What happens if you only receive one dose of Shingrix (zoster vaccine recombinant)?

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Last updated: March 17, 2025View editorial policy

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From the Guidelines

Getting only one dose of Shingrix provides incomplete protection against shingles, and it is essential to receive the second dose to achieve optimal immunity. The recommended regimen for Shingrix is two doses, given 2-6 months apart, to achieve optimal immunity. With just one dose, you'll have some protection, but studies show it's significantly less effective than the complete two-dose series.

Key Points

  • The first dose initiates the immune response, while the second dose strengthens and extends this protection, resulting in over 90% effectiveness against shingles for at least four years 1.
  • If you've only received one dose, you should get the second dose as soon as possible, even if more than 6 months have passed since the first dose.
  • There's no need to restart the series.
  • Shingrix is recommended for adults 50 years and older to prevent shingles, a painful rash caused by reactivation of the varicella-zoster virus.
  • The vaccine works by boosting your immune system's ability to recognize and fight this virus, which remains dormant in your body after a chickenpox infection.

Recommendations

  • Adults aged 50 years and older should receive two doses of Shingrix, 2-6 months apart, to prevent shingles and postherpetic neuralgia (PHN) 1.
  • The recombinant zoster vaccine, Shingrix, is preferred over the live-attenuated zoster vaccine, Zostavax, due to its higher efficacy and longer duration of protection 1.

From the Research

Vaccine Effectiveness with One Dose

  • The effectiveness of Shingrix (recombinant zoster vaccine) with one dose is estimated to be 56.9% (95% CI, 55.0-58.8) in preventing herpes zoster 2.
  • This is lower than the effectiveness of the two-dose regimen, which is estimated to be 70.1% (95% CI, 68.6-71.5) 2.

Comparison to Two-Dose Regimen

  • The two-dose regimen of Shingrix is recommended for optimal protection against herpes zoster, with the second dose administered 2-6 months after the first dose 3, 4.
  • Completing the two-dose series is important for ensuring adequate protection, as the effectiveness of a single dose is lower than that of the two-dose regimen 2.

Real-World Effectiveness

  • Real-world studies have demonstrated the effectiveness of Shingrix in preventing herpes zoster and postherpetic neuralgia, with estimates of vaccine effectiveness ranging from 56.9% to 76.0% 2, 5.
  • These studies have also shown that the vaccine is effective in various populations, including older adults and those with autoimmune or immunosuppressive conditions 2, 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

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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