Does having chickenpox as a child increase the risk of developing shingles later in life and how can it be prevented?

From the Guidelines

Having chickenpox as a child does increase the risk of developing shingles later in life because the varicella-zoster virus that causes chickenpox remains dormant in nerve tissues after recovery and can reactivate years later as shingles. The most effective prevention method is vaccination with Shingrix, the preferred shingles vaccine recommended for adults 50 and older, given as two doses 2-6 months apart, as it provides strong protection with effectiveness rates over 90% across age groups 1.

Key Points to Consider

• The varicella-zoster virus can reactivate years after the initial chickenpox infection, leading to shingles.
• Vaccination with Shingrix is the most effective method to prevent shingles, with a preference for this vaccine over Zostavax due to its higher efficacy and longer duration of protection 1.
• Additional preventive measures include maintaining a strong immune system through regular exercise, adequate sleep, stress management, and a nutritious diet, as shingles often emerges during periods of weakened immunity.
• For those who never had chickenpox, the varicella vaccine (Varivax) can prevent initial infection, thereby eliminating the risk of later shingles development.
• Early antiviral treatment (acyclovir, valacyclovir, or famciclovir) within 72 hours of rash appearance can reduce the severity and duration of a shingles outbreak if prevention fails.

Recommendations

• Adults 50 and older should receive the Shingrix vaccine to prevent shingles, given its high efficacy and preference over other available vaccines 1.
• Individuals who have never had chickenpox should consider vaccination with Varivax to prevent initial infection and subsequent risk of shingles.
• Maintaining a healthy lifestyle, including regular exercise, adequate sleep, and a balanced diet, can help reduce the risk of shingles by supporting immune function.

From the FDA Drug Label

The risk of developing HZ, which increases with age and with immunosuppression due to disease and/or therapy, appears to be related to a decline in varicella zoster virus (VZV)-specific immunity.

Having chickenpox as a child increases the risk of developing shingles later in life because the varicella-zoster virus remains dormant in the body and can reactivate as shingles. To reduce the risk of shingles, vaccination with SHINGRIX is recommended for adults aged 50 years and older, including those who have had chickenpox as a child 2. The vaccine has been shown to be effective in preventing shingles and postherpetic neuralgia, a complication of shingles, in adults aged 50 years and older 2. It is essential to note that the vaccine is not a guarantee against developing shingles, but it can significantly reduce the risk. Consult a healthcare professional to determine the best course of action for reducing the risk of shingles.

From the Research

Risk of Shingles after Chickenpox

• Having chickenpox as a child increases the risk of developing shingles later in life, as the varicella-zoster virus remains dormant in the body and can reactivate years later 3, 4.
• The risk of shingles increases with age, with up to 50% of individuals aged 80 years or more developing the condition 3.
• Other factors that increase the risk of shingles include a decline in cell-mediated immunity, which can occur with age or as a result of certain medical conditions or treatments 4.

Prevention of Shingles

• Vaccination is a effective way to reduce the risk of shingles, with studies showing that the zoster vaccine can reduce the incidence of shingles by 51% and postherpetic neuralgia by 67% 5, 6.
• The zoster vaccine is recommended for adults aged 60 years or older, and has been shown to be safe and well-tolerated in this age group 6.
• Other strategies, such as boosting cell-mediated immunity through vaccination, may also be effective in preventing shingles 5.
• It is essential to note that vaccination can have a significant impact on the epidemiology of varicella zoster virus, and understanding the mechanisms for maintaining immunity against varicella and zoster is critical for predicting the long-term effects of vaccination 7.

Reducing the Risk of Shingles

• Getting vaccinated against shingles is the most effective way to reduce the risk of developing the condition 5, 6.
• Maintaining a healthy lifestyle, including eating a balanced diet and exercising regularly, may also help to boost cell-mediated immunity and reduce the risk of shingles 4.
• Avoiding contact with individuals who have shingles or chickenpox may also help to reduce the risk of developing the condition, although this is not always possible 7.