6 Things to Know About the Shingles Vaccine

Katie Camero
·7 min read

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As you’ve probably guessed from years of getting icky colds and phlegmy coughs, there isn’t a microbe out there that doesn’t suck. But one sneaky virus can be particularly awful: varicella zoster, which causes shingles. This super common infection—one in three people will get it at some point—triggers an eruption of painful rashes and blisters that appear on one side of your body or face. While most people recover, shingles can lead to an agonizing nerve-related issue called postherpetic neuralgia (PHN) that can last for months or years; it can also endanger your vision, hearing, and, in rare cases, your life.

Luckily, shingles—which can strike in your 20s, 30s, or 40s, but is more common after age 50—doesn’t have to be on your getting older bingo card thanks to a highly effective vaccine that’s already sitting on pharmacy shelves. And here’s the thing: The varicella zoster virus is already living in many of us, hiding out inside our nerve cells. If you’ve ever had chicken pox, which is also caused by varicella zoster, the virus remains quietly in your body. Later in life it can become active again, travel down your nerves to your skin, and give you shingles—often if you’re already really stressed out, or if you have a weakened immune system. In other words, you can get this condition at any time and any age, although your risk jumps a whole lot as you get older. (If you got a chicken pox vaccine as a child, you’re a lot less likely to get shingles, but it can still happen.)

Here’s everything you need to know about the shingles vaccine, including when to get the shot and how well it works.

1. If you’re 50 or older, you should absolutely get the vaccine.

According to the CDC, all adults ages 50 and older should get the shingles vaccine, (called Shingrix) which includes two doses separated by 2 to 6 months. Why 50? It’s around this age when your risk for infection creeps upward. “As you get older, your immune system doesn't work as well,” Sabrina Assoumou, MD, PhD, an infectious disease doctor at Boston Medical Center, tells SELF. (BTW: There’s no maximum age to get the vaccine. And there’s some wiggle room—if you have had one dose but skipped the second shot, you don’t have to start over; you can just get that second one whenever you can.)

2. If you’re immunocompromised, you can get it beginning at age 19.

Up to 4% of people with shingles end up hospitalized, and of those, about 30% have a weakened immune system, so timely vaccination is critical for this group. This is why folks with certain cancers, HIV, or autoimmune or inflammatory conditions, or people taking meds like steroids that can diminish their ability to fight off infections, should get the shot as early as age 19.

If you are immunocompromised, you’re permitted to get your second shot a bit sooner—1 to 2 months after your first one—than other people, so ask your doctor if they feel that’s necessary in your particular case.

3. It’s more than 90% effective for most people.

The vaccine can prevent shingles in 97% of healthy adults between the ages 50–69, and 91% of people 70 and older—which is honestly pretty amazing. But just because the shot is nearly perfect doesn’t mean you’ll never get this painful skin problem, says Dr. Assoumou, who’s also an associate professor of medicine at the Boston University Chobanian & Avedisian School of Medicine. It simply lowers the chances (by a lot, I might add!) that the virus will wake up. And the good news? This immunity remains strong for at least seven years post vaccination in people ages 70 and older—which is about as long as Shingrix has been on the market. The FDA approved the shot in 2017, and so far its protection is holding up pretty well. So for now, you don’t have to worry about rolling up your sleeve again any time soon.

Similarly, the shot can prevent shingles in 68% to 91% of immunocompromised folks; how well it works for you may depend on the type of condition you have.

4. It lowers your risk of painful shingles complications.

Shingles itself hurts, but the complications can be even worse. As we mentioned, PHN is one of the biggies to be concerned about. It causes a burning, stabbing, or aching pain along your nerves where your rashes appear, which can seriously interfere with your daily life. About 10% to 18% of people who get shingles will end up with PHN (mostly older folks) and it can last months to years after your rashes go away—and sometimes a lifetime. Fortunately, the vaccine can prevent PHN in 91% of adults 50 years and older, and 89% of those ages 70 and older.

Vaccination can also lower your chances of other serious shingles complications. For example, if it shows up on your face, you can lose some of your vision. Or very rarely the infection can lead to issues like pneumonia, hearing difficulties, and inflammation in your brain, which can be potentially life threatening.

5. It’s safe to get even if you’ve had shingles, an older vaccine, or the chicken pox shot.

There was an OG shingles vaccine called Zostavax that became available in the US in 2006. But after research showed the newer jab offered better protection, it was taken off the market in November 2020. A recent study found that its effectiveness among adults ages 50 and older stood at 67% in the first year post vaccination, but then dropped to 50% the second year, 27% the eighth year, and 15% after a decade. So anyone who received the older vaccine should get Shingrix as soon as they can, Dr. Assoumou says.

The same advice applies to the chicken pox vaccine. If you were born in 1995 or later, you likely received the two-dose series as a kid; if you were born before that, you probably had a bout of chicken pox, even if you don’t remember it. Regardless of which bucket you fall into, you still can and should get the shingles shot when you turn 50.

Although most people only get shingles once in their life, you can get it a second time, especially if you’re immunocompromised. A study published in February found that shingles flared up again in up to 10% of people in the general population, and in up to 18% of folks with weakened immune systems. So that means it’s perfectly safe (recommended, even) to get the shot if you’ve already had shingles. There’s no specific amount of time you should wait to get your vaccine in this scenario, but do make sure any rashes are gone (this might take about 2–4 weeks) before making your appointment.

6. What side effects can you expect from Shingrix?

Like most vaccines, the shingles shot may temporarily leave you feeling a bit under the weather. You might develop a sore arm and some swelling around the injection site, as well as fatigue, muscle pain, headache, fever, stomach pain, or nausea after one or both doses. Side effects typically resolve in about 2–3 days and you can definitely take some over-the-counter pain meds if necessary. Just remember, these symptoms are totally normal. “Here's the deal: The reason you don't feel good is because this vaccine works really well. It gets your immune system going, revs things up, and makes really good antibodies that are going to protect you,” Dr. Assoumou says. “Maybe for a day or two you're not going to feel well, but it's worth it, because it’s going to decrease your chances of getting shingles and its complications.” In very rare cases, some people develop Guillain-Barré syndrome (GBS) after vaccination, which is a neurological disorder that can cause symptoms like muscle weakness, difficulty swallowing or talking, and abnormal heart rate. (Keep in mind that shingles itself can also cause GBS.)

So if you haven’t already received this shot, consider scheduling one when you can. The sooner you get vaccinated the better, because unlike some other viruses, varicella zoster can strike when it pleases. “As an infectious disease physician, nothing excites me more than to have a vaccine that could prevent something I know could have some consequences and could be very painful,” Dr. Assoumou says.

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