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Turning 50? Go Get a Shingles Vaccine
It’s extremely effective at preventing a super-unpleasant infection
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Shingles is sneaky. It’s caused by the same virus as chickenpox, varicella-zoster, which lies dormant for decades in the body, ready to pounce.
“Our body gets it under control, but it never fully goes away and lives in our nerves,” says Dr. Ian Neel, an associate professor of medicine and clinical lead of the Geriatric Medicine Consult Services at Senior Behavioral Health at UC San Diego Health. “But as we age, our immune system wanes, and it puts us at higher risk of this virus breaking out of its cage and reactivating.”
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In the U.S., 1 in 3 people will get shingles, usually after age 50, with the risk of complications climbing sharply after age 60. Since the risk rises with age, half of those who live to 85 will experience at least one episode.
Shingles’ most common symptom is an angry, blistering rash. And about 10 to 18 percent of people who develop that rash will also experience a complication known as postherpetic neuralgia, a condition that affects the nerve fibers and skin, causing burning and —sometimes incapacitating — pain that can last for months (or even years) after the rash disappears.
“Shingles rarely kills you,” says Dr. William Schaffner, a professor of preventive medicine and infectious diseases at the Vanderbilt University Medical Center in Nashville. “But it can make you wish you were dead.”
Enter Shingrix, a vaccine approved by the U.S. Food and Drug Administration in 2017. Unlike Zostavax, its predecessor, Shingrix is “spectacularly effective,” Schaffner says.
The numbers support his claim. The two-dose course of Shingrix is 97 percent successful at preventing shingles in people in their 50s and 60s, and 91 percent successful for those in their 70s and older. (That protection stays at over 85 percent in people 70-plus for four years after they get the vaccination.)
What’s more, studies suggest the vaccine may also lower the risk of shingles-related strokes in older adults. Plus, it may have additional health benefits. (Read more below.)
Why more adults aren’t getting the super-effective vaccine
Despite such impressive results, federal data has found that vaccine uptake is less than ideal. In 2024, roughly 44 percent of adults 50 and older reported receiving at least one dose of the shingles vaccine; just over half (51 percent) of adults 60 and older had received it.
What’s behind the hesitation? A couple of things.
First, says Dr. Kristin Christensen, an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us don’t take shingles as seriously as we should.
“People think, If it’s not going to kill me, I don’t need it, without realizing that shingles can be incapacitating, causing severe pain that can really limit people’s functioning,” she says.
What’s more, difficulty in getting the vaccine may have discouraged those who sought it out early on. The company that makes the vaccine couldn’t keep up with the initial demand, resulting in long waiting lists at pharmacies. (It’s more widely available now.)
Also, there’s the ouch factor — not the needle but the way the body initially responds to the vaccine itself.
“This is a moderately reactogenic vaccine, meaning 20 to 30 percent of people may get a fever, along with pain and swelling at the injection site,” says Dr. Gregory Poland, an infectious disease expert and founder of the Mayo Clinic’s Vaccine Research Group. However, he notes, the second dose tends to cause less of a reaction, so people do better with it.
“And the good news is that these symptoms almost always will go away on their own in just a few days,” says Dr. Pritish K. Tosh, an infectious disease specialist at the Mayo Clinic.
Besides, Schaffner says, “having your arm hurt for a day or so is a small price to pay to avoid this infection.” In fact, he adds, “I couldn’t be more insistent and enthusiastic about any vaccine more than the shingles vaccine.”
What to know about the shingles vaccine
Who needs it? The U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone 50 and older get Shingrix, even if they had the earlier recommended vaccine Zostavax or if they’ve already had a bout of shingles.
Older adults should also get this vaccine, whether or not they remember having had chickenpox as a child. Why? More than 99 percent of Americans over the age of 40 have been exposed to the varicella-zoster virus, even if they don’t recall getting chickenpox.
How often? It’s not an annual vaccine, like the flu shot. You need to complete the series only once (it’s two doses spaced two to six months apart). The vaccine is more than 90 percent effective after you’ve had both shots.
Why do you need it? One in 3 people will get painful, occasionally debilitating shingles, usually after age 50, and the risk increases as we get older. By age 85, half of adults will have experienced at least one outbreak.
Medicare enrollees with Part D don’t have any out-of-pocket costs for vaccines that the CDC’s Advisory Committee on Immunization Practices recommends for adults, including the shingles vaccine, under the 2022 prescription drug law. This rule went into effect Jan. 1, 2023, and national data suggests it has helped increase the number of older adults getting vaccinated for shingles.
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