Shingles, also known as herpes zoster, is a viral infection that causes a painful skin rash. The varicella-zoster virus, the same virus responsible for chickenpox, lies inactive in nerve cells after a chickenpox infection. Shingles occurs when this dormant virus reactivates. The rash typically appears as a band of blisters on one side of the body. While shingles is not life-threatening, it can be very painful and lead to complications like postherpetic neuralgia (PHN), a persistent nerve pain. The shingles vaccine helps prevent this illness or significantly reduce its severity and the risk of long-term complications.
The Recommended Shingles Vaccine Schedule
The currently recommended shingles vaccine, Shingrix, is administered as a two-dose series. For most adults with healthy immune systems, the second dose is typically given between 2 and 6 months after the first dose. This specific interval helps to build and maintain strong protection against the virus.
Completing both doses is important for achieving maximum effectiveness and sustained protection. Clinical trials have demonstrated that two doses offer significantly higher protection against shingles and PHN compared to a single dose.
For individuals who are immunocompromised, a shorter interval between doses may be recommended. In such cases, the second dose of Shingrix can be administered 1 to 2 months after the first. This adjusted schedule ensures that these higher-risk individuals develop protection more rapidly.
Eligibility and Important Considerations
The shingles vaccine is generally recommended for adults aged 50 years and older. This recommendation applies regardless of whether they recall having chickenpox, as most adults in this age group have been exposed to the varicella-zoster virus. Additionally, individuals aged 19 years and older who have weakened immune systems are also advised to receive the vaccine due to their increased risk of developing shingles.
Even if someone has previously experienced shingles, vaccination is still recommended to help prevent future occurrences. It is generally suggested to wait until the shingles rash has cleared before getting vaccinated. For those who received the older Zostavax vaccine, Shingrix is now the preferred vaccine, and it is recommended to get Shingrix to enhance protection. An interval of at least 12 months is generally advised between receiving Zostavax and the first dose of Shingrix.
There are certain situations where vaccination might be delayed or is not recommended. Individuals who have had a severe allergic reaction to a previous dose of Shingrix or any of its components should not receive the vaccine. Vaccination should also be postponed if a person currently has an acute shingles infection, waiting until the illness resolves. While not a strict contraindication, vaccination is generally postponed for pregnant or breastfeeding women due to limited data on its use in these populations.
Addressing Missed or Delayed Doses
If the second dose of the shingles vaccine is delayed beyond the recommended 6-month window, it is not necessary to restart the vaccine series. The Centers for Disease Control and Prevention (CDC) advises getting the second dose as soon as possible. Even with a delay, completing the series remains important for achieving the strongest and most sustained protection against shingles and its potential complications.
One dose of Shingrix provides some protection, but two doses are necessary for optimal and long-lasting immunity. Therefore, if a dose is missed, individuals should contact their healthcare provider to schedule the second shot promptly. If a first dose was inadvertently given too early, a healthcare provider should be consulted to determine if a repeat dose is needed, ensuring the proper timing for the series.