Ever since the popular science article on Shingles was published (link
Can it recur? Is the probability high? Will antibodies be produced after having it? Is vaccination still needed? How is the vaccine administered? Can it be vaccinated under the age of 50? How long does the vaccine protection last? Can it provide lifelong immunity? …
Today, we will answer the common questions. First, it is important to understand that shingles and chickenpox are caused by the same virus, the initial infection manifests as chickenpox, which then lies dormant in the ganglia, reactivation can occur when immune function is compromised, leading to shingles, which brings severe pain, which is why shingles on the waist is also known as “snake skin sores” or “waist-encircling dragon”.: Staying up late and anxiety may cause this skin disease, extremely painful! Contagious!), people have gained more understanding of shingles, as it causes intolerable pain, with pain lasting from a few weeks to several years, and it is also contagious, which naturally makes people fearful, leading to many questions. For example:
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What is the probability of shingles recurrence? Can it be contracted again after having it once?
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The probability of shingles recurrence is relatively low (about 1%-6.2%), but not lifelong immunity, studies with longer follow-up periods often show higher recurrence rates.
Reports have indicated: Chronic diseases such as diabetes, hypertension, dyslipidemia, chronic obstructive pulmonary disease, depression, and hypothyroidism are associated with the incidence and recurrence of shingles.
In cases of dyslipidemia, high cholesterol levels or the use of statins may lead to the reactivation of the varicella-zoster virus.
If patients have chronic diseases, tumors, long-term use of immunosuppressants, or are elderly, the risk of recurrence significantly increases.
Therefore, even if you have had the disease, you still need to be vigilant about secondary infections.
Is it necessary to get vaccinated after having shingles? How long after recovery can you get vaccinated?
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It is necessary to get vaccinated.
Some prospective and retrospective observational studies have shown that patients with shingles within a year have a lower recurrence rate (0.4-0.8%). That is, the level of varicella-zoster vaccine IgG remains unchanged one year after the onset of shingles.
In a 2-year follow-up of individuals with normal immune function, the recurrence rate of shingles is 0.1%, regardless of vaccination history.
However, in long-term cohort studies, after 20 years of follow-up, the recurrence rate of shingles increased to 5.3%.
The Advisory Committee on Immunization Practices of the U.S. Centers for Disease Control and Prevention has not specified a vaccination schedule for people with a history of shingles, while the “Australian Immunization Handbook” and the National Advisory Committee on Immunization in Canada both recommend vaccination at least 1 year after the onset of shingles. The UK Department of Public Health also suggests that individuals with normal immune function who have had shingles should delay zoster vaccination for 1 year.
Can you get vaccinated if you are under 50?
Although infection can provide some immunity, antibody levels decrease over time, and the risk of recurrence still exists.
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Recombinant zoster vaccine (Shingrix) is approved for adults aged 50 and above to reduce the incidence of shingles. However, the Shingrix shingles vaccine has not been approved by the U.S. Food and Drug Administration (FDA) for use in people under 50.
However, adults aged 19 and above with weakened immune systems may also receive two doses of the shingles vaccine, as they are at higher risk of developing shingles and related complications.
Shingrix (recombinant zoster vaccine) requires 2 doses, with an interval of 2 to 6 months. Two doses of Shingrix are over 90% effective in preventing shingles and postherpetic neuralgia. The protection rate of the Shingrix shingles vaccine remains at over 85% for at least 4 years.
The live attenuated vaccine (Zostavax/Gan Wei) is suitable for individuals over 40 years old. Zostavax is not yet approved for domestic use. The domestic zoster attenuated vaccine, Gan Wei, has been approved for individuals over 40 years old since 2023. If under the age but with high-risk factors (such as immunodeficiency, history of tumors, etc.), it needs to be decided by a doctor’s assessment whether to vaccinate in advance.
If you had shingles at a young age, do you need to wait until 50 to get the vaccine?
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If you are under 40 years old and have chronic diseases, tumors, long-term use of immunosuppressants, or other conditions that affect cellular immune function, it is recommended to discuss with a doctor whether to receive the vaccine in advance.
If a child has received the first dose of the chickenpox vaccine and has not completed the second dose when exposed to a patient with shingles, what is the risk?
The protection rate of the chickenpox vaccine first dose is about 80%, and the second dose can increase to 92%. If a child has not completed the full vaccination and is exposed to a patient with shingles (especially active rash), there is a certain risk of infection, but it is much lower than for those who have not been vaccinated. Suggestions:
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Avoid contact with the patient’s rash or discharge;
If there has been close contact, consult a doctor to assess whether antiviral medication is needed;
According to literature reviews, the incidence of shingles in children is significantly lower than in adults, and the incidence of shingles is even lower in countries with routine vaccination for chickenpox in children. The incidence in children increases with age, and only children with diagnosed immune deficiencies have an increased incidence.
What are the available shingles vaccines? How to choose?
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Available vaccines in China:
Recombinant zoster vaccine (Shingrix): Requires 2 doses (interval of 2-6 months), with an efficacy rate of over 90%, recommended as the first choice;
Live attenuated vaccine (Gan Wei): single dose vaccination, with an efficacy rate of about 60%, caution is advised for those with weakened immunity.
How long does the vaccine protection last? Is it a lifelong immunity after vaccination?
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Recombinant zoster vaccine(Shingrix): Studies show that the protection remains at over 80% 10 years after vaccination, and there is currently no evidence supporting the need for booster shots; Gan Wei: within 5 years it can provide about 50-60% protection, and its efficacy gradually decreases after 5 to 8 years post-vaccination.
Vaccines cannot provide lifelong immunity, but they can significantly reduce the risk of disease and the severity of sequelae.
In addition to vaccination, the prevention of shingles also requires a combination of health management to achieve better results, such as:
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Individuals over 50 and those with weakened immunity are advised to prioritize vaccination;
Maintain regular routines, balanced diet, and moderate exercise to enhance immunity;
Individualized plans should be formulated by doctors based on age, health status, and vaccine type.
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