Shingles is a viral infection that causes a painful rash, stemming from the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a person recovers from chickenpox, VZV remains dormant within the nervous system. The virus can reactivate years later, leading to shingles. While many people experience shingles only once, it is possible for it to return.
The Possibility of Shingles Returning
Most individuals who have had shingles will only experience it once in their lifetime. However, recurrence is a possibility. Estimates suggest that between 1.2% and 9.6% of people who have had shingles may experience another episode. For those with weakened immune systems, the recurrence rate can be higher, with some studies indicating up to 18% may experience shingles more than once.
While a second episode is not immediate, recurrence usually happens years after the initial infection. The interval can vary widely, from a few months to several decades. Research indicates the average time between episodes can range from approximately two years for adults aged 45-54 to three years for those 55 and older.
Key Factors in Recurrence
Recurrence is linked to the immune system’s declining ability to suppress the virus. Several factors can contribute to this weakening of immune defenses, increasing the likelihood of another shingles episode. Age is a significant factor, as immunity naturally lessens with advancing years, making individuals over 50 more susceptible.
Various health conditions and medical treatments can also compromise the immune system, raising the risk of recurrence. These include chronic conditions such as diabetes, HIV/AIDS, and certain cancers like leukemia and lymphoma. Additionally, medications that suppress the immune system, such as corticosteroids, chemotherapy drugs, and immunosuppressants used after organ transplants, can make reactivation more probable. Other contributing factors may involve significant stress, physical trauma, or even a family history of recurrent shingles.
Preventive Measures
Preventing shingles, including recurrent episodes, primarily involves vaccination. The recombinant zoster vaccine (RZV), known as Shingrix, is highly effective in preventing shingles and its complications. This vaccine is recommended for adults 50 years and older, even if they have previously had shingles or received an older shingles vaccine. For individuals aged 19 and older who are or will be immunocompromised, the vaccine is also recommended.
The Shingrix vaccine is administered as a two-dose series, with the second dose typically given two to six months after the first. Clinical trials have shown its efficacy against shingles to be over 90% in adults 50 and older, with real-world effectiveness also remaining high over several years. While the vaccine is the most targeted intervention, maintaining a generally healthy immune system through a balanced diet, adequate sleep, and stress management practices can also offer supportive benefits.