Ask The Expert: Shingles (Herpes Zoster) Vaccine

 

Ken Schmader, MD

Kenneth Schmader, MD

Professor of Medicine, Division of Geriatrics at Duke University School of Medicine

Q. What is shingles?

A. Shingles (herpes zoster) is a painful rash. It is caused when varicella-zoster virus (VZV), which causes chickenpox, reactivates in your body. VZV never leaves your body, even after you recovered from chickenpox. The virus hides in the nerves next to the spinal cord. The virus can become active at any time. This causes shingles.

Q. If I have never had chickenpox, can I still get shingles?

A. Possibly.  Some people infected by VZV may not get chickenpox but still have the virus in the body, which may reactivate later to cause shingles. If a person was never infected by VZV then they cannot get shingles, since shingles is caused by reactivation of the virus from within their body.   

Q. What are the symptoms of shingles?

A. If you have the following symptoms, you should see a healthcare professional right away. Treating shingles must be started within 72 hours (3 days) to have the best result in recovering from it. It is better for recovery if you start medication before the rash appears.

Shingles symptoms often follow a pattern:

  • Numb, painful, burning, or itchy skin appears for a few days
  • A rash on one side of the body appears
  • Small groups of blisters appear
  • Blisters dry out and form scabs after 7 to 10 days
  • The rash heals in about two to four weeks
  • Pain and tenderness may persist for months or years

You may also experience other symptoms, including nausea, aches, fevers, and tiredness.

Q. Are older adults at risk for getting shingles?

A. Yes. Older adults are at a higher risk for getting shingles. In fact, increasing age is the primary risk factor for getting shingles. Another strong risk factor for shingles is a weak immune system.

Q. How can I protect myself from shingles?

A. The best way to protect yourself from getting shingles is getting the shingles vaccine. This will help prevent shingles and its complications. The shingles vaccine is called Shingrix (recombinant zoster vaccine).

(Please note, a shingles vaccine called Zoster Vaccine Live (Zostavax) is no longer available in the United States. If you received Zostavax in the past, you should still get the Shingrix vaccine. Talk to your healthcare professional to determine the best time to get the Shingrix vaccine.)

Q. Who should get Shingrix?

A. The Centers for Disease Control and Prevention (CDC) recommends all people aged 50 or older should get two doses of Shingrix. After receiving the first dose, you should get the second dose within 2 to 6 months. If you have a weakened immune system, you can get the second dose 1 to 2 months after the first dose.

Q. Is the Shingrix vaccine safe for me?

A. Shingrix is safe. It is also highly effective in preventing complications of shingles. You should always talk to a healthcare professional when making health decisions that are best for you. However, you shouldn’t get the Shingrix vaccine if you:

  • Have ever had a severe allergic reaction to any part of the vaccine or after a dose of Shingrix
  • Currently have shingles
  • Currently are pregnant
  • Currently have a moderate or severe illness. You should usually wait to recover before you get the vaccine.

Q. Where can I get the Shingrix vaccine?

A. The Shingrix vaccine is available at most drug stores and provided by some healthcare professionals. You can call your local drug store or your healthcare professional to see if they provide the vaccine and/or schedule an appointment with them.

Q. Is the Shingrix vaccine covered by Medicare?

A. Medicare Part B does not cover the shingles shot. Starting in 2023, Medicare prescription drug plans (Part D or Medicare Advantage plans) do cover the shingles vaccine without out-of-pocket costs. Contact your Medicare drug plan for more information.

Q. Is the Shingrix vaccine covered by Medicaid?

A. Medicaid may cover the shingles vaccine.  Contact your insurer for more information.

 

Last Updated October 2023

 

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