Can You Still Get Shingles After the Shingles Vaccine?
Yes, you can still develop shingles after receiving Shingrix, but the vaccine reduces your risk by approximately 92%, meaning about 8 out of 100 vaccinated people might still develop shingles compared to unvaccinated individuals. 1
Vaccine Effectiveness and Breakthrough Cases
Shingrix demonstrates 97.2% efficacy in preventing herpes zoster in adults aged 50 years and older in clinical trials, with protection persisting for at least 8 years with minimal waning, maintaining efficacy above 83.3% during this period. 1
The vaccine cannot provide 100% protection because vaccine-induced immunity varies between individuals based on baseline immune function, age, and concurrent immunosuppressive conditions, with cell-mediated immune responses correlating most strongly with protection. 1
Real-world effectiveness data shows 92% effectiveness at 3.2 years of follow-up, meaning approximately 8 out of 100 vaccinated people might still develop shingles compared to the unvaccinated population. 1
Why Breakthrough Cases Occur
Patients on disease-modifying antirheumatic drugs (DMARDs) or other immunosuppressive medications may have reduced vaccine responses, and immunocompromised individuals remain at higher baseline risk for herpes zoster even after vaccination, though vaccination still provides meaningful protection. 1
Even with optimal vaccination, the vaccine contains only a recombinant viral glycoprotein fragment, not the complete virus, so immune responses may not be as robust as natural infection in some individuals. 1
Important Clinical Considerations
Vaccinated individuals who develop breakthrough shingles generally experience less severe disease and lower rates of postherpetic neuralgia compared to unvaccinated individuals. 1
The 8% breakthrough rate with Shingrix is dramatically better than the older Zostavax vaccine, which showed only 51% effectiveness initially and declined to just 14.1% efficacy by year 10. 1
Having shingles once does not provide reliable protection against future episodes, with a 10-year cumulative recurrence risk of 10.3%, so vaccination is recommended even after a prior shingles episode, waiting at least 2 months after acute symptoms resolve. 1, 2
Vaccination Remains Strongly Recommended
The substantial risk reduction (92% effectiveness) far outweighs the residual breakthrough risk, making Shingrix the preferred vaccine for all adults ≥50 years regardless of prior shingles history or previous Zostavax vaccination. 1
Complete the full 2-dose series for optimal protection, with the second dose given 2-6 months after the first dose (minimum interval of 4 weeks). 1
For immunocompromised adults aged ≥18 years, a shorter schedule with the second dose given 1-2 months after the first dose is recommended to provide earlier protection in this higher-risk population. 1