The varicella-zoster virus, the same agent that causes chickenpox, can reactivate years later to cause shingles, a condition known as herpes zoster. This reactivation typically results in a painful, blistering rash that follows a nerve path on one side of the body. To prevent this often debilitating illness and its long-term complication, postherpetic neuralgia, a highly effective recombinant zoster vaccine is now the standard preventive measure. This vaccine, known as Shingrix, is administered as a two-dose series to provide robust and lasting protection against the disease.
Who Should Receive the Shingles Vaccine
The recommendation for the shingles vaccine is primarily based on age, with all adults 50 years and older advised to receive the two-dose series. The risk of developing shingles and experiencing severe complications increases significantly with age, making this population the priority for vaccination. Protection from this vaccine is reported to be over 90% effective in preventing shingles in adults 50 and older with healthy immune systems.
Vaccination is also strongly recommended for adults aged 19 years and older who are or will be immunocompromised due to disease or therapy. These individuals have a higher risk of contracting shingles and experiencing more severe outcomes. A person should receive the vaccine even if they have had shingles in the past, as the infection does not guarantee future immunity.
The Standard Dosing Schedule
For adults aged 50 years and older who have healthy immune systems, the standard interval between the first and second dose is two to six months. This period is considered optimal for the immune system to fully respond to the vaccine components and develop long-term memory.
The second dose is necessary because a single dose does not provide the same high level of sustained protection against the virus. The two-dose regimen demonstrated superior efficacy in clinical trials, which remains sustained for many years following the complete series. Completing the second dose within the six-month window is highly encouraged to ensure the best possible protective effectiveness.
A shorter dosing schedule is recommended for adults aged 19 years and older who are immunocompromised. For this group, the second dose can be administered one to two months after the first dose. The accelerated schedule is intended to provide protection more quickly to those at higher risk of developing shingles and its complications.
Addressing Common Scheduling Questions
If the second dose is delayed past the recommended six-month window, the vaccine series should not be restarted. Instead, the second dose should be administered as soon as possible, as studies indicate that the vaccine’s effectiveness is maintained even with a prolonged interval. Receiving the late second dose is substantially better than having only the initial dose, which provides less robust protection.
For individuals who have recently experienced a shingles episode, they should wait until the acute rash has completely resolved before getting the vaccine. While there is no strict waiting period, many health organizations suggest a minimum of two months after the symptoms have cleared to ensure the immune system has recovered from the natural infection. Vaccination is still highly recommended after an episode to prevent future recurrences, as the risk of a second outbreak persists.
People who previously received the older Zostavax vaccine can receive Shingrix, but they should wait at least eight weeks after the Zostavax dose before starting the new series. The shingles vaccine can also be given at the same time as other adult vaccines, such as the influenza or pneumococcal shots, without affecting the immune response of either vaccine.