralgia by 67%.

Shingrix is a newer option that’s the preferred vaccine for preventing shingles. You’ll need to get it in two doses instead of one like Zostavax, and you’ll need to wait two to six months between shots. Shingrix is also intended for adults age 50 or older, and it’s the preferred choice because it’s over 90% effective at preventing shingles and postherpetic neuralgia. You should opt for Shingrix over Zostavax unless you’re allergic to Shingrix or it’s not available from your doctor or local pharmacy.

Should You Get the Shingles Vaccine?

Unless you’re absolutely certain you’ve never had chickenpox, you should get a shingles vaccine if you’re 60 or older. The CDC notes that 99% of Americans over age 40 have had chickenpox, so you may have had it even if you don’t remember it. You can still get the vaccine even if you’ve had shingles before or if you don’t know if you’ve had chickenpox. If you’ve already had Zostavax, you can also still get Shingrix, but you should wait at least two months after receiving Zostavax to begin your course of Shingrix.

There are a few situations in which you shouldn’t get the shingles vaccine. People who are or might be pregnant and people who have compromised immune systems should not get Zostavax. Likewise, pregnant or breastfeeding people should not have Shingrix. If you’re allergic to any of the ingredients in either of the vaccines and have had severe or life-threatening reactions to those ingredients in the past, you should not get vaccinated. If you’re currently ill with shingles, wait to get Shingrix until your symptoms clear up.

Receiving the Shingles Vaccine

Shingrix has been tested extensively and is not only effective but is also safe for most people to receive. Despite this, it’s possible you may experience some side effects after getting the vaccine. Shingrix can cause a strong response in your immune system because it’s so effective, and this can cause you to feel tired after receiving the first course of the vaccine. Shingrix can also cause side effects that mimic flu symptoms, including fatigue, fever, stomach pain, chills and muscle pain. Many people who receive this vaccine report that they experience soreness, redness and swelling around the injection site.

These side effects may last for a few days, but you can take an over-the-counter pain reliever like ibuprofen to ease the swelling and pain. Even if you do experience uncomfortable side effects, it’s important to get the second course of the vaccine so that you can develop full immunity. When you get the second shot, you might not have any side effects.

Resource Links:

https://www.mayoclinic.org/diseases-conditions/shingles/expert-answers/shingles-vaccine/faq-20057859

https://www.cdc.gov/shingles/multimedia/shringrix-50-older.html

https://vk.ovg.ox.ac.uk/vk/shingles-vaccine

https://www.publichealth.org/public-awareness/understanding-vaccines/vaccines-work/

https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/index.html

https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

https://www.cdc.gov/vaccines/vpd/vpd-vac-basics.html

https://www.goodrx.com/blog/new-shingles-vaccine-shingrix-zostavax/

https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/shingles-vaccine