“Shingles is caused by the herpes zoster virus,” says Michelle Henry, MD, dermatologist in New York City and clinical instructor at Weill Cornell Medical College. “It’s a chickenpox virus that many of us have already had, so once you’ve had the virus, it remains in the body and kind of lives in the nerve’s root, and it can be reactivated. Then you have what we call shingles.”
When someone has shingles, they may experience a painful rash (called a dermatome) that typically covers a band-like area on one side of the body. While chickenpox is infamous for being itchy, shingles is more known for causing a burning, stinging pain. Some patients may also experience complications of shingles, such as postherpetic neuralgia—long-term nerve pain that lasts months after shingles symptoms begin.
Having chickenpox doesn’t mean you’re guaranteed to develop shingles, but your risk increases with age and your immune status. In order for shingles to occur, the virus must be reactivated in your body, which is more likely if you have a weakened immune system. This can occur simply from age, or from certain diseases (like cancer or diabetes), chemotherapy, immunosuppressant medications, or HIV infection.
Shingles isn’t necessarily life-threatening, but preventing the disease has many benefits. For starters, the symptoms alone can be excruciating. Then, there’s the risk of complications like long-term pain and blindness. Plus—since shingles is more likely in someone who already has other diseases or is going through chemotherapy—developing shingles can add additional stress to your life as you go through other treatments.
There are two ways to prevent shingles: by getting the zoster vaccine to protect against shingles, or by getting the varicella vaccine as a child to protect against chickenpox. Since shingles occurs after a reactivation of the herpes zoster virus, if you can prevent yourself from ever getting the virus at all (i.e., never getting the chickenpox), then you won’t get shingles.
“We’re in a great age where it has become commonplace to have the chickenpox vaccine, so hopefully years from now, shingles will be a thing of the past,” says Dr. Henry, “or very, very, very rare.”
The zoster vaccine does not completely eliminate the risk of shingles, unfortunately: It has been shown to be about 90 percent effective, according to the Centers for Disease Control and Prevention (CDC). That said, those who receive the zoster vaccine but still develop shingles tend to have less severe symptoms and for a shorter period of time, and they tend to have a lower risk of complications.
Who Can Get the Zoster Vaccine?
“The shingles vaccine is not for everyone, but allow your primary care doctor to talk to you about the current guidelines, and if you’re a candidate for the shingles vaccine,” says Dr. Henry.
There are actually two types of zoster vaccines: One is available as a single injection (which is recommended by the CDC for healthy adults over 60), and the other is given in a series of two injections, six months apart (which is recommended by the CDC for adults over 50). The latter is the preferred option, but the single-dose vaccine is still used in certain cases.
“It’s never too late to get the shingles vaccine, so if you are considering getting it, I recommend having that discussion and making that decision with your primary care doctor,” says Dr. Henry.