Shingles is a viral infection that can cause a painful rash and other complications. Vaccination offers protection against this condition, which is caused by the same virus responsible for chickenpox. This article provides an overview of shingles and detailed information regarding vaccine recommendations and administration.
Understanding Shingles
Shingles, also known as herpes zoster, stems from the reactivation of the varicella-zoster virus (VZV). After an individual recovers from chickenpox, VZV remains dormant in the body’s nerve cells. Years later, the virus can reactivate and travel along nerve pathways to the skin, resulting in shingles.
Initial symptoms often include burning pain, tingling, or itching, typically on one side of the body or face. Within days, a rash emerges with fluid-filled blisters that usually scab over within 7 to 10 days and clear within 2 to 4 weeks. A common complication is postherpetic neuralgia (PHN), severe nerve pain that can persist for months or years. Other complications include vision loss if the rash affects the eye, or brain inflammation. Anyone who has had chickenpox is at risk of developing shingles, with the risk increasing with age, especially for adults over 50, and for those with weakened immune systems.
Recommended Age for Vaccination
The Centers for Disease Control and Prevention (CDC) recommends the recombinant zoster vaccine (RZV), known as Shingrix, for most adults. Adults aged 50 years and older should receive this vaccine to prevent shingles and its related complications. This recommendation applies regardless of whether they recall having chickenpox or a prior episode of shingles.
The vaccine is also recommended for individuals aged 19 years and older who are or will be immunocompromised due to disease or therapy. Immunocompromised individuals face a higher risk of developing shingles and experiencing more severe complications. This includes people with conditions like HIV/AIDS, those undergoing cancer treatment, or individuals taking medications that suppress the immune system.
The Shingles Vaccine: Type and Dosing
The currently recommended shingles vaccine is Shingrix, an adjuvanted recombinant zoster vaccine (RZV). Unlike older live-attenuated vaccines, Shingrix contains a non-live component of the virus, making it suitable for a broader range of individuals, including those who are immunocompromised. This vaccine works by stimulating a strong immune response to help protect against the virus.
The Shingrix vaccine is administered as a two-dose series. For most adults, the second dose should be given 2 to 6 months after the first dose. For immunocompromised individuals, the second dose can be administered sooner, typically 1 to 2 months after the first, to provide earlier protection. Completing both doses is important for achieving the full protection demonstrated in clinical trials.
Important Considerations for Vaccination
Individuals who have previously experienced shingles should still get vaccinated with Shingrix. While having had shingles provides some natural immunity, vaccination helps prevent future recurrences and strengthens protection. There is no specific waiting period required after a shingles episode before vaccination, but it is advised to ensure the rash has completely cleared.
There are certain situations where the vaccine might not be recommended. Individuals who have had a severe allergic reaction, or anaphylaxis, to a previous dose of Shingrix or to any component of the vaccine should not receive it. The vaccine is not recommended for pregnant individuals. Those currently experiencing an acute shingles outbreak should wait until the rash resolves before getting vaccinated. If an individual has a moderate or severe acute illness with a fever, it is best to wait until they recover before receiving the vaccine.