Shingles Vaccine Recommended Age
The shingles vaccine (Shingrix) is recommended starting at age 50 years and older for all adults, not age 60. 1
Current Standard Recommendation
The Advisory Committee on Immunization Practices (ACIP) and CDC recommend Shingrix vaccination beginning at age 50 years for all immunocompetent adults, superseding the older guideline that recommended starting at age 60 for the previous live-attenuated vaccine (Zostavax). 1
The American Geriatrics Society, American College of Physicians, and Infectious Diseases Society of America all align with the age 50 recommendation for Shingrix. 1
Why the Age Changed from 60 to 50
Shingrix demonstrates consistently high efficacy (>90%) across all age groups 50 and older, unlike Zostavax which had significantly declining efficacy with age (70% in ages 50-59 versus only 18% in those ≥80 years). 1
The vaccine maintains 97.2% efficacy in adults aged 50+ years and 89.8% efficacy in adults aged 70+ years, with protection persisting above 83.3% for at least 8 years. 1, 2
Starting vaccination at age 50 provides protection during the years when herpes zoster incidence begins to rise substantially, preventing more cases overall compared to waiting until age 60. 1
Special Populations Under Age 50
Adults aged 18 years and older who are or will be immunocompromised qualify for Shingrix vaccination regardless of age. 2
This includes patients on chronic high-dose glucocorticoids (≥20 mg/day prednisone equivalent), those with immunodeficiency diseases, patients on immunosuppressive therapy including biologics and JAK inhibitors, and those with hematologic malignancies or solid organ cancers. 2, 3
For immunocompromised adults under 50, use a shortened schedule with the second dose given 1-2 months after the first dose (rather than the standard 2-6 months). 2
Dosing Schedule
Administer Shingrix as a two-dose series intramuscularly, with the second dose given 2-6 months after the first dose for immunocompetent adults. 1
The minimum interval between doses is 4 weeks; if given earlier, the dose should be repeated. 1
Important Clinical Caveats
Never use the live-attenuated Zostavax vaccine in immunocompromised patients—only Shingrix is appropriate for this population. 3
Shingrix is recommended regardless of prior shingles history; previous herpes zoster infection is not a contraindication. 1
Adults who previously received Zostavax should receive the full 2-dose Shingrix series at least 2 months after the last Zostavax dose, as Zostavax efficacy declines to only 14.1% by year 10. 1