Patient information from BMJ

Shingles vaccine

Last published:Sep 08, 2021

The shingles vaccine is designed to protect against painful symptoms caused by the same virus that causes chickenpox.

This virus can "wake up" after being inactive in the body for many years. These problems usually affect older people.

What is shingles (herpes zoster)?

Shingles is caused by a virus called varicella zoster. It is the same virus that causes chickenpox. The medical name for shingles is herpes zoster.

Chickenpox is a common infection in children. It causes a fever and a rash but usually clears up by itself without causing serious problems.

But the chickenpox virus can remain inactive or "dormant" in the body for many years after the symptoms have gone. This means that the virus is still there, but it isn’t spreading or doing any harm. It’s as if it’s asleep.

In some older people, though, the virus can reactivate or "wake up". If this happens it can cause symptoms similar to chickenpox, but more severe.

Symptoms of shingles include:

• feeling generally unwell

• fatigue (tiredness)

• headache

• pain, burning, tingling, or numbness on an area of skin, usually on the torso (chest, back, and abdomen)

• a rash on the affected area a few days after the pain starts. This rash will develop small blisters. The rash will probably be on one side of your body. Many people get it around their waist, but it can occur anywhere.

Even with treatment, the symptoms usually last between two and four weeks, but some people develop long-lasting pain. Early treatment can help prevent long-term problems.

Some people have a rash involving an eye, which can cause vision damage if not treated quickly.

Shingles can sometimes be fatal, but this is rare.

For more information, see our leaflets: Shingles: what is it? and Shingles: What treatments work?

Who needs the shingles vaccination?

Shingles mainly affects older people, so people tend to be offered this vaccination as they get older. The vaccine used in the US is called Shingrix.

In the US, the vaccine is recommended for everyone ages 50 years and older. Unlike some vaccines, there is no age at which the vaccine stops being recommended. So you can have it any time after the age of 50.

You should have the vaccine even if you:

• have already had shingles in the past

• are not sure if you have had chickenpox, or

• have had an older shingles vaccine called Zostavax, which is no longer used in the US.

Is there anyone who shouldn’t have the vaccine?

You should not have the vaccine if you:

• are allergic to any of its ingredients. Tell the medical staff giving you the vaccine about any allergies you have

• are pregnant or think that you might be

• are breastfeeding, or

• have tested negative for immunity to varicella zoster. Instead, you should have the chickenpox vaccine.

Is it safe?

There have been no major safety problems with the shingles vaccine over many years of use.

But, like all vaccines, it can cause side effects in some people. These include:

• headache

• stomach pain

• nausea, and

• pain, itching, redness, warmth, and bruising where the shot was given (called the injection site).

Any side effects should only last a few days. If they last any longer, talk to your doctor.

Extremely rarely, the shingles vaccine can cause an extreme allergic reaction. The medical staff giving the vaccine will have been trained in how to deal with an allergic reaction.

How is the vaccination given?

The shingles vaccine is given as a shot into the upper arm. For the best protection you need two doses, which are given two to six months apart.

How well does the vaccine work?

The Shingrix vaccine seems to protect at least 90 in every 100 people from getting shingles, although it seems to be slightly less effective in people aged over 70 years.