When can a patient with a current herpes zoster (shingles) outbreak receive the varicella-zoster vaccine?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

Wait until your current shingles outbreak has completely resolved before getting the shingles vaccine, as the vaccine is most effective when the rash has crusted over and healed, which typically takes 2-4 weeks. According to the recommended adult immunization schedule, United States, 2020 1, the preferred vaccine is Shingrix, a two-dose series given 2-6 months apart, which is recommended for adults 50 and older. Key points to consider when getting vaccinated after having shingles include:

  • The vaccine works by boosting your immune system's ability to fight the varicella-zoster virus, which remains dormant in your body after chickenpox and can reactivate as shingles.
  • Getting vaccinated after having shingles is still important because having one outbreak doesn't prevent future recurrences.
  • The vaccine significantly reduces your risk of developing shingles again and can reduce the severity and complications if you do get another outbreak.
  • Common side effects include soreness at the injection site, fatigue, and muscle pain, which typically resolve within 2-3 days. It's essential to note that the vaccine should be administered at least 2 months after Zostavax, if previously received, as stated in the guidelines 1. By waiting for the current outbreak to resolve and then getting vaccinated, you can effectively reduce your risk of future shingles outbreaks and related complications.

From the Research

Vaccine Eligibility

  • The varicella zoster virus vaccine is approved for adults 50 years and older 2, 3, 4.
  • The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends this vaccine for adults 60 years and older, except for certain immunosuppressed patients 2.
  • The recombinant zoster vaccine (Shingrix) is preferred over a live attenuated HZ vaccine in immunocompetent individuals, according to the US and Canadian guidelines 3.

Timing of Vaccination

  • There is no specific guidance on when to get the vaccine after a current shingles outbreak.
  • However, it is recommended to complete the 2-dose regimen of Shingrix, with the second dose given 2-6 months after the first dose 5.
  • Delaying the second dose beyond the recommended 6 months did not impair effectiveness in one study 5.

Vaccine Effectiveness

  • The vaccine effectiveness of Shingrix was found to be 70.1% (95% confidence interval [CI], 68.6-71.5) for 2 doses and 56.9% (95% CI, 55.0-58.8) for 1 dose 5.
  • The 2-dose vaccine effectiveness was not significantly lower for beneficiaries aged >80 years, for second doses received at ≥180 days, or for individuals with autoimmune conditions 5.
  • The vaccine was also effective among individuals with immunosuppressive conditions 5, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Shingrix for Herpes Zoster: A Review.

Skin therapy letter, 2019

Research

Recombinant Zoster Vaccine (Shingrix): Real-World Effectiveness in the First 2 Years Post-Licensure.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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