Easy-to-read medicine information about the shingles vaccine (zoster vaccine or Zostavax) – what it is, when it is given and possible side effects.
Type of medicine
Protects against herpes zoster (shingles)
What is the shingles vaccine?
The shingles vaccine protects against herpes zoster (shingles) infection. Shingles is a painful, itchy skin rash that usually appears around your chest and back, but can also affect your legs or face. It appears on only one side of your body.
Shingles is caused by varicella-zoster virus (the same virus responsible for chickenpox).
It is more common in older adults and people with weakened immune systems.
Vaccination with the shingles vaccine can reduce your risk of shingles and the long-term pain it can cause.
About one third of people will develop shingles in their lifetime and 50% of people will develop shingles by the time they reach age 85 years.
While shingles can get better on its own, the most common complication occurring in up to 3 in every 10 people with shingles is pain that goes on after the shingles rash has cleared. This is called post-herpetic neuralgia (also called nerve pain).
Post-herpetic neuralgia is usually described as a burning or shooting pain, with itch, numbness, tingling or sensitivity to touch or temperature.
The risk and severity of both shingles and post-herpetic neuralgia increases with age.
Post-herpetic neuralgia can go on for months to years.
Having the shingles vaccine can help prevent shingles and reduce the risk of post-herpetic neuralgia. Read more about post-herpetic neuralgia.
How effective is the shingles vaccine?
Having the shingles vaccine reduces your risk of getting shingles and post-herpetic neuralgia, but the effect of the vaccine differs by age and time since vaccination.
Age at which you get vaccinated The shingles vaccine is most effective at preventing shingles in people aged 50–59 years (around 7 in 10 people who are vaccinated are protected) and becomes less effective as you get older. It is effective in about 5 in 10 people aged 65–69 years and about 4 in 10 people aged 80 years or older.
Times since vaccination Protection from the shingles vaccine wears off over time. The highest protection against shingles is during the first year after receiving the vaccine. By 6 years after being vaccinated, protection is very low.
Booster doses There is no information about whether a booster dose of the shingles vaccine provides any benefit. Although there are no recommendations, adults who have previously received the shingles vaccine can receive a second dose after 1 year. There are no safety concerns about receiving a second dose.
Who should get the shingles vaccine?
In New Zealand, one dose of the shingles vaccine is funded for people aged 65 years. People aged 66–80 years may also receive the funded vaccine until 31 December 2020.
Some people aged under 65 years who are at increased risk of shingles may also want to think about having the vaccination, although it is not funded for this group. If you would like to have it at a younger or older age, you may need to pay. Ask your doctor or nurse if you are unsure.
You may be at increased risk of shingles if you have:
a weakened immune system
inflammatory bowel disease
chronic obstructive pulmonary disease
chronic kidney disease
type 1 and 2 diabetes
The effectiveness of the vaccine does decrease over time so early vaccination may mean that protection is lost in older age when there is a higher risk of developing shingles and its complications. The shingles vaccine is currently approved for adults aged 50 years and older but is still effective and possible to give to younger adults following informed consent.
Who should NOT get the shingles vaccine?
The shingle vaccine is a live vaccine. This means that it can cause an infection in people with very weakened immune systems and should not be used in people with leukaemia, lymphoma, other conditions affecting your bone marrow, tuberculosis (TB) or in people having immunosuppressive therapy such as chemotherapy. It should also not be given to children and pregnant women.
What if I have had shingles recently?
If you have had shingles recently, your immunity has been boosted and this reduces the chances of getting shingles again in the short term. Therefore, if you have recently had shingles, it is recommended that you wait at least 1 year before getting the shingles vaccine.
How is the shingles vaccine given?
The shingles vaccine is given as an intramuscular injection (injected into the muscle on your upper arm). It is given as 1 dose.
Like all medicines, vaccines can cause side effects, although not everyone gets them.
What should I do?
Feeling unwell, tired or weak
These are quite common for the first 1 or 2 days after receiving the injection.
They usually settle within a few days.
Rest and drink plenty of fluids.
The routine use of paracetamol is not recommended following vaccinations, but may be used for relief of severe discomfort.
The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if you’ve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.
If you don’t have a family doctor, you can go to one of the after-hour medical clinics. Phone them first to make sure they can help you with the vaccination you need.
You can find a clinic near you on theHealthpointwebsite. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.
Vaccines on theNational Immunisation Scheduleare free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.
The following links provide further information on shingles vaccine:
Having the shingles vaccine reduces your risk of getting shingles, the severe pain associated with singles and the risk of post-herpetic neuralgia. Read more about shingles and post-herpetic neuralgia.
How well does the shingles vaccine work?
The effect of the shingles vaccine depends on the age at which you get vaccinated. The shingles vaccine is most effective at preventing shingles in people aged 50–59 years (around 7 in 10 people who are vaccinated are protected) and becomes less effective as you get older. About 5 in 10 people aged 65–69 years and 4 in 10 people aged 80 years or older are protected.
Although vaccination may not prevent herpes zoster in some older adults, studies suggest that vaccination boosts enough immunity to reduce herpes zoster pain and the risk of post-herpetic neuralgia.
Who can get the shingles vaccine for free?
In New Zealand, the shingles vaccine is funded for people who are 65 years old. People aged 66–80 years may also receive the funded vaccine until 31 December 2020.
How long does the shingles vaccine protect for?
Protection from the shingles vaccine wears off over time. The highest protection against shingles is during the first year after receiving the vaccine. By 6 years after being vaccinated, protection is very low.
If I have shingles now, can I get vaccinated?
The shingles vaccine is used to prevent shingles and it will not help if you already have shingles. If you have shingles, it is recommended that you wait at least 1 year before getting the shingles vaccine. You can get shingles more than once in your life, so even if you have had shingles before, the shingles vaccine may help to prevent another shingles episode.
If I've had shingles already, can I still have the shingles vaccine?
If you have had shingles before, you can still have the shingles vaccine. Your natural immunity is boosted by having shingles, but it is uncertain how long your immunity will last. If you have had shingles within the past year, your chances of getting shingles again soon is reduced, so it's recommended that you wait at least 1 year before getting the shingles vaccine.
If I have never had chickenpox, do I still need to get the shingles vaccine?
The vaccine is recommended for people whether or not they have had chickenpox.
Can a person with a weakened immune system (immunosuppressed) get the shingles vaccine?
No, people with a weakened system can't have the shingles vaccine. This includes people receiving certain medicines for rheumatoid arthritis or Crohn’s disease, or certain medicines for cancer, or people who are HIV-positive with a low CD4 count. Check with your doctor if you are unsure. If you need the shingles vaccine and need these treatments, it is best to have the vaccine at least 1 month before starting immunosuppressive treatment.
Can pregnant women have the shingles vaccine?
No, pregnant women should not get the shingles vaccine.
Can a person who is living in the same household as someone who is immunosuppressed or pregnant receive shingles vaccine?
Yes, shingles vaccine can be given to adults in close contact with babies and children, pregnant women or people with weakened immune systems. There is an extremely small risk of a vaccine-related rash and the low possibility of wildtype varicella-zoster virus transmission. Discuss your concerns with your doctor.
Can shingles vaccine be given at the same visit as other vaccines?
Yes, the shingles vaccine can be given at the same visit as any other vaccine, including influenza (Influvac® Tetra), pneumococcal (Pneumovax® 23), Tdap (Boostrix®) and Td (ADT™ Booster) vaccines. Separate syringes and different injection sites should be used.
If I'm taking antiviral medication such as for cold sores, can I get the shingles vaccine?
If you are being treated with any antiviral medication, such as acyclovir, valaciclovir or valganciclovir, it is best that the treatment is stopped for at least 24 hours before getting the shingles vaccine and for 14 days after vaccination. This allows the vaccine virus to replicate and induce an immune response.
If I'm receiving blood products, can I get the shingles vaccine?
Yes, if you are getting a blood transfusion or immunoglobulin products, you can have the shingles vaccine.
This section will be of most interest to clinicians (eg, nurses, doctors, pharmacists and specialists).
Prevention of herpes zoster (shingles), post-herpetic neuralgia and reduction of acute and chronic zoster-associated pain in older adults.
Subsidised from 1 April 2018 for adults turning 65 years, with a 2 year catch-up period for those aged 66–80 years until 31 December 2020.
Vaccination is appropriate regardless of varicella zoster (chickenpox) or herpes zoster history.
Consider delaying vaccination by at least 1 year if recent episode of herpes zoster.
Severe allergy or anaphylaxis to any component of the vaccine.
Significant immunosupression: people undergoing immunosuppressive treatment, people with primary and acquired immunodeficiency such as leukaemia, lymphoma, other conditions affecting the bone marrow or lymphatic system, AIDS and cellular immune deficiencies.
Active untreated tuberculosis.
Store Zostavax between 2°C and 8°C.
Reconstitute Zostavax with the diluent provided and use within 30 minutes, preferably immediately.
Administer reconstituted Zostavax as a single 0.65 mL dose subcutaneously into the region over the deltoid.