Does receiving the varicella (chickenpox) vaccine as a child reduce the likelihood of developing herpes zoster (shingles) later in life?

From the Guidelines

Getting the varicella vaccine as a child does lessen the likelihood of developing shingles later in life, as it reduces the risk of establishing latent infection in nerve cells compared to natural chickenpox infection. The varicella vaccine contains a weakened form of the varicella-zoster virus, which provides immunity against chickenpox while posing a significantly lower risk of establishing latent infection in nerve cells compared to natural chickenpox infection 1. Since shingles occurs when the dormant varicella-zoster virus reactivates in someone who previously had chickenpox, having fewer viruses lying dormant in your nervous system means less chance of reactivation.

The standard childhood vaccination schedule includes two doses of varicella vaccine, typically given at 12-15 months and 4-6 years of age, which has been shown to be highly effective in preventing varicella disease, with an estimated vaccine efficacy of 98% over a 10-year observation period for prevention of any varicella disease 1. Even if a vaccinated person does develop shingles later in life, the illness is generally milder than in those who had natural chickenpox.

Some key points to consider include:

• The varicella vaccine has been shown to reduce the incidence of varicella by 71-84% and varicella-related hospitalizations by 88% 1
• The vaccine also reduces the risk of varicella-related deaths, with a 92% decrease in varicella-related deaths in 1- to 4-year-old children 1
• While breakthrough varicella can occur, the median number of skin lesions is generally <50, the duration of illness is shorter, and the incidence of fever is lower than that in an unimmunized person 1
• The occurrence of breakthrough varicella raises concerns about the risk of severe varicella associated with VZV infection in adolescence and adulthood, as well as the potential for contagion and outbreaks in highly immunized populations 1

From the Research

Varicella Vaccine and Shingles

• The varicella vaccine is primarily administered to children to protect against chickenpox, but its impact on the likelihood of shingles in later life is also an important consideration.
• Studies have shown that the varicella vaccine can provide protection against herpes zoster (shingles) in certain populations, such as immunocompromised children 2.
• However, the relationship between varicella vaccination in childhood and the risk of shingles in adulthood is complex, and more research is needed to fully understand this connection.
• One study found that adults who received the varicella vaccine as young adults had a similar incidence of shingles as the general population in the prevaccine era 3.
• Other studies have focused on the use of herpes zoster vaccines, such as Shingrix, which have been shown to be effective in preventing shingles in adults aged 50 and older 4.
• Immunization guidelines recommend that adults receive two doses of the varicella vaccine, separated by 4 weeks, if they do not have immunity or contraindications, and that adults aged 60 and older receive a single dose of the herpes zoster vaccine unless contraindicated 5.

Key Findings

• Varicella vaccine can provide protection against herpes zoster in certain populations.
• The relationship between varicella vaccination in childhood and shingles risk in adulthood is complex and requires further research.
• Herpes zoster vaccines, such as Shingrix, are effective in preventing shingles in adults aged 50 and older.
• Immunization guidelines recommend varicella and herpes zoster vaccination for adults based on age and immunity status.