Licensed in 2006, it has been recommended that all seniors who are at least 60 years old get Zostavax, the shingles vaccine.
When given as a one time dose, it can help reduce your risk of developing shingles by 51% and risk of developing post-herpetic neuralgia (PHN) by 67%. That protection will last about five years.
Since you can get shingles more than once, you can get the shingles vaccine even if you have already had shingles.
Myths About the Shingles
A lot of people don’t understand shingles (herpes zoster).
What is shingles? It is a reactivation of the varicella zoster virus, which also causes chicken pox. Although we don’t know why, it is clear that in some people, instead of staying dormant, the chicken pox virus can reactivate from the dorsal root ganglia of a spinal nerve.
Is shingles contagious? Yes, but other people exposed to shingles won’t actually get shingles, instead, they can get chicken pox (if they are not immune).
Can you catch shingles? No, but you can catch chicken pox (if you are not immune) from someone that has shingles.
Can kids get shingles? Yes, you can get shingles at just about any age, but the risk increases as you get older, which is why the elderly are most at risk.
What does herpes zoster have to do with genital herpes? Nothing. Shingles got the name herpes zoster before it was known that it was caused by the chicken pox virus (varicella zoster).
Can you get shingles if you have never had chicken pox? Yes, if you have had the chicken pox vaccine, although the risk is much less than after a natural chicken pox infection with the wild-type chicken pox virus. In fact, so far, it has been shown that vaccinated children have a moderately decreased risk of getting shingles after being vaccinated with the chicken pox vaccine.
Are we seeing more cases of shingles in adults because kids get the chicken pox vaccine now? No. While an interesting theory, it has been shown over and over and over that the chicken pox vaccine is not creating an epidemic of shingles. Studies have shown that shingles cases were rising before we started giving the chicken pox vaccine and they have been rising in countries that don’t even protect children with the chicken pox vaccine. The two are not connected.
Myths About the Shingles Vaccine
A lot of people also don’t understand the shingles vaccine.
They especially don’t seem to understand that it is same live strain of virus that is in the chicken pox vaccine, only with higher virus titers (it is more potent).
Why is it just for seniors who are at least 60 years old? That’s the age that it works best and since the immunity is not life long and it is given as just one dose, experts felt that would be the best time to get it. You can get it later though. You could even get it earlier, as early as age 50 years. Can you get it even earlier? You might consider getting the vaccine off-label at an earlier age if you have already had one or more severe cases of shingles, but it is only routinely recommended for people who are at least 60 years old.
Can you get the shingles vaccine if you have never had chicken pox? No, you should get the chicken pox vaccine instead. But keep in mind that most adults born in the pre-vaccine era, especially if they were born before 1980, are presumed to have had chicken pox already, even if they don’t remember it. Talk to your doctor if you really don’t think you have though.
“If you see a turtle sitting on top of a fence post, it didn’t get there by accident.”
President Bill Clinton
Does the shingles vaccines cause shingles? No. Since it only reduces your risk of developing shingles by 51% and the duration of protection is about 5 years, there is certainly a chance that you could get shingles even after having the vaccine, but the shingles vaccine doesn’t actually cause shingles.
Is it worth getting vaccinated against shingles? It is if you want to try and avoid getting shingles! And even though the vaccine isn’t perfect, it is safe, and “In general, with increasing age at vaccination, the vaccine retained efficacy against severity of zoster better than against zoster itself.” So even if you do get shingles later on, it should be a milder case.
Why do some folks think that the shingles vaccine can cause shingles? In 2014, the package insert for the shingles vaccine was updated to mention that shingles could be a side effect after getting the vaccine. It was added to the Adverse Events section of the package insert, where “these reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to the vaccine.”
Vaccines are monitored for safety even after they are approved by the FDA, so it is not a surprise that the package insert would be updated like this.
Since they reportedly found the vaccine strain of the virus (VZV-Oka), the implications are pretty clear. But that likely just means that they got the shingles vaccine without having any immunity to chicken pox. After all, if they were immune to chicken pox from a past infection, then they would have had wild-type virus (VZV-WT) in their shingles lesions, not vaccine strain virus. And then, just like someone who got the chicken pox vaccine could still get shingles, these folks got shingles.
“The absence of VZV-Oka in samples from cases of HZ in zoster vaccine recipients indicates either that VZV-Oka rarely, if ever, establishes latency in sensory ganglia already latently infected with VZV-WT, or that if VZV-Oka does establish latent neuronal infections in VZV seropositive vaccine recipients, it rarely, if ever, reactivates to cause HZ. ”
Ruth Harbecke, et al on A Real-Time PCR Assay to Identify and Discriminate Among Wild-Type and Vaccine Strains of Varicella-Zoster Virus and Herpes Simplex Virus in Clinical Specimens, and Comparison With the Clinical Diagnoses
That still wouldn’t mean that the shingles vaccine caused shingles though. Remember, we know that “Among vaccine recipients, the attenuated Oka/Merck strain of VZV included in varicella vaccine also can establish a latent infection and clinically reactivate as zoster.” Again, that means you can get shingles after getting the chicken pox vaccine.
So the shingles vaccine could theoretically have caused a latent infection that reactivated = shingles.
But doesn’t that mean that the shingles vaccine caused them to have shingles. Maybe indirectly, but then it also gave them immunity against chicken pox. It has been shown that the shingles vaccine can safely provide immunity to adults who never had chicken pox before.
It’s not an accident that some people think that the shingles vaccine can cause shingles though and are maybe even afraid to get it. Like most anti-vaccine misinformation, this myth is spread on the Internet, this time with the help of personal injury lawyers.
What To Know About the Shingles Vaccine
The shingles vaccine is a safe way to decrease your risk of developing shingles and post-herpetic neuralgia, and it doesn’t directly cause shingles.
For More Information on the Shingles Vaccine:
- Ask the Experts about Shingles Vaccines
- Shingles Vaccination: What Everyone Should Know
- CDC – Prevention of Herpes Zoster Recommendations of the Advisory Committee on Immunization Practices (ACIP)
- Shingles VIS
- Shingles ACIP Vaccine Recommendations
- Pinkbook – Varicella
- FDA – Zostavax (package insert)
- A Look at Each Vaccine : Shingles
- History of the Shingles Vaccines
- Study – A Real-Time PCR Assay to Identify and Discriminate Among Wild-Type and Vaccine Strains of Varicella-Zoster Virus and Herpes Simplex Virus in Clinical Specimens, and Comparison With the Clinical Diagnoses
- Study – Safety and immunogenicity of a zoster vaccine in varicella-zoster virus seronegative and low-seropositive healthy adults.
- Study – Population-based incidence of herpes zoster after introduction of a publicly funded varicella vaccination program.