Key points
Getting vaccinated is the best way to prevent shingles.
Overview
Shingles, or herpes zoster, is a painful skin rash that develops on one side of the face or body.
Available vaccines & manufacturer package inserts
- The FDA licensed Shingrix in 2017 to prevent shingles. CDC recommends that adults age 50 years and older receive two doses of Shingrix. 1
- Shingrix is the preferred vaccine to prevent shingles.1
- Shingrix is the preferred vaccine to prevent shingles.1
- The FDA licensed Zostavax in 2006 to prevent shingles. CDC recommends one dose of Zostavax for adults age 60 years and older. This vaccine may be used in certain cases, such as when a person prefers Zostavax or is allergic to Shingrix.2
Keep Reading:
Shingles Vaccine Information Statements
Who should & should not get the vaccine
Many people should get vaccinated; others should consult with their healthcare provider first.
Keep Reading:
Who should & should not get the shingles vaccine
Common side effects
Shingrix
- Pain, redness, and swelling at the injection site.
- Muscle pain.
- Tiredness.
- Headache.
- Shivering.
- Fever.
- Upset stomach.
Most side effects are mild to moderate— lasting 2-3 days—and could affect normal daily activities. Side effects are more common in younger people.
Zostavax
- Redness, pain, swelling, warmth, or itching at the injection site.
- Headache.
Most side effects are mild to moderate, and last 1-3 days.
When to call 911
Severe allergic reactions following vaccination are rare, but can be life threatening. If someone experiences symptoms of a severe allergic reaction, which can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness.
Vaccines, like any medicine, can have side effects. Because the two herpes zoster vaccines are different in composition, their potential side effects can differ.
Report possible adverse events to VAERS
The Vaccine Adverse Event Reporting System (VAERS) is an early warning system, co-managed by CDC and FDA, that monitors for potential vaccine safety problems. Healthcare providers and vaccine manufacturers are required by law to report certain adverse events (any side effect or health problem after vaccination that is concerning to you, even if you are not sure if the vaccine caused the event) following vaccination to VAERS; patients and caregivers can also submit reports.
A closer look at the safety data
Both Shingrix and Zostavax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.
Shingrix
In 8 clinical trials of more than 10,000 participants:
- Grade 3 reactions (vaccination-related reactions severe enough to prevent normal activities) were common (17%) after patients received Shingrix.
- About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling.
- About 1 out of 10 reported grade 3 systemic reactions such as myalgia (muscle pain), fatigue (feeling tired), headache, shivering, fever, and gastrointestinal illness.
- Most people (78%) who got Shingrix reported at least some pain at the injection site.
Zostavax
- A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. 3
- A 2012 study found a small risk for allergic reactions 1 to 7 days after Zostavax.4
- In rare cases, people who got vaccinated with Zostavax experienced a blister-like rash; some were found to have been caused by the vaccine.
How CDC monitors vaccine safety
CDC and the Food and Drug Administration (FDA) are committed to ensuring that vaccines provided to the public are safe and effective. Once vaccines are licensed or authorized for emergency use in the United States, CDC and FDA continuously monitor them through several safety systems.
Keep Reading:
About Vaccine Safety Programs
- Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep 2018;67:103–108. DOI: http://dx.doi.org/10.15585/mmwr.mm6703a5
- https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm
- Morrison, V. A., Oxman, M. N., Levin, M. J., Schmader, K. E., Guatelli, J. C., Betts, R. F., Gelb, L. D., Pachucki, C. T., Keay, S. K., Menzies, B., Griffin, M. R., Kauffman, C. A., Marques, A. R., Toney, J. F., Simberkoff, M. S., Serrao, R., Arbeit, R. D., Gnann, J. W., Greenberg, R. N., Holodniy, M., ... Shingles Prevention Study Group (2013). Safety of zoster vaccine in elderly adults following documented herpes zoster. The Journal of infectious diseases, 208(4), 559–563. https://doi.org/10.1093/infdis/jit182
- Tseng, H. F., Liu, A., Sy, L., Marcy, S. M., Fireman, B., Weintraub, E., Baggs, J., Weinmann, S., Baxter, R., Nordin, J., Daley, M. F., Jackson, L., Jacobsen, S. J., & Vaccine Safety Datalink (VSD) Team (2012). Safety of zoster vaccine in adults from a large managed-care cohort: a Vaccine Safety Datalink study. Journal of internal medicine, 271(5), 510–520. https://doi.org/10.1111/j.1365-2796.2011.02474.x
- English D. Willis, Meredith Woodward, Elizabeth Brown, Zoran Popmihajlov, Patricia Saddier, Paula W. Annunziato, Neal A. Halsey, Anne A. Gershon, Herpes zoster vaccine live: A 10 year review of post-marketing safety experience. Vaccine. 2017 Dec 19:35(52):7231-7239.
- Cunningham AL, Lal H, Kovac M, Chlibek R, Hwang SJ, Diez-Domingo J, et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older.NEJM. 2016:375(11), 1019-32.
- Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang SJ, Levin MJ, McElhaney JE, Poder A, Puig-Barberà J, Vesikari T. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. NEJM. 2015:372(22):2087-96.
- Cohen J. A New Vaccine to Prevent Herpes Zoster, NEJM. 2015:372:2149-2150 [Link: https://www.ncbi.nlm.nih.gov/pubmed/25916342]
- Baxter R, Tran TN, Hansen J, Emery M, Fireman B, et al. Safety of Zostavax™-A cohort study in a managed care organization.Vaccine. 2012 Oct 19;30(47):6636-41.
- Gagliardi AM, Gomes Silva BN, Torloni MR, Soares BG. Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2012 Oct 17;10:CD008858.
- Hales CM, Harpaz R, Ortega-Sanchez I, Bialek SR. Update on Recommendation for Use of Herpes Zoster Vaccine . MMWR. 2014 Aug 22; 63(33):729-731.
- Harpaz R, Ortega-Sanchez IR, Seward JF. Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR Recomm Rep. 2008 Jun 6;57(RR-5):1-30.
- Mills R, Tyring SK, Levin MJ, Parrino J, Li X, et al. Safety, tolerability, and immunogenicity of zoster vaccine in subjects with a history of herpes zoster.Vaccine. 2010 Jun 7;28(25):4204-9.
- Morrison VA, Oxman MN, Levin MJ, Schmader KE, Betts RF, et al. Safety of Zoster Vaccine in Elderly Adults Following Documented Herpes Zoster. J Infect Dis. 2013;208(4):559-563.
- Murray AV, Reisinger KS, Kerzner B, Stek JE, Sausser TA, et al. Safety and tolerability of zoster vaccine in adults ≥60 years old.Hum Vaccin. 2011 Nov;7(11):1130-6.
- Schmader KE, Levin MJ, Gnann JW Jr, McNeil SA, Vesikari T, et al. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years.Clin Infect Dis. 2012 Apr;54(7):922-8.
- Simberkoff MS, Arbeit RD, Johnson GR, Oxman MN, Boardman KD, et al. Safety of herpes zoster vaccine in the shingles prevention study: A randomized trial.Ann Intern Med. 2010 May 4;152(9):545-54.
- Tseng HF, Liu A, Sy L, Marcy SM, Fireman B, et al. Safety of zoster vaccine in adults from a large managed-care cohort: A Vaccine Safety Datalink study.J Intern Med. 2012 May;271(5):510-20.
- Vermeulen JN, Lange JM, Tyring SK, Peters PH, Nunez M, et al. Safety, tolerability, and immunogenicity after 1 and 2 doses of zoster vaccine in healthy adults ≥60 years of age.Vaccine. 2012 Jan 20;30(5):904-10.
- Weinmann S, Naleway AL, Koppolu P, Baxter R, Belongia EA, Hambidge SJ, Irving SA, Jackson ML, Lewin B, Liles E, Marin M, Smith N, Weintraub E, Chun C. Incidence of Herpes Zoster Among Children: 2003-2014. Pediatrics. 2019 Jul; 144(1). Pii: e20182917. Epub 2019 Jun 10.
- Donahue JG, Kieke BA, Gargiullo PM, Jumaan AO, Berger NR, McCauley JS, et al. Herpes zoster and exposure to the varicella zoster virus in an era of varicella vaccination. Am J Public Health. 2010;100(6):1116-1122.
- Mullooly JP, Riedlinger K, Chun C, Weinmann S, Houston H. Incidence of herpes zoster, 1997-2002[PDF – 120 KB]. Epidemiol Infect.2005;133(2):245-253.
- Zerbo O, Bartlett J, Fireman B, Lewis N, Goddard K, Dooling K, Duffy J, Glanz J, Naleway A, Donahue JG, Klein N. Effectiveness of Recombinant Zoster Vaccine Against Herpes Zoster in a Real-World Setting. Ann Intern Med. 2024 Jan 9. doi: 10.7326/M23-2023. Online ahead of print.
- Nelson JC, Ulloa-Perez E, Yu O, Cook AJ, Jackson ML, Belongia EA, Daley MF, Harpaz R, Kharbanda EO, Klein NP, Naleway AL, Tseng HF, Weintraub ES, Duffy J, Yih WK, Jackson LA. Active Post-Licensure Safety Surveillance for Recombinant Zoster Vaccine Using Electronic Health Record Data. Am J Epidemiol. 2022 Oct 4. doi: 10.1093/aje/kwac170. Online ahead of print.