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Jul 23, 2021
5 min read

The shingles vaccine: who should get it, side effects, effectiveness

Shingles is a common and potentially serious illness. It’s caused by the reactivation of the virus that causes chickenpox. There’s a highly effective vaccine against shingles. The CDC recommends it for most adults over age 50. The vaccine is called Shingrix, and it may produce temporary side effects. More serious complications are possible but rare.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Shingles is a common viral illness. Roughly one in three Americans will get it at some point (Harpaz, 2008).

If you’ve ever had chickenpox, you’re at risk for shingles. The virus that causes chickenpox is called varicella-zoster virus (VZV). That virus stays in your body even after you recover from chickenpox. Years or even many decades later, it can reactivate and make you sick with shingles (Albrecht, 2021). 

Shingles usually takes the form of a painful, blistering rash. Someone who has a shingles rash or shingles blisters is contagious, and the condition is associated with dangerous complications, including chronic pain and loss of vision (Nair, 2021).

Fortunately, there’s a highly effective shingles vaccine. That vaccine is called Shingrix. 

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What is the shingles vaccine, and how does it work?

Vaccines are designed to cause beneficial immune-system changes. Those changes can help improve your immune system’s response to a virus or bacteria. 

In the case of Shingrix, those changes can help your immune system block or suppress the virus that causes shingles. The shingles vaccine does this in part by boosting the ability of white blood cells—also known as T cells—­­to suppress the reactivated varicella-zoster virus that causes shingles (Albrecht, 2021).

Shingrix involves two shots (injections) in your upper arm. You should get these shots 2–6 months apart (CDC-b, 2018).

How effective is the shingles vaccine?

Very. Research has found that in people older than age 50, Shingrix reduces the risk of developing shingles by 97% (Lal, 2015). The vaccine isn’t quite as effective in older adults; among those 70 and older, Shingrix reduces the risk of developing shingles by 90% (Cunningham, 2016).

Along with significantly lowering your risk for shingles, Shingrix also reduces your risk for postherpetic neuralgia—a common chronic pain condition that stems from an outbreak of shingles blisters (McGirr, 2019).

Is there more than one shingles vaccine?

Yes. Along with Shingrix, there is an older shingles vaccine called Zostavax. The Centers for Disease Control and Prevention (CDC) no longer recommends Zostavax, and it’s no longer available in the U.S. (CDC-c, 2020). That’s partly because studies have found that Shingrix lasts longer and is more effective at lowering your risk of shingles (McGirr, 2019). 

Who should get the shingles vaccine?

The CDC recommends that all healthy adults 50 and older get Shingrix, even if you’ve had shingles in the past, aren’t sure if you ever had chickenpox, or have already had the older Zostavax shingles vaccine (CDC-b, 2018). Even if you’ve had the chickenpox vaccine, the CDC still recommends that you get the shingles vaccine (CDC-d, 2020). 

Who should not get the shingles vaccine?

On the other hand, you should not get Shingrix if (CDC-c, 2020):

  • You’ve ever had a severe allergic reaction to a vaccine
  • You test negative for a past varicella-zoster infection—meaning you’ve never had chickenpox. (In this case, you should first get the chickenpox vaccine).
  • You currently have shingles.
  • You’re currently pregnant or breastfeeding.
  • You currently have a cold, flu, or another temporary illness that causes your temperature to rise above 101.3 degrees. 

If you have rheumatoid arthritis or some other autoimmune disorder, you may not be a good candidate for the shingles vaccine. If you’re not sure, talk with your healthcare provider to determine if you should get Shingrix (Dagnew, 2021).

Side-effects of the shingles vaccine 

The vaccine causes side effects in 11% of people who get it (Lal, 2015). These side effects tend to last no more than 2–3 days, and they’re more common in younger people. These side-effects include (CDC-b, 2018):

  • Arm soreness following the shot
  • Pain, redness, or swelling at the injection site
  • Fatigue
  • Muscle pain
  • Chills or shivering
  • Headache
  • Upset stomach or nausea

You may experience these side effects after either (or both) of the two vaccine shots (CDC-b, 2018).

Complications of the shingles vaccine

Some research has linked Shingrix with minimal risk for Guillain-Barré syndrome (GBS) (FDA, 2021). 

GBS is a rare neurological disorder that can cause temporary weakness or, in extreme cases, paralysis. But even in those severe cases, most people recover from GBS (NINDS, 2020). 

While the link between Shingrix and GBS is uncertain, some research has found an increased risk—about six additional GBS cases per 1 million people—among those age 65 or older who were vaccinated with Shingrix. All of those cases occurred within 42 days of the initial Shingrix shot (FDA, 2021). 

Along with those links to GBS, Shingrix can, in rare cases, cause a severe allergic reaction. According to the CDC, only 1 or 2 people out of 1 million who receive the Shingrix vaccine will have this kind of reaction (CDC-b, 2018). 

The symptoms of an allergic reaction to Shingrix start within minutes or hours and include:

  • Hives
  • Swelling of the face or throat
  • Breathing problems
  • Dizziness
  • Racing heart
  • Weakness

If you have any of these symptoms, get medical attention immediately (CDC-b, 2018). 

What does the shingles vaccine cost?

That depends. Some insurers cover the shingles vaccine—in whole or in part—while others do not. Likewise, Medicare and Medicaid may or may not cover the vaccine (CDC-b, 2018).

If you’re paying out of pocket, the shingles vaccine can be quite expensive—more than $150. That’s according to Gourd, a for-profit company that tracks the cost of vaccines and other medicines (GoodRX, 2021). 

Where can I get the shingles vaccine?

Most doctor’s offices, medical clinics, and other healthcare facilities, including commercial pharmacies, offer the shingles vaccine. You shouldn’t have any trouble finding it (CDC-b, 2018). 

If you’re older than 50, or younger and your doctor recommends it, getting the shingles vaccine can protect you from a common and potentially serious illness.

References

  1. Albrecht, M, & Levin, M. (2021). Vaccinations for the prevention of shingles (herpes zoster). In UpToDate. Hirsch, M., and Mitty, J. (Eds.) Retrieved on July 15, 2021 from https://www.uptodate.com/contents/vaccination-for-the-prevention-of-shingles-herpes-zoster
  2. Centers for Disease Control and Prevention (CDC)-a. (2019). Shingles (herpes zoster): about shingles (herpes zoster). Centers for Disease Control and Prevention. Retrieved July 15, 2021 from https://www.cdc.gov/shingles/about/index.html
  3. Centers for Disease Control and Prevention (CDC)-b. (2018). Vaccines and preventable diseases: shingles vaccination. Centers for Disease Control and Prevention. Retrieved July 15, 2021 from https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
  4. Centers for Disease Control and Prevention (CDC)-c. (2020). Vaccines and preventable diseases: Shingrix recommendations. Centers for Disease Control and Prevention. Retrieved July 15, 2021 from https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/recommendations.html
  5. Centers for Disease Control and Prevention (CDC)-d. (2020). Vaccines and preventable diseases: frequently asked questions about Shingrix. Centers for Disease Control and Prevention. Retrieved July 15, 2021 from https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/faqs.html
  6. Cunningham, A. L., Lal, H., Kovac, M., Chlibek, R., Hwang, S. J., Díez-Domingo, J., et al. (2016). Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. The New England Journal of Medicine, 375(11), 1019–1032. doi: 10.1056/NEJMoa1603800. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1603800
  7. Dagnew, A. F., Rausch, D., Hervé, C., Zahaf, T., Levin, M. J., Schuind, A., & ZOE-50/70 study group (2021). Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials. Rheumatology (Oxford, England), 60(3), 1226–1233. doi: 10.1093/rheumatology/keaa424. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32910152/
  8. GoodRx.com. (2021). Shingrix. GoodRx. Retrieved July 15, 2021 from https://www.goodrx.com/shingrix
  9. Harpaz, R., Ortega-Sanchez, I. R., Seward, J. F., & Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC) (2008). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18528318/
  10. Lal, H., Cunningham, A. L., Godeaux, O., Chlibek, R., Diez-Domingo, J., Hwang, S. J., et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. The New England Journal of Medicine, 372(22), 2087–2096. doi: 10.1056/NEJMoa1501184. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMoa1501184
  11. McGirr, A., Widenmaier, R., Curran, D., Espié, E., Mrkvan, T., Oostvogels, L., et al. (2019). The comparative efficacy and safety of herpes zoster vaccines: A network meta-analysis. Vaccine, 37(22), 2896–2909. doi: 10.1016/j.vaccine.2019.04.014. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30982636/
  12. Nair, P. A., & Patel, B. C. (2021). Herpes zoster. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441824/
  13. National Institute of Neurological Disorders and Stroke (NINDS). (2020). Guillain-Barré Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. Retrieved July 15, 2021 from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Guillain-Barré-Syndrome-Fact-Sheet
  14. U.S. Food & Drug Administration (FDA). (2021). FDA requires a warning about Guillain-Barré Syndrome (GBS) be Included in the prescribing information for Shingrix. U.S. Food & Drug Administration. Retrieved July 21, 2021 from https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/fda-requires-warning-about-guillain-barre-syndrome-gbs-be-included-prescribing-information-shingrix