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Who Should Get the Shingles Vaccine? Recommendations and Guidelines for Immunization

Shingles, also known as herpes zoster, is a painful skin rash caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. While anyone who has had chickenpox can develop shingles, certain groups are at higher risk.

Shingles vaccination is an effective way to prevent shingles and its complications. This article provides an overview of who should get the shingles vaccine, along with the recommendations and guidelines for immunization.

Understanding Shingles and Its Risks

What is Shingles?

Shingles is characterized by a painful rash that typically appears on one side of the body or face. The rash forms blisters that scab over in 7 to 10 days and usually clears up within 2 to 4 weeks. The pain associated with shingles can be severe and debilitating. In some cases, individuals may develop postherpetic neuralgia (PHN), a condition where the pain persists long after the rash has healed.

Who is at Risk?

Anyone who has had chickenpox is at risk for developing shingles because the varicella-zoster virus remains dormant in the body and can reactivate years later. The risk of shingles increases with age, particularly after the age of 50. Additionally, individuals with weakened immune systems, due to conditions like HIV/AIDS, cancer treatments, or immunosuppressive medications, are at a higher risk of developing shingles.

Shingles Vaccination: An Overview

Types of Shingles Vaccines

There are two vaccines available for shingles: Zostavax and Shingrix. Zostavax, a live attenuated vaccine, was the first shingles vaccine introduced but is less commonly used now. Shingrix, a non-live recombinant vaccine, has become the preferred option due to its higher efficacy.

Effectiveness of Shingles Vaccination

Shingrix has been shown to be over 90% effective in preventing shingles and PHN in adults aged 50 and older. Its effectiveness remains above 85% for at least the first four years after vaccination. Zostavax, while also effective, has a lower efficacy rate, particularly in older adults.

Recommendations for Shingles Vaccination

Age-Based Recommendations

The Centers for Disease Control and Prevention (CDC) recommends that healthy adults aged 50 years and older receive the Shingrix vaccine. The vaccine is administered in two doses, with the second dose given 2 to 6 months after the first. Even individuals who have had shingles before or received Zostavax are advised to get Shingrix, as it provides stronger and longer-lasting protection.

Immunocompromised Individuals

Individuals with weakened immune systems are at a higher risk for shingles and its complications. However, the decision to vaccinate immunocompromised individuals should be made on a case-by-case basis. Shingrix is preferred in these cases due to its non-live nature, making it safer for those with compromised immunity.

Those with Chronic Conditions

People with chronic medical conditions such as diabetes, chronic kidney disease, or chronic obstructive pulmonary disease (COPD) should consider getting the shingles vaccine. These conditions can increase the risk of complications from shingles, making vaccination an important preventive measure.

Special Considerations

Previous Shingles Infection

Individuals who have previously had shingles should still receive the Shingrix vaccine. Shingles can recur, and vaccination can help prevent future episodes and reduce the risk of complications such as PHN.

Those Who Received Zostavax

Those who have already received the Zostavax vaccine are advised to get the Shingrix vaccine as well. Shingrix provides more robust protection, and receiving it even after Zostavax can enhance immunity against shingles.

Vaccination Timing

It’s essential to consider the timing of the shingles vaccination. Ideally, individuals should get vaccinated before they turn 50, as the risk of shingles increases with age. For those planning to receive immunosuppressive therapy or other treatments that might weaken the immune system, it’s advisable to get vaccinated before starting such treatments.


Shingles is a painful and potentially debilitating condition that can significantly impact an individual’s quality of life. Vaccination is a highly effective way to prevent shingles and its complications. The CDC recommends the Shingrix vaccine for all healthy adults aged 50 and older, as well as for certain high-risk groups. By getting vaccinated, individuals can protect themselves from the pain and discomfort of shingles, enhancing their overall health and well-being.

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