What is the recommended vaccination for Herpes Zoster (shingles)?

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Last updated: March 27, 2025View editorial policy

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From the Guidelines

The recommended vaccination for Herpes Zoster (shingles) is Shingrix (recombinant zoster vaccine), which is preferred over Zostavax due to its higher efficacy and longer-lasting protection. The Shingrix vaccine is administered as two doses given 2-6 months apart, via intramuscular injection, and is over 90% effective at preventing shingles and postherpetic neuralgia (PHN) 1. This vaccine is recommended for immunocompetent adults aged 50 years and older, and it is advised to get Shingrix even if you previously received the older Zostavax vaccine, had shingles before, or don't remember having chickenpox.

Some key points to consider about the Shingrix vaccine include:

  • High efficacy: Shingrix has been shown to be 97.2% effective in preventing HZ in individuals aged 50 years, and 89.8% effective in those aged 70 years 1.
  • Long-lasting protection: The vaccine's efficacy persists above 83.3% for up to 8 years, and decreases to 73% at 10 years 1.
  • Safety profile: While Shingrix is associated with a higher rate of injection-site and systemic reactions compared to Zostavax, there are no differences in serious adverse events (SAEs) between the two vaccines 1.
  • Importance of vaccination: Nearly 1 in 3 people will develop shingles in their lifetime, and the risk increases with age, making vaccination a crucial preventive measure.

Common side effects of the Shingrix vaccine include pain and swelling at the injection site, muscle pain, fatigue, and headache, which typically resolve within 2-3 days 1. These reactions indicate that your immune system is responding to the vaccine. Overall, the benefits of vaccination with Shingrix far outweigh the risks, and it is a highly effective way to prevent shingles and its complications.

From the Research

Recommended Vaccination for Herpes Zoster (Shingles)

The recommended vaccination for Herpes Zoster (shingles) is the recombinant zoster vaccine, also known as Shingrix. This vaccine is approved for the prevention of herpes zoster in adults aged 50 years and older 2, 3, 4, 5.

Key Characteristics of Shingrix

  • Shingrix is a subunit vaccine that contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system 3.
  • The vaccine is administered in two doses, given 2-6 months apart, and has been shown to be highly effective in preventing herpes zoster and postherpetic neuralgia 2, 3, 5.
  • Shingrix has been found to be well-tolerated, with common adverse reactions including injection-site reactions, myalgia, and fatigue, which are typically mild to moderate in severity 3, 5.

Comparison to Other Vaccines

  • Shingrix has been shown to have significantly better efficacy than the live attenuated zoster vaccine, Zostavax 4, 5.
  • The Advisory Committee on Immunization Practices (ACIP) recommends the routine use of Shingrix as the preferred vaccine for the prevention of herpes zoster in immunocompetent adults 50 years of age and older 5.

Special Considerations

  • Shingrix is not contraindicated in immunocompromised individuals and is preferred over live attenuated HZ vaccine in immunocompetent individuals, according to the US and Canadian guidelines 3.
  • The vaccine has been found to be effective in individuals with autoimmune conditions and those taking immunosuppressive medications 2, 3.

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

Shingrix: The New Adjuvanted Recombinant Herpes Zoster Vaccine.

The Annals of pharmacotherapy, 2018

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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