Merck Manual

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Shingles Vaccine

(Herpes Zoster Vaccine)


Margot L. Savoy

, MD, MPH, Lewis Katz School of Medicine at Temple University

Full review/revision Jan 2023

There are two herpes zoster (shingles) vaccines. The newer herpes zoster vaccine is preferred over the older herpes zoster vaccine because it provides better and longer-lasting protection.

  • The newer vaccine contains only noninfective pieces of the virus (called a recombinant vaccine). There is no live virus in this vaccine.

  • The older vaccine contains live but weakened virus (called a live-attenuated vaccine). It is no longer available for use in the United States.

For more information, see the Centers for Disease Control and Prevention's (CDC) Recombinant shingles vaccine information statement and the Live shingles vaccine information statement.

The herpes zoster virus is the same virus that causes chickenpox Chickenpox Chickenpox is a highly contagious viral infection with the varicella-zoster virus that causes a characteristic itchy rash, consisting of small, raised, blistered, or crusted spots. Chickenpox... read more Chickenpox . After chickenpox resolves, the virus remains in the body. It can be reactivated years later and cause shingles, which is a painful rash, usually on only one part of the body. The rash resolves after several weeks, but postherpetic neuralgia, which causes severe chronic pain, can last for months or years. Herpes zoster can also cause other problems due to malfunction of the nervous system (such as problems with vision, hearing, or balance).

Administration of Shingles Vaccine

The newer recombinant herpes zoster vaccine is given in two doses, injected into a muscle. The doses are given 2 to 6 months apart and at least 2 months after the live-attenuated herpes zoster vaccine was given.

The recombinant vaccine is recommended for people aged 50 and over whether or not they have ever had shingles or have been given the live-attenuated vaccine. This vaccine is also recommended for people aged 19 and older who have or will have a weakened immune system because of a disease or treatment for a disease.

Certain conditions may affect whether and when people are vaccinated (see also CDC: Who Should NOT Get Vaccinated With These Vaccines?). If people have a temporary illness, doctors usually wait to give the vaccine until the illness resolves.

Side Effects of Shingles Vaccine

The most common side effects of the recombinant vaccine are pain, soreness, redness, and swelling at the injection site and headache, fatigue, muscle pain, shivering, fever, and digestive upset.

The most common side effects of the live-attenuated vaccine are soreness, redness, swelling, and itching at the injection site and headache.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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