Can someone develop herpes zoster (shingles) from being around someone who received the varicella-zoster virus (VZV) vaccine, also known as the shingles vaccine (Zostavax) (live attenuated herpes zoster vaccine)?

From the Guidelines

No, you cannot get shingles from being around someone who recently received the shingles vaccine. The shingles vaccines available today are not live virus vaccines that can spread to others. Shingrix is a recombinant vaccine containing only a protein from the virus, not the virus itself. While the older Zostavax was a weakened live virus vaccine, it still couldn't cause shingles in contacts. However, if someone develops a rash after receiving Zostavax (which is rare), there is a very small theoretical risk that virus from the rash could cause chickenpox (not shingles) in a person who has never had chickenpox or been vaccinated against it, as noted in studies 1.

According to the prevention of varicella recommendations by the Advisory Committee on Immunization Practices (ACIP) 1, healthy, vaccinated persons have a minimal risk for transmitting vaccine virus to their contacts. The benefits of vaccinating household contacts of immunocompromised persons outweigh the extremely low potential risk for transmission of vaccine virus to immunocompromised contacts, as stated in 1.

Key points to consider:

• Shingles itself can only develop in people who previously had chickenpox, as it's caused by reactivation of the dormant varicella-zoster virus already in their body, not from external exposure to someone else.
• The risk of transmission of vaccine virus from vaccine recipients is low, and precautions should be taken by vaccine recipients who develop a rash after vaccination, especially if they are healthcare personnel or household contacts of immunocompromised persons, as recommended in 1.
• The shingles vaccines are safe and effective in preventing shingles and its complications, and the risk of transmission of vaccine virus is extremely low.

From the Research

Shingles Vaccine and Transmission

• The shingles vaccine, such as Zostavax, is a live attenuated vaccine, which means it contains a weakened form of the varicella-zoster virus 2, 3.
• There is no evidence to suggest that someone can get shingles from being around someone who has received the shingles vaccine 2, 4, 3, 5, 6.
• The vaccine is designed to prevent the reactivation of the varicella-zoster virus, which causes shingles, and not to transmit the virus to others.
• The studies reviewed did not report any cases of shingles transmission from vaccinated individuals to others.

Vaccine Safety and Efficacy

• The shingles vaccine has been shown to be safe and effective in preventing herpes zoster and postherpetic neuralgia in adults aged 50 years and older 2, 4, 3.
• The vaccine has been found to reduce the incidence of herpes zoster and postherpetic neuralgia, and to have a favorable safety and tolerability profile 2, 3.
• The efficacy of the vaccine has been maintained in the longer term, albeit with a gradual decline over time 2, 3.

Vaccination Recommendations

• The Centers for Disease Control and Prevention (CDC) recommends that adults aged 50 years and older receive the shingles vaccine 4, 6.
• The vaccine is recommended for adults who have not had shingles or have not received the vaccine before 4, 6.
• Providers should routinely assess adults' vaccination status and strongly recommend or offer needed vaccines to their patients 6.