How to Prevent Shingles — Can Shingles be Prevented?

Question: How to Prevent Shingles — Can Shingles be Prevented?

Shingles is a disease known as herpes zoster, characterized by a painful rash. It's caused when the chicken pox virus from a previous infection reactivates in the body, usually after the age of 50. As you age, your chance of getting shingles increases, along with the risk of serious long-term complications. By the time you're 85, you have about a 50/50 chance of having had shingles.

Can this painful disease be prevented?


Yes, shingles can be prevented. The three main ways shingles can be prevented are:

  1. Avoid getting exposed to the chicken pox virus (varicella-zoster virus or VZV)

    This is much easier said than done, as the US Centers for Disease Control and Prevention (CDC) estimate that as much as 95% of the population has been exposed to the chicken pox virus, even if adults don't remember having the disease. As with all herpes viruses, according to the CDC, the chicken pox virus remains within the body after infection. While it is not known why some people get shingles and others do not, it is believed to be related to reduced immune function. Immunity against the virus seems to decline around the age of 50.

  2. Get a vaccine against chicken pox: Wide-scale vaccination against chicken pox — launched in the mid-1990s — has reduced the incidence of chicken pox. The two-dose vaccine against chicken pox is not a guarantee that you are protected against shingles, however: the CDC estimate that the vaccine will prevent about 98% of chicken pox cases. There's still a chance you may get chicken pox, leaving you at risk of shingles.

    According to a 2011 paper published in Canadian Family Physician, this immunization program may eventually be shown to reduce the risk of shingles. To date, however, there's no proof that being vaccinated against chicken pox prevents shingles in the general aging population.

    The CDC recommends a chicken pox vaccine for children, adolescents and adults.

  1. Get the shingles vaccine

    The shingles vaccine is considered your best bet in preventing the disease, according to the CDC and Health Canada. It was approved in 2011 in both countries for adults over the age of 50, and is recommended for those aged 60 and older. Called Zostavax, the vaccine is manufactured by Merck Research Laboratories.

    The vaccine is about 50% effective at preventing shingles, meaning it will prevent about half the cases of shingles that would occur if no one was vaccinated. Perhaps its greatest value however, is that it will reduce the severity of symptoms if you do get this potentially devastating disease. What's more, it will also reduce the risk of severe postherpetic neuralgia or chronic long-term nerve pain from shingles, by about two-thirds, for people over the age of 60. This was the finding of the large-scale Shingles Prevention Study, involving more than 38,000 subjects aged 60 and older, to determine the effectiveness of the vaccine in this age group.

    The shingles vaccine is not recommended for anyone who's already been vaccinated against chicken pox, according to the US Advisory Committee on Immunization Practices (ACIP).

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    Does getting shingles prevent another case of it in the future? Though this is a rare occurrence, a person can unfortunately get shingles more than once. For that reason, the CDC and Health Canada recommend that even people who've had shingles get vaccinated.


    Age Page: Shingles. US National Institute on Aging Public Information Sheet. Accessed March 4, 2013.

    Brisson M. "Estimating the number needed to vaccinate to prevent herpes zoster-related disease, health care resource use and mortality." Can J Public Health. 2008 Sep-Oct;99(5):383-6.

    CDC Seeks to Protect Older Adults With Shingles Vaccine Message. US Centers for Disease Control and Prevention Public Information Sheet. Accessed March 13, 2013.

    Chickenpox Vaccine: What You Need to Know. US Centers for Disease Control and Prevention Public Information Sheet. Accessed March 27, 2013.

    Marla Shapiro, Brent Kvern, Peter Watson, Lyn Guenther, Janet McElhaney, and Allison McGeer. "Update on Herpes Zoster Vaccination: A Family Practitioner's Guide." Canadian Family Physician October 2011 vol. 57 no. 10 1127-1131.

    Rafael Harpaz, Ismael R. Ortega-Sanchez, Jane F. Seward. "Prevention of Herpes Zoster Recommendations of the Advisory Committee on Immunization Practices (ACIP)." Morbidity and Mortality Weekly Report (MMWR)of the US Centers for Disease Control and Prevention. Accessed March 27, 2013.

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