Shingles is a painful rash resulting from inflammation of the nerves. This condition develops when a specific virus that has been dormant inside the body becomes active again. The intense pain and discomfort associated with shingles make the prospect of a second episode a serious concern for many individuals.
The Viral Origin
Shingles is caused by the varicella-zoster virus (VZV), the same pathogen responsible for chickenpox, typically contracted during childhood. After recovery, the virus does not leave the body. Instead, VZV travels along nerve pathways and establishes a state of dormancy, or latency, within the sensory nerve roots near the brain and spinal cord.
This latent virus remains stored within the nerve cells for decades, held in check by the immune system. Shingles is a reactivation of this existing, long-dormant virus, not a new infection. The virus reactivates when immune surveillance declines, allowing VZV to replicate and travel back down the nerve fiber toward the skin.
Understanding Shingles Recurrence
The direct answer to whether a person can get shingles more than once is yes; it is biologically possible for the virus to reactivate repeatedly. While most individuals only experience a single episode, the potential for recurrence always exists due to the virus’s latent nature. Recurrence is less common than the initial event, but it is a recognized phenomenon referred to as recurrent herpes zoster.
The statistical likelihood of a second episode varies widely, but research suggests that between 1.2% and 9.6% of people who have had shingles will experience a recurrence. For individuals with a weakened immune system, this rate can be significantly higher, sometimes reaching up to 18%. The mechanism behind a second episode is the same as the first: the dormant VZV is stimulated to replicate.
Once reactivated, the virus travels along the nerve to the skin, causing the characteristic painful, blistering rash in a specific area known as a dermatome. The time between episodes can range from a few months to many years, with the average interval being approximately two to three years for adults. A previous episode of shingles does not provide lasting immunity against future reactivations.
Factors That Increase Reactivation Risk
Advanced age, especially in adults over 50, is the primary factor increasing the risk for both the initial episode and recurrence. As the body ages, the effectiveness of the cell-mediated immune response naturally diminishes. This reduced immune surveillance allows the latent virus to break its dormancy.
Compromised immunity from specific health conditions also makes recurrence more likely. This includes individuals managing:
- Diseases like HIV and autoimmune disorders such as lupus or rheumatoid arthritis.
- Certain types of cancer.
- Immunosuppressive medications, including high-dose corticosteroids, chemotherapy, or drugs used after an organ transplant.
The severity of the initial shingles episode can also influence the risk of a second event. People who experienced severe or long-lasting pain (postherpetic neuralgia) or whose initial rash involved the eye show a higher propensity for recurrence. Chronic conditions like diabetes, high blood pressure, and dyslipidemia may additionally increase the probability of VZV reactivation.
Prevention Strategies
The most effective strategy to mitigate the risk of a second shingles episode involves vaccination. The current recombinant zoster vaccine is recommended for all adults aged 50 and older, including those who have already experienced shingles. This non-live vaccine is administered as a two-dose series, with the second dose given two to six months after the first.
Clinical data shows the vaccine is highly effective, demonstrating over 90% efficacy in preventing shingles in adults over 50. This protection is robust and long-lasting, maintaining high effectiveness for a decade or more after inoculation. Even if recurrence occurs after vaccination, the severity and duration of the illness are often reduced.
Maintaining a healthy lifestyle also supports the immune system’s ability to keep the virus dormant. This includes prioritizing adequate sleep, adopting a nutrient-rich diet, and engaging in stress-reducing practices. However, these general health measures are supplemental to vaccination, which remains the most powerful tool for preventing both initial and recurrent episodes.