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COVID-19 May Increase Your Risk for Shingles

A new study shows a link between the two illnesses in older adults

man holding a covid test

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Adults age 50 and older infected with COVID-19 are 15 percent more likely to develop shingles within six months of the diagnosis compared to people who weren’t infected, according to a large observational study published in the journal Open Forum Infectious Diseases. The risk rises to 21 percent if you’ve been hospitalized with COVID-19, according to the study.

Shingles, an outbreak of a blistering rash, is caused by the same virus (varicella zoster) that causes chicken pox. After you’ve had chicken pox, the virus lies dormant in your body. Years later, it can reactivate as shingles, often as a result of stress or a weakening of the immune system.

For the study, the researchers analyzed medical data from nearly 400,000 older adults who contracted COVID-19 and more than 1.5 million who were never diagnosed. They excluded anyone who was vaccinated against either shingles or COVID-19.

Older adults already at higher risk of shingles

Ardeshir Hashmi, M.D., a geriatrician and section chief of Cleveland Clinic’s Center for Geriatric Medicine, calls the study “incredibly important.” He says his clinic has seen a “striking” jump in shingles cases among older adults since the pandemic hit.

“We thought it was related to the stress and strain of the pandemic,” he says. “This is interesting in the sense that we will now keep a closer eye on older adults who get COVID, who are more likely to get shingles.” Surveys show a “major increase” in the number of adults who reported stress, anxiety and depression during the pandemic, according to the Mayo Clinic.

About 1 out of 3 people in the United States will develop shingles in their lifetime, usually after age 50, according to the Centers for Disease Control and Prevention (CDC). And, as with COVID-19, older adults are at significantly higher risk of shingles because immunity naturally declines with age, says Thomas Holland, M.D., infectious disease specialist and associate professor at Duke University Hospital.

Other diseases, such as HIV, that attack the body’s defenses are already known to increase shingles risk. So it’s logical that COVID-19 — which is known to lower immune function — would act in a similar way, Holland says. “This is just one of the many, many things that can happen that can prompt an episode of shingles,” he says.

Vaccines can protect you

Experts say the study underscores how important it is for older adults to get both the COVID-19 vaccine and the shingles vaccine.

The COVID-19 vaccine has been found to be highly effective in preventing severe illness from COVID-19. Hospitalizations in February 2022 were nine times higher in unvaccinated individuals age 65 and older, compared to their vaccinated and boosted peers, federal data shows.

To prevent shingles, the CDC recommends the two-dose Shingrix vaccine for all adults age 50 and older. However, only about 35 percent of Americans ages 60 and older reported that they had received the vaccine as of 2018, according to the most recent CDC data.

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Shingrix is about 97 percent successful at preventing shingles in people in their 50s and 60s, and 91 percent successful for those age 70 and older. The vaccine may also lower the risk of shingles-related strokes in older adults.

The study linking COVID-19 and shingles was conducted by pharmaceutical company GSK, maker of the Shingrix vaccine. However, the findings are backed by research showing an increase in shingles cases during the pandemic, as well as case reports that hypothesized a link between the two diseases. Hashmi says the study’s design appears to be sound.

Although the main symptom of shingles is a blistering rash, lingering pain from the disease can last for months or years after the rash goes away.

“The rash is bad, but the pain is what you really want to avoid,” Hashmi says. “This pain is significant — it’s excruciating pain — which there is really not a great treatment for. For a lot of patients, just from moving the bedsheet, they are screaming in pain.”

Hashmi said he emphasizes to patients that the Shingrix vaccine is particularly effective at eliminating the risk of pain.

“People who have had the (Shingrix) vaccine, even if they get the rash, the pain associated with it is almost zero compared to people who have never had the vaccine,” he says. “If the vaccine can cause you to have no pain, that’s a huge benefit.”

Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader's Digest, Real Simple, Prevention, The Washington Post and The New York Times.