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Shingles Vaccine
I’ve heard conflicting advice about when to get the shingles vaccine. I’ve seen the debilitating effects of the virus on my 73-year-old mother—who suffered severe ear and facial pain, as well as hearing loss. But I’ve also heard stories of people in their 30s and 40s getting severe cases.
I asked Glen P. Carlson, MD, an internal medicine physician with HealthPartners, for the lowdown on the vaccine.
First, could you describe briefly what shingles is?
Shingles is a viral infection that causes a painful rash. Shingles is caused by the varicella zoster virus which is the same virus that causes chicken pox. After you have had chicken pox, the virus lies inactive in nerve tissue and years later can reactivate, causing a painful rash that looks like blisters. Most often the rash appears in a line around the right or left side of your torso, but can affect any part of the body including the face and eyes. Individuals have a 20-30% chance of getting shingles during their lifetime, and it is more likely to occur when you get older. The most common complication of shingles is post herpetic neuralgia, which causes persistent pain long after the blisters have disappeared and can last for months.
At what age should we get the shingles vaccine?
The current vaccine for shingles is approved to be given starting at age 50. The vaccine is a two-dose series with the second dose given two to six months after the first dose.
Is it possible to get the vaccine before the recommended age?
The shingles vaccine is FDA approved for adults 50 and older. Studies are currently under way looking at giving the vaccine earlier for select patients (immunocompromised), but at this time we give the vaccine starting at age 50.
Can you describe the vaccine? How long has it been around? Is there a new brand on the market that’s showing better efficacy?
One shingles vaccine, Shingrix, is available in the United States. It was licensed by the FDA in 2017. The manufacturer of a previous vaccine, Zostavax, discontinued making this vaccine in 2020.* In clinical trials, Shingrix was 97% effective at preventing shingles in adults ages 50-69 and 91% for adults 70 years and older. Shingrix is not a live vaccine.
Are there side effects?
The most common side effects of the vaccine include redness, pain, and swelling at the injection site. These are similar to other vaccines that are given such as tetanus or the flu shot.
Some people I spoke to said they decided not to get the shingles vaccine because it was expensive. Do you know why the shingles vaccine has such a high out-of-pocket cost? Is it not covered by insurance?
The cost of the vaccine will vary based on insurance coverage, so individuals are advised to check with their insurance plan first. All Medicare Part D plans cover the Shingrix vaccination. Medicare Part B does not cover the cost of the vaccine.
Is there anything else you think is important for people to know about the shingles virus or the vaccine?
The best way to prevent shingles and avoid its complications is to get vaccinated. Data shows that almost everyone older than age 40 has been exposed to chickenpox at some point. Even if you don’t remember having chickenpox as a child, you should get the vaccine.
—Glen P. Carlson, MD, HealthPartners
*According to the CDC website: “Zostavax is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.”
