Shingles, or Herpes Zoster, is a painful rash caused by the reactivation of the varicella-zoster virus (VZV), which is the same virus responsible for chickenpox. After a person recovers from chickenpox, VZV does not leave the body but instead lies dormant in nerve tissue near the spinal cord and brain. The virus can reactivate years later, often due to a decline in the body’s immune defenses, and the risk of this happening increases significantly with advancing age.
Understanding the Shingles Vaccine
Vaccination is the most effective measure available for preventing shingles and its associated complications, such as long-term nerve pain. The current standard of care is a recombinant zoster vaccine (RZV), designed to stimulate a strong immune response to suppress VZV. This vaccine is generally recommended for healthy adults beginning at age 50, and also for immunocompromised adults starting at age 19.
The recombinant vaccine works by introducing glycoprotein E (gE), a protein found on the surface of the VZV. It also includes an adjuvant, which enhances the body’s immune reaction to the gE protein. This combination prompts the immune system to generate a robust response from specialized T cells.
The standard vaccination schedule requires two doses, typically administered two to six months apart, to achieve the highest level of protection. This two-dose regimen demonstrates over 90% efficacy in preventing shingles in adults aged 50 and older. Protection rates remain high even for those aged 70 and above.
The vaccine is still recommended even if a person has previously had shingles or received the older, less effective vaccine. For individuals who are immunocompromised, the timeline for the second dose may be shortened to between one and two months to ensure they receive protection sooner.
Clarifying Transmission Risks
A person cannot “catch” shingles from another individual who has the condition, as shingles results from VZV reactivation within one’s own body. However, a person with active shingles can transmit the varicella-zoster virus to someone who has never had chickenpox or the chickenpox vaccine.
In this scenario, the exposed, non-immune individual would develop chickenpox, not shingles. The virus is only spread through direct contact with the fluid contained within the shingles rash blisters, not through coughing or casual contact. The risk of transmission exists only during the blister phase, from when the rash first appears until the lesions have fully crusted over.
To prevent spreading the virus, people with an active shingles rash should keep the affected area covered with clean, loose clothing or a bandage. Frequent handwashing is also advised to minimize the risk of transferring the virus. Individuals with active shingles should avoid contact with vulnerable populations, such as non-immune pregnant women, premature infants, and people with severely weakened immune systems.
Lifestyle Strategies to Support Immunity
Since VZV reactivation is closely linked to a decline in immune function, maintaining robust cellular immunity through lifestyle choices can be a supportive measure against shingles. Chronic psychological stress is a recognized factor that can suppress the immune system, primarily by triggering the sustained release of the hormone cortisol. Elevated cortisol levels can impair the function of T cells, which normally keep the dormant VZV suppressed in the nerve ganglia.
Prioritizing consistent, high-quality sleep is integral to immune maintenance, as sleep deprivation has been shown to negatively impact T-cell activity. Studies link sleep disorders to an increased risk of developing shingles, suggesting that restorative sleep helps the body regulate its antiviral defenses.
Maintaining a balanced diet rich in specific micronutrients provides the necessary building blocks for immune cells. Vitamin D plays a role in regulating immune responses and is associated with a lower risk of VZV reactivation when levels are optimal. Adequate intake of Vitamin C, Zinc, and Vitamin E is also important, as these antioxidants and minerals sustain overall immune health. Focusing on a varied diet filled with fruits and vegetables ensures the intake of these protective compounds.