How long should you wait between shingles shots

Ask the doctors

How long should you wait between shingles shots

Q. I've had the Zostavax vaccine to prevent shingles, but now I've heard there is a new vaccine that is supposed to be more effective. Should I get the new vaccine? And can I get it, since I already had the Zostavax shot?

A. You heard correctly. The Centers for Disease Control and Prevention (CDC) now recommends that healthy adults over age 50 get two doses of a new vaccine called Shingrix, which was approved by the FDA in October 2017. Doses are given two to six months apart. Shingrix is said to be more than 90% effective against shingles and postherpetic neuralgia — a painful nerve condition that can arise as a shingles complication.

This new vaccine is much more effective than Zostavax, which had been used in the past. It reduced the risk of shingles by only 51%. Research has also shown that Zostavax loses its ability to prevent shingles after five years. Zostavax is no longer available in the United States.

If you've ever had chickenpox, you are at risk for shingles, which is essentially a re-emergence of the virus that caused your chickenpox. The CDC says you should get vaccinated with Shingrix even if you aren't sure you've had chickenpox and if you've already had shingles. Although it's uncommon, you can get shingles more than once. In addition, you should get the Shingrix vaccine even if you already got the Zostavax vaccine.

While some people can have a very sore arm, fatigue and low-grade fever after the vaccine, most people who get Shingrix experience only mild side effects.

— by Hope Ricciotti, M.D., and Hye-Chun Hur, M.D., M.P.H.
Editors in Chief, Harvard Women's Health Watch

Image: © Highwaystarz-Photography | GettyImages

Vaccines are a vital tool for mitigating illness from many infectious diseases, including COVID-19 and shingles.

The COVID-19 vaccine can protect you from becoming ill and lower your risk of serious illness or hospitalization.

For example, recent data from the United Kingdom has found that, compared to unvaccinated individuals, the risk of hospitalization with the Omicron variant is 65 percent and 81 percent lower in people who’ve had 2 doses and 3 doses of the COVID-19 vaccine, respectively.

The shingles vaccine protects you from shingles and can also prevent postherpetic neuralgia, a common complication of shingles that can cause long-term pain. Compared to 2019, shingles vaccinations dropped by 89 percent early in the pandemic, although rates began climbing again later in 2020.

You may wonder how much time needs to pass between getting your shingles and COVID-19 vaccines. Keep reading as we explore the answer to this question and others.

The Centers for Disease Control and Prevention (CDC) recommends that adults ages 50 and older receive 2 doses of the shingles vaccine, Shingrix. The doses are separated by 2 to 6 months.

It’s important to get the shingles vaccine, even if you:

  • have had shingles previously — Shingrix can help prevent future occurrences
  • are unsure whether you’ve had chickenpox — most people in the United States have had chickenpox, even if they don’t remember being ill
  • received an older shingles vaccine called Zostavax, which is no longer available in the United States

Shingrix is highly effective at protecting you from shingles and postherpetic neuralgia. According to the CDC, Shingrix is 90 percent effective at preventing these conditions after 2 doses. This protection remains high for at least 4 years.

Who shouldn’t get the shingles vaccine?

You shouldn’t receive the shingles vaccine if:

  • You’ve had a previous severe allergic reaction to Shingrix or any of its ingredients.
  • You currently have shingles.
  • You’re pregnant or breastfeeding.
  • You have no immunity to chickenpox, which means you should get the chickenpox vaccine instead.

Having a mild illness like a cold isn’t a reason to not get your shingles vaccine.

However, if you have a moderate to severe illness or a fever of 101.3 or higher, you should recover before getting your shingles vaccine.

The CDC guidelines state that the COVID-19 vaccine may be given without regard to the timing of other vaccines.

This means you don’t have to wait to receive your COVID-19 and shingles vaccinations.

In fact, you can get your COVID-19 vaccine and shingles vaccine at the same time. If you choose to do this, make sure to receive your injections at two different sites.

The most common side effects of the COVID-19 vaccine include:

  • redness, swelling, or soreness where you got your shot
  • fatigue
  • fever
  • chills
  • headache
  • muscle aches and pains
  • nausea

Side effects felt throughout your body are typically more common after receiving the second and booster doses of the COVID-19 vaccine. Like the shingles vaccine, COVID-19 vaccine side effects typically last only a couple of days.

When COVID-19 and flu circulate at the same time, it has the potential to cause many people to become ill and overburden the healthcare system. As such, it’s essential to receive both COVID-19 and flu vaccines.

It’s safe to receive your COVID-19 and flu vaccine at the same time.

Though we’re still learning more about giving the COVID-19 vaccine with other vaccines, a November 2021 study found no safety concerns when the COVID-19 and flu vaccine were given at the same time. Also, participants produced expected antibody responses to both vaccines.

The CDC recommends that all people ages 6 months and older get a flu vaccine. The flu vaccine can help prevent illness and reduce the risk of serious flu-related complications in vulnerable individuals, such as:

  • older adults
  • young children
  • pregnant people
  • people with specific health conditions such as asthma, heart disease, and diabetes

It’s important to get the COVID-19 and shingles vaccines when you’re eligible. These vaccines can protect you from two illnesses that could potentially cause severe complications.

You don’t have to wait between getting the COVID-19 vaccine and others, such as the shingles or flu vaccines.

Your doctor can answer any questions or concerns you may have about the timing of your COVID-19 and shingles vaccinations.

How far apart can Shingrix be given?

Shingrix (recombinant zoster vaccine) should be administered to immunocompetent adults aged 50 years and older and adults aged ≥19 years who are or will be immunodeficient or immunosuppressed because of disease or therapy as a two-dose series (0.5 ml each), 2 to 6 months apart (0, 2-6 months).

Do I need to get Shingrix every 5 years?

A: Studies confirmed that Shingrix was safe and immunogenic when administered 5 or more years after Zostavax. Intervals shorter than 5 years have not been studied. However, there are no data or theoretical concerns to indicate Shingrix would be less safe or effective when given less than 5 years after Zostavax.