No Testing Required Before Shingrix After Chickenpox
You do not need any laboratory testing to determine when you can receive Shingrix after having had chickenpox—you can proceed directly to vaccination if you are age 50 or older (or age 18+ if immunocompromised). 1
Why Testing Is Unnecessary
Prior chickenpox infection confirms VZV immunity, which is the only prerequisite for Shingrix eligibility—the vaccine prevents shingles (reactivation of dormant VZV), not primary chickenpox infection. 1
Serologic testing after natural chickenpox infection is not recommended because your history of clinical disease already establishes VZV seropositivity, and commercial antibody assays are designed to detect disease-induced immunity reliably. 2
The 88-91% seroprevalence data applies to people WITHOUT recalled chickenpox history—since you specifically had chickenpox, you are definitively VZV-positive and don't fall into the uncertain category requiring testing. 1
When You Can Receive Shingrix
Age 50 or older (immunocompetent adults): Proceed immediately with the 2-dose series, with doses given 2-6 months apart. 1, 3
Age 18-49 (immunocompromised only): Shingrix is indicated for adults on immunosuppressive therapy, with biologics, JAK inhibitors, or conditions like HIV, cancer, or autoimmune diseases requiring immunomodulators—use a shortened 1-2 month interval between doses. 1, 3
After a recent shingles episode: Wait at least 2 months after acute symptoms resolve before vaccinating, though no absolute minimum is mandated—this allows complete symptom resolution and immune recovery. 1
Important Clinical Caveats
Do not confuse varicella (chickenpox) vaccine with Shingrix—varicella vaccine is only for people who never had chickenpox and test VZV-seronegative, requiring 2 doses 4 weeks apart. 1, 4
Testing would only be indicated if you had NO history of chickenpox and uncertain immunity—in that scenario, VZV IgG testing would determine whether you need varicella vaccine (if seronegative) or can proceed to Shingrix at the appropriate age (if seropositive). 4
Healthcare personnel are an exception—they require serologic screening even with positive chickenpox history due to nosocomial transmission risks, but this doesn't apply to general population vaccination decisions. 2, 4
The Testing Pitfall to Avoid
Commercial antibody assays lack sensitivity for vaccine-induced immunity (detecting antibodies in only some vaccinated individuals), but they reliably detect natural infection antibodies—however, since you already have confirmed chickenpox history, this limitation is irrelevant to your situation. 2
Routine post-vaccination antibody testing is explicitly not recommended after receiving Shingrix because 92-99% develop antibodies, seroconversion doesn't always equal full protection, and cell-mediated immunity (not measurable by standard tests) provides the primary long-term protection. 2