The Shingles Vaccine: 10 Practical Considerations

1) Who should get the shingles vaccine?

The Centers for Disease Control and Prevention recommend a shingles vaccine for:

• All people 50 years and older with rare exceptions (see below), regardless of whether they have knowingly had chickenpox (and 99% of Americans born prior to 1981 have)

• People who may have previously had a dose of Zostavax, an earlier version of the shingles vaccine (no longer available widely in the US) with much lower efficacy

• Any individuals 19 or older with compromised immune systems

2) Are there people who should not get the vaccine? What are the “rare exceptions”?

You should not get the shingles vaccine if you:

• Have ever had a severe allergic reaction to any component of the vaccine or after 1 dose of the 2-dose regimen

• Currently have shingles

• Are pregnant (if so, wait to get the vaccine until after delivery)

If you currently have a cold (or something minor), you are eligible to get the vaccine, but might prefer to wait until you feel better. If you have a more severe illness, such as the flu with a fever, likewise, it would be smarter to wait until you have recovered before getting the vaccine.

3) What about age? Is there any age too young or too old?

The U.S. Centers for Disease Control and Prevention advise that the shingles vaccine is important for those age 50 and up. Additionally, for any individuals over the age of 19 with compromised immune systems, getting the vaccine is critical. The CDC argues that there is no age past which an individual should not be vaccinated. Others suggest that, due to waning efficacy in those older than 80, depending on the health of the individual, getting a shingles vaccine may not be worth it if you fall into this age bracket.

Seek guidance from your health care provider if you have any questions and want to talk through your specific situation.

4) Are all shingles vaccines the same?

No. There are two types of shingles vaccines available depending on where you are: “Shingrix” and “Zostavax.” Shingrix requires two doses separated by at least 6 weeks (and preferably 2 months); Zostavax is administered in one dose. Shingrix has an efficacy rate of 97.2% and Zostavax 51%. Given the much lower efficacy of Zostavax, it is much less available in the U.S. and Shingrix is preferred. In Santa Fe, the only shingles vaccine available is Shingrix.

5) Can I get the shingles vaccine at the same time that I am getting other vaccines?

In general, yes. The current recommendation is that it is fine to get a shingles vaccine at the same time as other vaccines, such as for COVID19.

There is currently research being conducted, however, on whether it is better to space the shingles vaccine with the flu vaccine so, for now, it is probably better to space these two specific vaccines by a couple of weeks.

If more than 6 months has elapsed since your first dose of Shingrix, get the second dose as soon as possible. There is no need to start all over.

6) Are there any downsides to getting a shingles vaccine? What are the risks?

All vaccines carry some risk, but the shingles vaccine is considered safe and effective given what is known to date.

The shingles vaccine available locally (Shingrix) can cause mild pain, redness, swelling or mild itching at the site on the arm where the injection takes place. Like other vaccines, it can cause 1-3 days of mild flu-like symptoms, including headaches, muscle pain, fever, and fatigue.

There is also the potential for rare, but serious side effects, such as an anaphylaxis response, Guillain-Barré Syndrome (GBS), an extremely rare neurological disorder that can cause weakness and paralysis, and postherpetic neuralgia (pain that lingers at the site of injection).

In terms of any potential side effects, individual responses will vary, so discuss any concerns you have with your provider before vaccination, keeping in mind that we now know that preventing shingles, or lessening the duration of an outbreak, significantly decreases your risk for dementia.

7) What is Guillan-Barré Syndrome? (sounds like it might be huge downside!)

Guillan-Barré Syndrome (GBS) is a rare and very serious condition in which the body's immune system attacks the nerves. It can cause weakness, numbness or paralysis and the exact cause is not known, but most people report symptoms of some kind of an infection (such as respiratory or a gastrointestinal infection, COVID19, Zika virus, etc.) about 6 weeks before symptoms occur. In addition to tingling and weakness, additional signs can be an unsteady gait or inability to walk; trouble with facial movements, including speaking chewing or swallowing; double vision; trouble with bladder or bowel function; rapid heart rate; and trouble breathing. Although there is no known cure, several treatment options can ease symptoms and help speed recovery. If you experience any of the symptoms, consult your provider immediately. Most people with the condition need treatment in a hospital.

For every one million shingles vaccines administered, three individuals have gotten GBS, each within 42 days of the vaccine. There is also, however, a very small increased risk of GBS after having shingles.

8) I know that the shingles vaccine decreases the risk for dementia, but what are the risk factors for dementia, and do they carry similar amounts of risk? 

The risk factors for dementia include diabetes, high blood pressure, smoking, physical inactivity, obesity, depression, hearing loss, genetic predisposition, and sex (with women at greater risk than men). Diabetes causes the greatest increased risk – far more than even genetic risk. A simple genetic test (done with a saliva sample), however, can determine if you are a carrier of the APOE ε4 gene, which elevates risk.

9) If I get the shingles, what happens? Should I get treated? Is it contagious?

Shingles usually produces a painful rash initially evident by a string of blisters around the torso or back. It often lasts for a week or two (although can last longer) and, on rare occasions, includes complications, the most serious of which can lead to a loss of vision. The most common complication is called “postherpetic neuralgia,” a kind of nerve pain that lingers after the infection. Preventing the shingles, or even shortening the duration of a shingles episode and lessening the likelihood of complications, is worthwhile, which is reason to consider a shingles vaccine.

A person with shingles can pass the virus to another individual (who isn’t immune to chickenpox) through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox rather than shingles. Chickenpox can be dangerous for some people and, until shingles blisters scab over, you are contagious. Avoid physical contact with anyone who hasn't yet had chickenpox or the chickenpox vaccine; this category includes people with weakened immune systems, pregnant women, and newborns.

10) Where can I get a shingles vaccine in New Mexico?

Some pharmacies that offer the shingles vaccine are included below. Please call first to determine current availability and if an appointment is necessary.

Albertson’s Market Pharmacy

3001 South St. Francis Drive | Tel: 505-992-8663

Christus St Vincent Pharmacy

465 St. Michael’s Drive, Suite 112 | Tel: 505-913-5000

CVS

511 West Cordova | Tel: 505-983-5546

Scheduling link

Santa Fe Public Health Office

605 Letrado St. B | Tel: 505-476-2600

Walgreens

525 West Zia Rd | Tel: 505-820-2196

1096 South St Francis | Tel: 505-982-9811

Shingrix also has this website for information on accessibility to the vaccine based on zip code.