Information you need about the Shingles Vaccine

April 10, 2025
Robert C. Alley, MD
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Herpes zoster, also known as shingles, results from a reactivation of the chickenpox virus that has resided in your nerve cells since the original chickenpox infection.  Upon reactivation, the virus travels down the nerve endings to produce the characteristic rash seen with shingles.  It is estimated that up to 30% of persons in the United States will experience shingles during their lifetime.  This rate increases with age.  It is unclear if varicella immunization impacts the incidence of shingles.   Patients who have no immunity to chickenpox can develop chickenpox after being exposed to someone with shingles.  Fortunately, the majority of the time, shingles is a self-limited disease which causes mild to moderate pain and spontaneous resolution in 1 to 3 weeks.  A dreaded complication is postherpetic neuralgia, which occurs in 10 to 15% of patients who develop shingles.  This is defined as a persistence of shingles pain 90 days after the onset of the rash.  Unfortunately, these patients are difficult to treat and most suffer from lifelong, persistent pain.  There are antiviral medications which appear to decrease the duration and severity of shingles.  Those medications may decrease the spread of the infection.  There is no evidence to date that antiviral treatment decreases the risk of postherpetic neuralgia.  Fortunately, there is a vaccine available which is effective in decreasing the risk of shingles infection/postherpetic neuralgia.  Shingrix vaccine is indicated for people ages 50 and above who have healthy immune systems.  It is indicated for immunocompromise individuals at the age of 18 and above.  I strongly recommend that patients consider shingles vaccination.