Anyone who has had chickenpox carries the virus that causes it for life. Years later, often after 50, it can wake up as shingles: a painful, blistering rash, usually in a band on one side of the body. For some people the nerve pain lasts long after the rash heals. A highly effective vaccine can prevent most of it.

Why shingles is worth preventing

The CDC estimates that about 1 in 3 people in the United States will get shingles in their lifetime. The CDC notes that the risk of shingles and its complications rises with age. The most common complication is long-term nerve pain where the rash was, called postherpetic neuralgia (PHN), and shingles can sometimes lead to vision loss. If you think you have shingles, contact your doctor as soon as possible: antiviral medicines work best when started as soon as the rash appears.

Who should get Shingrix, and how well it works

The shingles vaccine used in the United States is the recombinant zoster vaccine, Shingrix. The CDC recommends it for:

  • All adults 50 and older, with no upper age limit.
  • Adults 19 and older with a weakened immune system from disease or treatment.

You should still get Shingrix if you have already had shingles, if you received the older Zostavax vaccine (no longer sold in the U.S. since November 2020), or if you are not sure you had chickenpox. If you have shingles now, wait until the rash is gone. People who had a severe allergic reaction to the vaccine or its ingredients should not get it, and people who are pregnant should wait.

Shingrix is a two-dose series. For adults 50 and older, the second dose comes 2 to 6 months after the first. For people with a weakened immune system, the second dose can be given 1 to 2 months after the first. Both doses are needed for full protection, so it helps to book the second when you get the first.

The protection is strong. The CDC reports that in healthy adults, two doses of Shingrix are:

  • 97 percent effective against shingles in people 50 to 69.
  • 91 percent effective in people 70 and older.
  • 91 percent effective against postherpetic neuralgia in adults 50 and older.
  • 68 to 91 percent effective in adults with weakened immune systems, depending on the condition.

Protection stayed high for at least 7 years in healthy adults 70 and older who were followed.

Side effects

Shingrix is known for making people feel it for a day or two. The CDC lists a sore arm with redness or swelling, tiredness, muscle aches, headache, chills, fever, stomach pain and nausea as common reactions, usually lasting 2 to 3 days and more common in younger adults. Many people plan the shot before a quiet day. A reaction to the first dose is not a reason to skip the second. Guillain-Barré syndrome has been reported very rarely after the vaccine. Call 911 for signs of a severe allergic reaction, such as trouble breathing or swelling of the face and throat.

A note on shingles vaccines and memory

You may have seen headlines linking the shingles vaccine to a lower risk of dementia. The best-known study, published in Nature in 2025, took advantage of a birth-date cutoff for vaccine eligibility in Wales. People who became eligible were about 20 percent less likely to receive a new dementia diagnosis over seven years than people born just too early to qualify. Two cautions: that study looked at the older live vaccine, Zostavax, not Shingrix, and the finding is not a reason on its own to get vaccinated. Preventing shingles and its nerve pain is reason enough, and any effect on memory would be a bonus that research is still sorting out.

Cost and coverage

Medicare covers the shingles vaccine under Part D, the drug benefit. According to Medicare.gov, people with Part D pay nothing for vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, with no deductible or copayment. If you have other coverage, check with your plan.

Shingles is one of several vaccines that matter more after 50. Our articles on the yearly flu vaccine, RSV and pneumococcal vaccines cover the others. Dr. Shtern can review which vaccines you are due for as part of your preventive care, and the first visit is a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.