Shingles Vaccine: Who Should Get It and When

Shingles isn’t just a rash. For many people, it’s months of burning pain that won’t go away-even after the blisters heal. That’s because shingles is caused by the same virus that gives you chickenpox. Once you’ve had chickenpox, the virus stays hidden in your nerves. Years later, it can wake up and cause shingles. And the older you get, the more likely it is to happen. About 1 in 3 adults will get shingles in their lifetime. The good news? There’s a vaccine that works extremely well: Shingrix.

Who Needs the Shingles Vaccine?

You don’t need to wait until you’re 70 to think about the shingles vaccine. The CDC recommends Shingrix for everyone aged 50 and older, no matter if you’ve had shingles before or not. Even if you got the old vaccine (Zostavax), you still need Shingrix-it’s far more effective.

What if you’re younger than 50? You might still need it if your immune system is weakened. That includes people with HIV, those on chemotherapy, organ transplant recipients, or anyone taking long-term steroid medications. For these adults aged 19 and older, Shingrix is not just safe-it’s essential. The old vaccine wasn’t allowed for these groups because it used a live virus. Shingrix doesn’t. It’s made from a piece of the virus, not the whole thing. That’s why it’s safe for people with compromised immune systems.

People with diabetes, heart disease, or lung conditions are also at higher risk for severe shingles. The American Association of Clinical Endocrinology specifically recommends Shingrix for adults with diabetes. If you have a chronic illness, talk to your doctor. You’re not just protecting yourself from a rash-you’re preventing long-term nerve damage that can last for years.

When Should You Get It?

Shingrix is given in two doses. The first shot gets the job started. The second shot makes sure your protection lasts. The standard gap between doses is 2 to 6 months. That’s the sweet spot for maximum immunity.

But there are exceptions. If you’re immunocompromised and about to start treatment that weakens your immune system-like chemotherapy or a transplant-you can get the second dose as early as 1 month after the first. The absolute minimum is 4 weeks. If someone accidentally gives you the second shot too soon, you’ll need to repeat it after waiting the full 4 weeks.

Timing matters. If you just had shingles, wait at least one year before getting vaccinated. Your body is still fighting the virus, and vaccinating too soon might not give you the best protection. If you’re unsure, ask your doctor. They can check your medical history and give you the right timeline.

There’s no upper age limit. People in their 80s and 90s benefit just as much as those in their 50s. In fact, the risk of shingles and its worst complication-postherpetic neuralgia (PHN)-goes up with age. PHN can turn everyday things like a shirt brushing your skin into unbearable pain. Shingrix cuts the risk of PHN by over 90% in older adults.

How Effective Is Shingrix?

Shingrix is one of the most effective vaccines ever made for adults. Clinical trials showed it prevents shingles in more than 90% of healthy adults aged 50 and older. Even for people over 70, it still works at over 90% effectiveness. That’s a huge jump from the old vaccine, Zostavax, which only worked about half the time.

And it lasts. Data from the CDC shows protection stays strong for at least 7 years after the second dose. Studies are still tracking longer-term results, but so far, there’s no sign it wears off quickly. That’s why you don’t need a booster right now.

What about side effects? You’ll likely feel them. About 8 out of 10 people get pain, redness, or swelling at the injection site. Nearly half feel muscle aches. One in three feels tired or gets a headache. Some even get a fever. These usually last 2 to 3 days. They’re not dangerous-they’re your immune system doing its job.

People often say, “I felt worse after the second shot.” That’s normal. The second dose triggers a stronger immune response. That’s why it’s so effective. If you’re planning a big trip, a wedding, or a busy work week, don’t schedule it right after your shot. Give yourself a couple of days to recover.

What About Cost and Insurance?

Shingrix costs around $185 to $220 per dose in the U.S., depending on where you get it. That’s two doses, so total out-of-pocket could be $370-$440. But most people pay much less-or nothing.

Medicare Part D covers Shingrix. You might still pay a copay, but it’s usually under $50 per dose. Private insurance plans also cover it under preventive services. If you’re uninsured, some pharmacies offer discount programs. Community health centers often have vaccines at reduced prices.

Don’t let cost stop you. Shingles can cost thousands in medical bills if it leads to complications. One study found that treating PHN can cost over $10,000 in the first year. Vaccination is cheaper, safer, and far less painful.

Why Shingrix Over the Old Vaccine?

Zostavax, the old shingles vaccine, was discontinued in 2020. It was a live virus vaccine, which meant it couldn’t be given to people with weak immune systems. It also only worked about half the time. Shingrix replaced it because it’s better in every way: more effective, longer-lasting, and safe for more people.

There’s no reason to use Zostavax anymore. Even if you got it in the past, you still need Shingrix. The CDC says so. Your doctor will tell you the same. The science is clear: Shingrix is the only vaccine you need now.

What If You’re Not Sure?

Some people worry about side effects. A 2024 Kaiser Family Foundation survey found that 41% of adults aged 50+ didn’t get vaccinated because they were afraid of reactions. But here’s the truth: the pain from shingles lasts months. The side effects from the vaccine last days.

If you’ve had a severe allergic reaction to any ingredient in Shingrix-like gelatin or neomycin-you shouldn’t get it. Otherwise, the risks are minimal. Even people with egg allergies can get Shingrix. It doesn’t contain egg proteins.

Ask your doctor if you’re unsure. Bring your medical history. Mention any medications you’re taking. If you’re immunocompromised, your doctor might need to coordinate with your specialist. But in most cases, getting Shingrix is one of the easiest and most important decisions you can make for your health after 50.

What’s Next for the Vaccine?

GlaxoSmithKline is testing a single-dose version of Shingrix in clinical trials. If it works, it could make vaccination simpler and increase uptake. But that’s still years away. For now, two doses are the standard-and they work.

Experts are also pushing to start vaccinating at age 50, not 65. The risk of shingles rises sharply after 50, and many people don’t realize that. Waiting until Medicare eligibility means missing the window where protection matters most.

By 2030, one in five Americans will be over 65. That means more people at risk for shingles. The best way to protect yourself, your parents, and your loved ones is to get vaccinated now.

What to Do Next

If you’re 50 or older, call your doctor or local pharmacy today. Ask if they have Shingrix in stock. Many pharmacies offer walk-in appointments. Bring your insurance card. If you’re immunocompromised, bring a list of your medications.

Don’t wait for symptoms. Shingles doesn’t always come with a warning. Once it hits, there’s no cure-only ways to manage the pain. The vaccine is your best defense. Two shots. One decision. Years of protection.