Are the chicken pox (varicella) vaccine and shingles (herpes zoster) vaccine the same?

From the Guidelines

No, the chicken pox (varicella) vaccine and shingles (herpes zoster) vaccine are not the same, although they target the same virus. The varicella vaccine (Varivax) contains a weakened live form of the varicella-zoster virus and is given to children to prevent chicken pox, typically administered in two doses at 12-15 months and 4-6 years of age. The shingles vaccine comes in two forms: Zostavax (a live attenuated vaccine no longer preferred in the US) and Shingrix (a non-live recombinant vaccine), with Shingrix being the recommended option for adults 50 and older, given as two doses 2-6 months apart. While both vaccines target the same virus, they differ in composition, potency, and intended age groups. The shingles vaccine contains a much higher concentration of viral antigens because it needs to boost immunity in older adults whose natural protection against the virus has waned over time. This is why someone who received the chicken pox vaccine as a child will still need the shingles vaccine later in life to prevent the reactivation of the dormant virus that can cause painful shingles outbreaks, as supported by the most recent study 1.

Some key points to consider:

• The varicella vaccine is primarily used in children to prevent chicken pox, with a typical administration schedule of two doses at 12-15 months and 4-6 years of age.
• The shingles vaccine, specifically Shingrix, is recommended for adults 50 and older, given as two doses 2-6 months apart, to prevent the reactivation of the varicella-zoster virus.
• The composition and potency of the varicella and shingles vaccines differ, with the shingles vaccine containing a higher concentration of viral antigens to boost immunity in older adults.
• The use of Zostavax, a live attenuated vaccine, is no longer preferred in the US due to its lower efficacy compared to Shingrix, as noted in studies such as 1 and 1.

Overall, the chicken pox and shingles vaccines are distinct and serve different purposes in preventing varicella-zoster virus infections at different stages of life, with the most recent evidence supporting the use of Shingrix for adults 50 and older 1.

From the Research

Vaccine Comparison

The chicken pox vaccine and shingles vaccine are not the same, although they are both designed to protect against the varicella-zoster virus (VZV) [ 2, 3 ].

• The chicken pox vaccine, also known as the varicella vaccine, is primarily used to prevent varicella (chicken pox) in children [ 2 ].
• The shingles vaccine, on the other hand, is used to prevent herpes zoster (shingles) in adults, particularly those over 50 years old [ 4, 3 ].

Vaccine Mechanism

Both vaccines work by establishing immunity to VZV, but they have different mechanisms and effects:

• The varicella vaccine establishes latency in ganglionic neurons, similar to natural infection, and provides long-term immunity to varicella [ 3 ].
• The shingles vaccine, however, is designed to boost immunity to VZV and prevent reactivation of the virus, which causes shingles [ 3 ].

Vaccine Development

Researchers are working to develop new vaccines that can prevent not only varicella but also the establishment of latency and subsequent reactivation of VZV, which would ultimately prevent herpes zoster [ 5, 6 ].

• A neuro-attenuated vaccine that prevents neuronal and latent infection is considered essential for the eventual eradication of VZV [ 6 ].
• The development of a genetically-defined live-attenuated VZV vaccine that prevents primary varicella and latent infection is also being explored [ 6 ].