Do You Need the Shingles Vaccine?
(And If So, How Often?)

Updated July 2023

One out of every three Triangle residents may have a painful disease lying dormant in their systems, waiting for an opportunity to strike. 

Anyone who has had chickenpox is at risk of developing shingles, a painful, red, blistering rash that develops on one side of the body. It’s caused by the same virus that causes chickenpox. It is dormant in the system until it “reactivates” later.

Because the rash can cause debilitating pain, it’s important to know the symptoms, who it affects, and how to protect yourself. We’ll review the latest information about the shingles vaccine, examine who is at risk of developing shingles, and provide an overview of the symptoms to watch for.

What You Need to Know About the Shingles Vaccine

While shingles is not a life-threatening infection, if it’s not treated in a timely manner, it can lead to complications that cause pain long after the rash has cleared, a condition called postherpetic neuralgia. The vaccine remains the best way to protect yourself from this disease.

There is often some confusion around this immunization, centering on who should receive the vaccine and how often it should be administered. 

Who Should Get the Shingles Vaccine?

We recommend that if you’re 50 years old or older, you should get the vaccine—regardless of whether or not you remember having chickenpox. 

Why?

Because 99 percent of adults 40 and older have had chickenpox, although some may not remember having the disease.

If you’ve already had shingles, getting the vaccine can help you prevent getting the disease again in the future, although you should wait to be sure your rash has disappeared completely before getting the vaccine.

The vaccine does not guarantee that you’ll never get this illness, but it can reduce the severity of it if you get it.

Are There Side Effects to the Shingles Vaccine?

Some people may get a small, temporary rash similar to chickenpox after getting the shot or even a slight headache. However, the most common side effect is mild tenderness with redness /itching at the injection site, mild fever, and/or malaise and fatigue.  Remember, any inconveniences caused by side effects are much less severe and painful than having shingles.

How Often Do You Need to Get the Shingles Vaccine?

You will need two doses of the vaccine that are given two to six months apart.   If you previously had the Zostavax shingles vaccine a few years ago, you need to get the updated Shingrix vaccine series in order to provide enhanced protection.

Who Should Not Get a Shingles Vaccine?

If your immune system is weakened for any reason, or if you have tuberculosis, you should not get a shingles vaccine. It’s also not recommended if you’re getting radiation or chemotherapy, or if you’ve had leukemia or lymphoma.

Some people may be allergic to some of the ingredients in the vaccine, such as gelatin. If you’re not sure, or if you have any concerns, just speak with us. We’ll be glad to provide details to help you make the right decision.

Is There a New Shingles Vaccine? 

The vaccine we recommend is called Shingrix, and we administer it in our office. 

Shingrix is more than 90% effective in those 50 years old or older. In addition, the immunity remains strong for seven years after receiving the immunization. 

If you have a weakened immune system, Shingrix is still 68% to 91% effective, depending upon the illness you have that is weakening your immune system. 

Important Facts About Shingles

The virus that causes shingles is the varicella zoster virus (VZV), which is the same one that causes chickenpox. After someone recovers from chickenpox and the rash goes away, the VZV virus still remains in the body. It stays dormant, but it is possible for it to reactivate later in a person’s life, which is what causes shingles.

Can You Get Shingles More Than Once?

While you can get shingles more than once in your life, most people only have one episode.

Is Shingles Contagious?

If you have shingles, then you have an active VZV virus, and you can spread this virus to those who have never had chickenpox before (or who have never been vaccinated for chickenpox). However, this spread is only through direct contact, so you can help reduce the spread of shingles by covering the rash. In addition, those with shingles cannot spread the virus before the rash appears.

If someone who has not had chickenpox is infected after coming in contact with the shingles virus, they will develop chickenpox, not shingles.

What Are the Symptoms of Shingles?

The most obvious sign is a telltale rash that typically manifests itself as a stripe around the left or right side of the body. Occasionally, the rash may appear on the face, and it may be more widespread in those with weakened immune systems.

Other shingles symptoms include:

• Headaches
• Chills
• Upset stomach
• Fever
• Joint pain
• Swollen lymph nodes
• Malaise or general ill feeling
• Blisters

Around one-to-five days before the rash forms, people frequently have itching or tingling where it will appear. 

Who Is at Risk of Getting Shingles?

If you have had chickenpox, you’re at risk for developing this disease and this risk increases substantially as you age. It’s most common in those who are more than 50 years old.

If your immune system is suppressed because of disease, cancer treatment, or immunosuppressive drugs, you are also at a higher risk for developing this illness.

Those at greatest risk include:

• Those 60 and older
• Those who had chickenpox before age 1
• Those with HIV or another disease that weakens the immune system
• Those who are on medication that suppresses the immune system
• Those who haven’t been vaccinated against it

Raleigh Adult Medicine Offers the Shingles Vaccine and Other Immunizations

As internal medicine doctors in Raleigh, we believe that prevention is an important element of staying healthy, and a key element is getting the appropriate vaccine.

In addition to the shingles vaccine, we also offer immunizations for:

• Seasonal influenza
• HPV
• Pneumonia
• Tetanus, Diphtheria and Pertussis (Tdap)
• Hepatitis A
• Hepatitis B
• COVID- 19

If you need one of these vaccines, or if you aren’t sure whether or not one is appropriate for you, please schedule an appointment with us. We’ll take a closer look at your overall health and provide recommendations to help you.

Complications from Shingles

While most people are able to recover from shingles without any long-term effects, there is the possibility of developing serious complications. These include:

POST-HERPETIC NEURALGIA (PHN)

Those with PHN continue to have severe, often debilitating, pain where the shingles rash was, even after the rash has cleared up. Sometimes, the pain continues for several years after the patient has recovered from shingles. While rare among those under age 40, the risk of developing PHN increases with age, particularly if over 60.

Blindness

If shingles are located in or around an eye, painful infections can develop. This can lead to vision loss. In extreme cases, it may cause blindness.  Urgent consultation with an ophthalmologist is crucial if shingles develops around the eye.

Skin Infections

It’s very important to receive proper treatment for blisters. If not, extensive bacterial skin infections can develop.

Neurological Problems

Shingles can affect different nerve systems throughout the body. Depending upon which section is damaged, it can result in hearing problems, balance issues, and even brain inflammation (called encephalitis).

Treatment for Shingles

Our internal medicine specialists in Raleigh can effectively treat this disease, but it’s important to see us as soon as your rash develops. Treatment includes antiviral medications and /or analgesics to help alleviate pain.

If you have shingles, do not touch or scratch the rash and keep it covered.  While you can’t spread it through casual contact, you can spread chickenpox to those who haven’t already had it. Therefore, it’s important to wash your hands and avoid interaction with those who have weakened immune systems, have had organ transplants, or those undergoing chemotherapy.

It’s very important that those with shingles avoid contact with pregnant women who have never had chickenpox or the chickenpox vaccine. It can cause premature birth or low infant birth weight.

Raleigh Adult Medicine Offers the Vaccinations That Can Prevent Shingles

If you have any of the risk factors, don’t take a chance. While most people have only one outbreak, for others the pain of the disease can last for several years after treatment.

 If you have had chickenpox, you should get a shingles vaccination, which greatly reduces your chance of getting the illness.  We offer this vaccination, as well as other immunizations, in our office.  Contact us today to schedule an appointment.