Vaccination against shingles guide

There is a vaccine that helps reduce your risk of getting shingles and reduces the severity of symptoms if you develop the disease.

Shingles is caused by the same virus as chickenpox. Anyone can develop shingles because most people have had chickenpox (even if they don’t remember having it).

This guide describes shingles, the Zostavax vaccine and the benefits of the vaccination and who is eligible for the vaccine this year. If you have problems with your immune system and cannot have the live Zostavax vaccine you may be eligible for 2 doses of the Shingrix vaccine.

Definition of shingles

Shingles isn’t like other infectious diseases because you don’t catch it from someone else. Most of us had chickenpox when we were young, although some of us will not be aware that we’ve had it. If you did have it, then the virus that caused it can stay in your body for the rest of your life without you knowing it is there. If the virus reactivates it causes a disease called shingles.

Shingles can be very painful and tends to affect people more commonly as they get older. And the older you are, the worse it can be. For some, the pain caused by shingles can last for many years. Shingles can really affect your life, stopping you from doing all the things you usually enjoy.

Shingles (also known as herpes zoster) is caused by the reactivation of an infection of a nerve and the area of skin that it serves, resulting in clusters of painful, itchy, fluid-filled blisters. These blisters can burst and turn into sores that eventually crust over and heal. These blisters usually affect an area on one side of the body, most commonly the chest but sometimes also the head, face and eye.

How long shingles lasts and how serious it can be

The rash usually appears a few days after the initial pain and tingling, and lasts for about a week. The older you are, the more likely you are to have long-lasting pain. Sometimes shingles develops in the eye and may also affect the eyelid.

This can cause severe pain and lead to decreased vision or even permanent blindness in that eye. Most people recover fully, but for some, the pain goes on for several months or even years – this is called post-herpetic neuralgia (PHN).

This is a particularly unpleasant condition with severe burning, throbbing or stabbing nerve pain. The vaccine reduces the risk of getting shingles and PHN. Even if you still get shingles, the symptoms may be much reduced.

What causes shingles

Shingles is caused by the same virus that causes chickenpox – the varicella zoster virus. When you recover from chickenpox most of the virus is destroyed but some survives and lies inactive in the nervous system. It can then reactivate later in life when your immune system is weakened by increasing age, stress or other conditions and treatments that reduce your immunity.

How you get shingles

You don’t catch shingles. Chickenpox virus caught earlier in your life reactivates later to cause shingles. You can’t catch shingles from someone who has chickenpox.

However, if you have shingles blisters, the virus in the fluid can infect someone who has not had chickenpox and they may develop chickenpox.

Incidence of shingles

About 1 in 5 people who have had chickenpox develop shingles. This means that every year in England and Wales, tens of thousands of people will get shingles. It is more common in people aged over 70 years, and of these, about 14,000 go on to develop PHN and over 1,400 are admitted to hospital because of it.

Effectiveness of vaccination

By having the vaccination you will significantly reduce your chance of developing shingles. In fact, in the first 3 years since the vaccine was introduced there were about 17,000 fewer GP consultations for shingles. And, if you do go on to have shingles the symptoms are likely to be milder and the illness shorter, than if you had not had the vaccination.

Where in the body the vaccination is given and how many you will need

Like most vaccinations, the vaccine will be given in your upper arm. You will only have the vaccination once.

If you have the Zostavax vaccine, you will just need one injection. If you are not eligible for the live vaccine, you will need 2 doses of the Shingrix vaccine 2 months apart to give you the best protection. Once your course is completed, you will not need any more shingles vaccines.

Side effects

Side effects are usually quite mild and don’t last very long. The most common side effects, which occur in at least 1 in every 10 people, are headache, and redness, pain, swelling, itching, warmth, and bruising at the site of the injection. If the side effects persist for more than a few days you should discuss this with your GP or practice nurse.

Vaccine safety

Like all licensed vaccines, the shingles vaccine has been thoroughly tested and meets UK and European safety and licensing requirements. It has been used extensively in several countries including the United States of America and Canada.

In the first 4 years of the shingles vaccination programme more than 2.3 million people were vaccinated in England.

Who is eligible for the vaccine

People aged 70 years of age are eligible for the vaccine.

The vaccine is also available for those previously eligible but who missed immunisation. For example, anyone in their 70s who has not yet had the vaccine.

You become eligible for the shingles vaccine as you turn 70 and remain eligible up to the age of 79.

People under 70 years of age are at lower risk of shingles but will become eligible for the vaccine when they turn 70. People aged 80 years and over are not eligible for the shingles vaccination because the vaccine becomes less effective as people get older. If you are worried about shingles speak to your GP.

How to get the vaccination

If you are eligible, contact your GP practice to make an appointment to have your vaccination.

People who shouldn’t have the vaccination

There are 2 shingles vaccines available. One contains a weakened version of the live shingles virus.

The live vaccine is the one that is routinely used in the UK but people who have weakened immune systems, for example due to cancer treatment, should not have it. They should have the inactivated shingles vaccine. Your doctor will advise whether this applies to you. Further information is available on the Shingrix vaccine.

If you’ve had a severe reaction to any of the substances that go into the vaccine, you shouldn’t have it. Again, your GP will advise you.

The live shingles vaccine used in the UK contains porcine gelatine. Some people may not want this vaccine but it is the recommended vaccine unless you cannot have it because you have a weakened immune system.

Can the vaccine give you shingles?

Most people do not get a rash from the vaccine but in the rare event that you do, please seek advice from your GP practice.

If you miss a vaccination

If you missed the shingles vaccine, you can still have it up to your 80th birthday. Please contact your GP practice to make an appointment. It’s important that you do not leave it too late to have the vaccination.

Summary of the disease and the vaccine

Shingles

is a common disease that can cause long-lasting, severe pain
has been known to cause permanent disability
occurs more frequently in those over 70 years of age who are also more likely to have worse symptoms

The vaccine

is significantly reducing the number of cases
will reduce the severity of symptoms in vaccinated people if they develop the disease
has been used extensively in the US and Canada
cannot cause shingles in healthy people

Having your routine shingles vaccination is a good way of looking after your health so that you can get on with enjoying life without the pain of shingles.

Further information

Speak to your GP or practice nurse, for more information before or after you’ve had the vaccination.

Further information is available on the Zostavax® vaccine and Shingrix® vaccine.

Public Health Isle of Man has adapted this information leaflet with kind permission from UK Health Security Agency: Shingles Vaccination Guide (GOV.UK)

Updated: 2 December 2021