If you’re like an estimated 99% of people born before 1980, chances are you’ve had the varicella-zoster virus, which causes chickenpox. It usually shows up in childhood with a trademark itchy and crusty rash, though it can strike at any time, with or without symptoms.

Many people who got chickenpox as a child have long since forgotten about it — or perhaps never knew they had it in the first place. But fast forward a few decades and you may experience a potentially painful and long lasting complication: herpes zoster, also called shingles.

There is a shingles vaccine. The Food and Drug Administration (FDA) approved Shingrix in 2017 after finding it safe and highly effective at preventing shingles. But it’s mostly recommended for people ages 50 and over.

Read on to learn about the reasons behind the over-age-50 rule and a few exceptions to that rule.

The Centers for Disease Control and Prevention (CDC) recommends the shingles vaccine for people with healthy immune systems who are ages 50 and over. This is because your immune system becomes less robust as you age, so your risk of developing shingles increases.

The CDC also recommends the vaccine for people ages 19 and over who are immunocompromised. This means they have a weakened immune system.

Shingrix is a vaccine that contains an inactive form of the herpes zoster virus. It helps you develop an immunity to the active virus.

Adults receive the vaccine in two separate doses. Generally, healthy adults over age 50 get their second dose 2 to 6 months after the first dose. Immunocompromised adults may get the second dose sooner.

There is no maximum age for getting Shingrix.

Shingles is caused by a reactivation of the varicella-zoster virus, which is the virus that causes chickenpox.

When you get chickenpox and recover, the varicella-zoster virus doesn’t go away. Instead, it stays dormant in your nerve cells. As you get older, your body is less able to fight off viruses. During this time, the virus can reactivate.

The hallmark sign of shingles is a pronounced rash of painful blisters filled with clear fluid. It usually shows up on one side of the body, especially on the head, neck, or torso. That said, it can appear anywhere on your body.

Other symptoms include:

  • fever
  • headache
  • chills
  • upset stomach

The blisters typically start healing within 7 to 10 days and go away within a month. Yet the condition can sometimes cause persistent nerve pain, called postherpetic neuralgia (PHN).

PHN may affect the same area where you had the shingles rash. It can persist for months or years, become intensely painful, and sometimes interfere with daily life.

About 1 million people get shingles each year. The risk of getting shingles gets higher as you get older. In fact, people ages 65 or over are three times more likely to get shingles than younger people.

According to the CDC, 1 in 3 people will get shingles in their lifetime. Shingles is more common in women than in men, and it is more common in white people than in Black people.

Risk factors for shingles include:

  • having had chickenpox, even if asymptomatic
  • having had the chickenpox vaccine, although the risk is lower than with naturally occurring infection

Certain conditions or medications that affect your body’s immunity also increases your risk, particularly:

  • cancer, especially leukemia and lymphoma
  • HIV
  • bone marrow or solid organ (renal, cardiac, liver, and lung) transplants
  • immunosuppressive medications, including:
    • steroids
    • chemotherapy
    • transplant-related immunosuppressive medications

People born after 1995 are less likely to get shingles because they are less likely overall to get chickenpox. That year, a vaccine was released, which reduced chickenpox transmission significantly.

You can get shingles after vaccination with the chickenpox vaccine, but it’s less likely than if you got chickenpox.

Depending on when you get Shingrix, the vaccine is more than 90% effective in preventing shingles and PHN.

Having a reaction?

If you’ve gotten Shingrix and are experiencing an adverse reaction, you can report it to the FDA and CDC’s Vaccine Adverse Event Reporting System (VAERS) at https://vaers.hhs.gov/reportevent.html

Was this helpful?

Chickenpox and shingles are caused by the same virus, varicella-zoster. When you recover from chickenpox, the virus stays in the cells in your nervous system.

It can become active again if your body is no longer able to suppress it. It spreads down nerve fibers and up to your skin, causing a rash, inflammation, burning, and pain.

A doctor will examine the rash on your skin and ask you about your symptoms. This is usually how healthcare professionals diagnose shingles.

A healthcare professional may remove some fluid from a blister for testing, but typically this is not necessary.

Vaccination is the key to preventing shingles. The CDC recommends:

  • two doses of chickenpox vaccine regardless of age
  • two doses of Shingrix for adults over age 50 and adults with weakened immune systems (immunocompromised)

According to the CDC, you should get the vaccine even if, in the past, you:

  • had shingles
  • received Zostavax, another vaccine that is no longer on the market
  • received the varicella (chickenpox) vaccine

Creating and maintaining healthy lifestyle habits — such as stress management, a healthy diet, regular exercise, and getting plenty of sleep — can also help prevent or lessen flare-ups.

Shingles can be painful but the blisters often begin to heal within a week. Your skin usually clears up within a month.

People who develop PHN can have it for months or years afterward, but not everyone who has shingles will develop PHN.

Healthcare professionals can help treat shingles and shorten its duration with prescription antiviral drugs. These can also reduce your likelihood of having PHN.

Most people only get shingles once, though it is possible to get it again.

Can I get the shingles vaccine if I am under age 50?

Shingrix is not recommended for adults under age 50 who have a healthy immune system.

It is recommended for adults ages 19 or over who are immunocompromised, such as people with an immune-related health condition or who are receiving immunosuppressive agents, which are medications that reduce the body’s immune response. These medications may help prevent organ rejection after an organ transplant and treat other medical conditions.

What happens if I didn’t get the second dose within 6 months of the first one?

It’s recommended that you get a second dose between 2 and 6 months after the first. But, if you have waited longer than 6 months, according to the CDC, you will not have to start over. Just get your second dose as soon as possible.

Do I have to get a first and second dose if I’ve never had chickenpox (varicella)?

Yes. You can still catch the varicella-zoster virus if you’ve never had chickenpox, and that may cause shingles.

How long will immunity last?

Immunity stays strong for at least 7 years and is more than 90% effective at preventing shingles and PHN among people ages 50 and over, per the CDC. It is between 68% to 91% effective in immunocompromised adults over age 18.

Are there side effects?

Most people don’t develop side effects from the shingles vaccine, but some can occur. The vaccine is injected into your arm, so pain and soreness at the injection site are common.

The FDA also issued a warning in 2021 that there may an association between receiving the vaccine and developing Guillain-Barré Syndrome (GBS), though the relationship is poorly understood and more research is needed.

GBS is a rare condition in which your body’s immune system attacks part of the nervous system.

Are vaccines different for healthy adults over age 50 and immunocompromised adults over age 50?

No, the CDC recommends that all people over age 50 get the shingles vaccine.

Who should not get the vaccine?

You should not get Shingrix if you:

  • have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
  • have shingles right now
  • are pregnant
  • currently have a moderate or severe health condition, with or without fever

Shingles is a painful condition caused by the same virus as chickenpox. The virus can remain dormant in your nervous system for decades before reactivating.

There is one FDA-approved vaccine that prevents shingles and its complications. It’s usually given to adults over age 50 or to those ages 19 or over who have compromised immune systems. Your doctor may be able to prescribe it to you sooner depending on your circumstances.

If you do get shingles, it usually goes away within a month. Yet it’s possible to develop PHN that lasts for months or years. Your healthcare professional may be able to prescribe antiviral drugs that will shorten the duration of the shingles infection and help prevent PHN.