Timing of Shingles Vaccination After a Shingles Outbreak
After having a shingles outbreak, you should wait at least 2 months before getting the shingles vaccine. 1
Rationale for the 2-Month Waiting Period
- The 2-month interval recommendation is based on documented evidence showing this is the minimum interval between an episode of herpes zoster and potential recurrence 1
- This waiting period allows for:
Country-Specific Recommendations
- Different countries have varying recommendations for the time frame between a shingles episode and vaccination: 1
Risk of Recurrence Without Vaccination
- Recent US study with 5.6 years of follow-up showed cumulative incidence of shingles recurrence: 1
- 2.5% at 2 years
- 4.8% at 4 years
- 6.6% at 6 years
- 8.0% at 8 years
- 10.3% at 10 years
Vaccine Options After Shingles
- Both available vaccines can be administered after a shingles episode: 1
- Recombinant zoster vaccine (RZV, Shingrix) - preferred option
- Live zoster vaccine (ZVL, Zostavax)
- RZV (Shingrix) is generally preferred due to higher efficacy and stronger immune response 1
Special Considerations
- For patients with inflammatory arthritis or immunocompromised conditions, RZV is preferred as it's not a live vaccine 2
- For patients previously vaccinated with ZVL who develop shingles, RZV is recommended with a minimum 8-week interval between vaccines 1
- Complete vaccination with 2 doses of RZV is strongly recommended for optimal protection 1
Clinical Pitfalls to Avoid
- Don't wait too long after the 2-month minimum period, as the risk of recurrence increases over time 1
- Don't confuse the waiting period after shingles with the interval between vaccine doses (RZV requires 2 doses, with the second dose given 2-6 months after the first) 1
- Don't administer live zoster vaccine (ZVL) to immunocompromised patients 1
- Don't miss the opportunity to vaccinate older adults who have had shingles, as they remain at risk for recurrence 1