When can you get the shingles vaccine after having shingles

Dear Dr. Roach: I am 81 years old and was diagnosed with shingles at the end of October 2020. After taking famciclovir, I am healing, but still have a scaly rash and shooting pains on the right side of my head where the shingles occurred. I was told that the pain could last for a year or more. Is this true? The initial outbreak was on my scalp, forehead, brow and eye area. I did see my ophthalmologist and was fortunate that the shingles did not get into my eye, just on my eyelid.

I also saw my physician, who recommended I get the shingles vaccine in February 2021. My eye doctor disagrees and said to wait six to nine months. What is the recommended time span between the onset of shingles and getting the vaccine? How long does the vaccine protect someone? Once you have the vaccine, can you ever get shingles again?

— L.H.

Dear L.H.: Both your doctors are right. Your regular doctor who recommended a four-month time span is correct, but your eye doctor, who said six to nine months, is right also. In fact, the vaccine may be given at any time after the shingles lesions are healed (crusted over). Getting shingles again within a year is very unlikely, so it is fine to wait up to a year after the bout of shingles.

The length of protection seems to be long. But this is still a new vaccine, and it is unclear how long the protection will last.

Unfortunately, no vaccine is perfect -- even our best vaccines. Some people will get shingles despite getting the vaccine. Fortunately, the vaccine is even better at preventing the worst complication of shingles, persistent pain called postherpetic neuralgia. Trials have shown 89% to 100% protection against this terrible complication. In people in their 80s, it can indeed last up to a year and occasionally longer.

Dear Dr. Roach: My 34-year-old son who has Crohn’s disease told me he is using pure 91% bottled alcohol to cleanse his hands because of possible contact with coronavirus when he has to go out. He is being careful especially since he is being treated with Remicade. I want to know if this alcohol use is safe for him. Doesn’t isopropyl alcohol get absorbed into the bloodstream? Could this poison him? I asked him to stop using it too, since it will make his hands cracked and dry for winter.

— Anon.

Dear Anon.: Hand sanitizers may be made from wither isopropyl alcohol (rubbing alcohol) or ethanol (the kind in alcoholic drinks). Both can be absorbed to some extent through the skin, but the amount absorbed through the hands is not enough to cause toxicity. However, using isopropyl alcohol as a fever reducer all over the body CAN cause enough absorption into the body to cause toxicity. It is not recommended.

You are quite right that any alcohol can remove the skin’s natural protective layers and make the hands dry and susceptible to cracking. Rather than using plain alcohol, I recommend using a commercial hand sanitizer product that contains emollients to protect the hands. There are many brands.

Dr. Roach Writes: Several of my colleagues wrote to correct my recent column: the outer shell of bone is called cortical, while the inside, where the bone marrow is, is called cancellous.

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Overview

What is the shingles vaccine?

The shingles vaccine can protect you against shingles and postherpetic neuralgia (PHN), which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters.

What does the shingles vaccine do?

The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone who’s had chickenpox can get shingles. That’s because the varicella-zoster virus lives silently in your nervous system after you've had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.

What is the name of the shingles vaccine?

In the United States, there is currently one shingles vaccine authorized for use. The shingles vaccine is called Shingrix™ (recombinant zoster vaccine). As of November 18, 2020, another shingles vaccine called Zostavax® is no longer available for use in the United States.

Who should get the shingles vaccine?

The CDC recommends all healthy adults ages 50 years and older get two doses of the shingles vaccine to prevent shingles and problems that can develop after you’ve had the disease. The two doses should be separated by two to six months. You should get the shingles vaccine even if you:

• Have had shingles: If you’ve had shingles in the past, you should get the shingles vaccine to help prevent getting the disease again. You should wait until the shingles rash is gone before getting the vaccine.
• Aren’t sure if you’ve had chickenpox: Studies show more than 99% of Americans ages 40 and older have had chickenpox at some point in their lives. You should get the shingles vaccine whether or not you remember having chickenpox because they’re caused by the same virus.
• Received the old shingles vaccine (Zostavax): Before November 18, 2020, people were vaccinated with a shingles vaccine called Zostavax. You can’t get Zostavax in the United States anymore. If you were vaccinated with Zostavax, you should get vaccinated with the new shingles vaccine, Shingrix.

Who should not get the shingles vaccine?

Some people shouldn’t get the shingles vaccine. These people include those:

• Who currently have shingles.
• Who have had a severe allergic reaction to the shingles vaccine in the past.
• Who have tested negative for immunity to the varicella-zoster virus, meaning you’ve never had chickenpox. If you’ve never had chickenpox, you should get the chickenpox vaccine.
• Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
• Who are pregnant or breastfeeding.

Procedure Details

How is the shingles vaccine given?

Your healthcare provider will give you the shingles vaccine as an injection (shot) in your upper arm. You will get two doses of the vaccine separated by two to six months.

Risks / Benefits

What are the advantages of getting the shingles vaccine?

The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month.

Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach.

For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia (PHN), and it is the most common complication of shingles.

What side effects can the shingles vaccine cause?

The shingles vaccine helps your body’s immune system build up a solid defense against shingles, so you may experience temporary side effects after getting the shots. These side effects may include:

• Pain or soreness at the injection site.
• Redness or swelling at the injection site.
• Tiredness (fatigue).
• Headache.
• Fever.
• Abdominal pain.
• Nausea.

Severe reactions to the shingles vaccine are extremely rare. If you develop any of the following signs of an allergic reaction, call 911 or go to your nearest ER:

• Hives.
• Swelling of your face and throat.
• Difficulty breathing.
• Rapid heartbeat.
• Dizziness.
• Weakness.

Recovery and Outlook

How effective is the shingles vaccine in preventing shingles?

The shingles vaccine can provide strong protection against shingles and postherpetic neuralgia (PHN), the most commonly occurring shingles complication.

The shingles vaccine is 97% effective in preventing shingles in people ages 50 to 69 years old. It’s 91% effective in people ages 70 years and older.

In addition, the shingles vaccine is 91% effective in preventing PHN in people ages 50 to 69 years old. It’s 89% effective in people ages 70 years and older.

How long does the shingles vaccine last?

More than 85% of people ages 70 years and older remained protected from shingles for at least four years after they were vaccinated. Since your risk of shingles and PHN increases as you get older, it’s important to have strong protection against shingles in your older years.

Can you get shingles after you’ve been vaccinated?

While the shingles vaccine is highly effective, some people can still get shingles. However, people who do get shingles after getting the shingles vaccine usually have milder symptoms and a shorter illness. You’ll also be less likely to have complications from shingles, including postherpetic neuralgia.

Can you get shingles if you had the chickenpox vaccine?

Some people get shingles years after they received the chickenpox vaccine. However, it is much less common to get shingles after receiving the chickenpox vaccine than after having chickenpox.

When to Call the Doctor

What questions should I ask my healthcare provider?

It’s normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:

• When should I get the shingles vaccine?
• What side effects should I expect?
• How does the shingles vaccine work?
• When should I schedule each dose of the shingles vaccine?
• How effective is the shingles vaccine?
• Is there any reason I shouldn’t get the shingles vaccine?
• What could happen if I don’t get the shingles vaccine?

Frequently Asked Questions

How long after I’ve received the shingles vaccine am I contagious?

With the currently authorized shingles vaccine, Shingrix, you won’t be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.

Shingrix doesn’t use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.

A note from Cleveland Clinic

No one likes to get shots, especially for something you’ve already been vaccinated for. But the newer version of the shingles vaccine is one you’ll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.