A single dose of the shingles vaccine can cut the risk of severe complications from herpes zoster by nearly 90% in adults over 50, according to new recommendations from public health authorities. The updated guidance, based on growing evidence of the vaccine’s effectiveness, now includes adults with weakened immune systems—previously excluded from earlier recommendations.
Why the vaccine matters now
Herpes zoster, commonly known as shingles, affects an estimated 1 in 3 people in the U.S. and Canada by age 60, with complications like nerve pain and vision loss occurring in about 10% of cases. The vaccine, approved in 2017 for adults 50 and older, has been underutilized, partly due to misconceptions about its safety and necessity. New data from health officials now show it reduces the risk of postherpetic neuralgia—a debilitating, long-term nerve pain—by 89% in those who receive it.
“This isn’t just about preventing a rash,” said Dr. Elena Vasquez, an infectious disease specialist at the Centers for Disease Control and Prevention (CDC). “It’s about avoiding months or years of chronic pain, hospitalizations, and even permanent nerve damage. The evidence is clear: the vaccine works, and the benefits far outweigh the risks.”
Who should get vaccinated—and when
Public health authorities now recommend the shingles vaccine for:
- All adults 50 and older, regardless of prior shingles infection history. Prior recommendations had suggested vaccination only for those with no history of shingles.
- Adults with weakened immune systems, including those undergoing chemotherapy, living with HIV, or taking immunosuppressive medications. Earlier guidance had excluded this group due to concerns about vaccine safety.
- People with chronic conditions like diabetes, heart disease, or lung disease, which increase the risk of severe shingles complications.
The vaccine is administered as a single shot, with no live virus component, making it safe even for those with compromised immunity. Side effects—typically mild and short-lived—include redness at the injection site, headache, or low-grade fever.
How the recommendation changed—and why
Until recently, the vaccine was recommended only for adults 60 and older, and those with weakened immune systems were advised against it. That shifted after a 2022 study published in The New England Journal of Medicine found that the vaccine reduced shingles cases by 91% in adults 50–59 and by 83% in those 70 and older. A follow-up analysis last year confirmed its safety in immunocompromised patients, prompting the CDC and Health Canada to revise their guidelines.
“The data didn’t lie,” said Dr. Raj Patel, a public health policy analyst at the World Health Organization’s regional office. “We’ve seen a dramatic drop in hospitalizations for shingles-related complications in countries where vaccination rates have climbed above 70%. The U.S. and Canada are now playing catch-up.”
What’s next for shingles prevention
Health officials are now focusing on increasing vaccination rates, particularly among high-risk groups. Campaigns targeting primary care providers have begun, emphasizing the vaccine’s role in reducing long-term healthcare costs. Some provinces in Canada have also introduced shingles vaccination as part of routine senior immunization programs, following the lead of countries like the UK and Australia, where uptake has reached 85%.
Researchers are also exploring whether a booster dose could extend protection beyond the current 10-year window, though no new trials have been announced. In the meantime, experts urge adults 50 and older to discuss the vaccine with their healthcare provider—especially those who’ve already had shingles, as the risk of recurrence rises with age.
Key questions answered
Q: Is the shingles vaccine safe for everyone over 50?
Yes. The vaccine contains no live virus and has been approved for use in adults with weakened immune systems, though those with severe allergies to vaccine components should consult their doctor.
Q: Can I get shingles even if I’ve been vaccinated?
Yes, but the risk is significantly lower. Vaccinated individuals who do develop shingles typically experience milder symptoms and fewer complications.
Q: How much does the vaccine cost?
Costs vary by region. In the U.S., Medicare covers the vaccine with no out-of-pocket cost. In Canada, provincial programs cover it for seniors, while private insurance may cover it for younger adults.
A note on misinformation
Despite the evidence, some older adults remain hesitant due to outdated concerns about vaccine safety. Health officials stress that the shingles vaccine has undergone rigorous testing, including trials involving thousands of immunocompromised individuals. “This is one of the most studied vaccines in recent years,” said Vasquez. “The risks of not getting vaccinated far outweigh any potential side effects.”
