From the Guidelines
Yes, individuals who have had herpes zoster (shingles) should receive vaccination against varicella-zoster virus (VZV) to prevent future episodes and related complications. The most recent and highest quality study, published in 2024 1, recommends that immunocompetent adults aged 50 years or older receive either Zostavax (ZVL) or Shingrix (RZV) to prevent herpes zoster (HZ) and postherpetic neuralgia (PHN), with a preference for RZV due to its higher efficacy. The Shingrix vaccine has been shown to be over 90% effective in preventing shingles and postherpetic neuralgia, and its protection persists for up to 10 years 1. Key points to consider include:
- The vaccine efficacy of ZVL decreases with increasing age and wanes over time, whereas RZV maintains its efficacy for up to 10 years 1.
- The CDC recommends that adults 50 years and older receive two doses of Shingrix, regardless of previous shingles episodes or prior vaccination with Zostavax 1.
- Common side effects of the Shingrix vaccine include pain at the injection site, muscle pain, fatigue, and headache, which typically resolve within 2-3 days 1.
- It is essential to wait until a shingles outbreak has completely resolved before getting vaccinated 1. Overall, the benefits of vaccination against VZV outweigh the risks, and individuals who have had herpes zoster should receive the vaccine to prevent future episodes and related complications, as supported by the most recent study published in 2024 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. The answer is yes, individuals who have had herpes zoster (shingles) can receive vaccination against varicella-zoster virus (VZV) as the label indicates the vaccine is for prevention of HZ in adults aged 50 years and older, with no contraindication for those who have had HZ before 2.
- The vaccine is intended to prevent future episodes of HZ.
- It is not indicated for prevention of primary varicella infection (chickenpox).
From the Research
Vaccination Against Varicella-Zoster Virus (VZV) After Herpes Zoster
- Individuals who have had herpes zoster (shingles) can still benefit from vaccination against varicella-zoster virus (VZV) 3, 4, 5, 6, 7.
- The live, attenuated shingles (herpes zoster) vaccine, such as Zostavax, is approved for use in adults aged ≥50 years and has been shown to reduce the incidence of herpes zoster and postherpetic neuralgia 3, 4, 6, 7.
- Studies have demonstrated that the vaccine is effective in preventing herpes zoster and postherpetic neuralgia in adults aged ≥60 years, with a sustained boost of VZV-specific cell-mediated immunity 5, 6.
- The vaccine has been shown to reduce the burden of illness associated with herpes zoster, including the incidence of postherpetic neuralgia, and is generally well tolerated with mild adverse events 3, 4, 6, 7.
- The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices has recommended universal vaccination for those 60 years of age and older, including those who have experienced previous episodes of shingles 7.