Who can receive the Shingrix (zoster vaccine recombinant) vaccine?

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Last updated: June 11, 2025View editorial policy

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From the Guidelines

Shingrix (zoster vaccine recombinant) is recommended for adults aged 50 years and older. The vaccine is administered as a two-dose series, with the second dose given 2-6 months after the first dose 1.

Key Points

  • Shingrix can be given regardless of prior history of herpes zoster (shingles) or prior receipt of Zostavax (the older shingles vaccine) 1.
  • It is also recommended for those who previously received Zostavax, with Shingrix administration at least 8 weeks after Zostavax.
  • The vaccine works by boosting the immune system's response to the varicella-zoster virus, which causes both chickenpox and shingles.
  • Shingrix is highly effective, providing over 90% protection against shingles in adults across all age groups 1.

Side Effects

  • Common side effects include pain and swelling at the injection site, muscle pain, fatigue, and headache, which typically resolve within 2-3 days.
  • The vaccine has been shown to have a significantly higher rate of injection-site and systemic reactions compared to Zostavax, but no differences in serious adverse events (SAEs) between the two vaccines 1.

Recommendations

  • The CDC recommends that healthy adults 50 years and older receive two doses of Shingrix, 2 to 6 months apart 1.
  • Immunocompetent adults, aged 50 years, may receive either ZVL or RZV to prevent HZ and PHN, with a preference for RZV 1.

From the FDA Drug Label

SHINGRIX is a vaccine indicated for prevention of herpes zoster (HZ) (shingles): • in adults aged 50 years and older. • in adults aged 18 years and older who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression caused by known disease or therapy

Eligible individuals for the Shingrix vaccine include:

  • Adults aged 50 years and older
  • Adults aged 18 years and older who are or will be at increased risk of HZ due to immunodeficiency or immunosuppression caused by known disease or therapy 2

From the Research

Eligibility for Shingrix Vaccine

The Shingrix vaccine is recommended for adults aged 50 years and older [ 3, 4,5 ].

  • The vaccine is dispensed as 2 doses given 2-6 months apart 3.
  • It is also effective among individuals with autoimmune or immunosuppressive conditions 3, 4.

Special Considerations

  • The vaccine effectiveness was not significantly lower for beneficiaries aged >80 years, or for second doses received at ≥180 days 3.
  • Two-dose vaccine effectiveness against postherpetic neuralgia was 76.0% 3.
  • Shingrix is a nonreplicating vaccine and is thus safe in immunocompromised persons 4.

Comparison with Other Vaccines

  • Recombinant zoster vaccine (RZV) is more effective for prevention of HZ than the live-attenuated varicella-zoster virus (VZV) vaccine (ZVL) 4.
  • Shingrix demonstrated an overall vaccine efficacy of 97.2% among participants 50 years of age or older 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Recombinant Zoster Vaccine (Shingrix): Real-World Effectiveness in the First 2 Years Post-Licensure.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021

Research

Herpes Zoster Vaccines.

The Journal of infectious diseases, 2021

Research

Shingrix for Herpes Zoster: A Review.

Skin therapy letter, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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