Shingles vaccine

Overview

The shingles vaccine is a safe injection that helps protect you from getting shingles. Shingles is a painful rash caused by the same virus that causes chickenpox. The vaccine lowers your risk of getting shingles and, if you do get it, makes the illness much milder.

Shingles is common, especially in older adults. About 1 in 3 people will get shingles at some point in their life. The shingles vaccine has made it much less common in people who are vaccinated.

The shingles vaccine is for adults aged 50 and over, and for people aged 18 and over who have a condition that weakens their immune system, such as certain cancers, HIV, or treatments like chemotherapy.

Symptoms

Common symptoms

• A painful, burning, or tingling feeling on one side of the body or face
• A red rash that turns into fluid-filled blisters that crust over
• Fever, headache, chills, and upset stomach

Symptoms in children

• Shingles is rare in children, but they can get it if they had chickenpox. Symptoms are usually milder, with a small rash and less pain.

Symptoms in older adults

• Older adults often have more intense pain and a larger rash. The pain can last for months or years after the rash heals (called postherpetic neuralgia).

Causes

Main causes

• Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you have chickenpox, the virus stays asleep in your nerve cells. Later in life, it can wake up and cause shingles.

Risk factors

• Being over 50 years old
• Having a weakened immune system (from illness, medicines, or stress)
• Having had chickenpox before (everyone who has had chickenpox can get shingles)
• Not getting the shingles vaccine

When to see a doctor

See a doctor urgently if:

• If you think you might have shingles, see your doctor as soon as possible. Starting antiviral treatment within 3 days can help it heal faster and reduce pain.

Book a routine appointment if:

• Talk to your doctor about the shingles vaccine if you are 50 or older, or if you have a weakened immune system and are 18 or older.

Diagnosis

Your doctor can usually diagnose shingles just by looking at the rash and asking about your symptoms. If the rash is unusual, they may take a small sample of fluid from a blister to test for the virus.

Tests that may be done

• Physical exam and history of symptoms
• Laboratory test (PCR or culture) of blister fluid if needed

What to expect at your appointment

The diagnosis is quick and painless. Your doctor will examine your rash and ask about pain, fever, and other symptoms. They might also check your eyes if the rash is near your face.

Treatment

Shingles treatment focuses on reducing pain, speeding up healing, and preventing complications. Your doctor may prescribe antiviral medicine if started early. Pain relief and self-care are also important.

Self-care at home

• Keep the rash clean and dry to prevent infection
• Apply cool, wet compresses to the rash for 20 minutes several times a day
• Take over-the-counter pain relievers (like paracetamol or ibuprofen) – ask your pharmacist or doctor for advice
• Wear loose, soft clothing to avoid irritating the rash
• Rest and drink plenty of fluids

Medical treatments

Antiviral medicines can be prescribed by your doctor to fight the virus. They work best when started within 72 hours of the rash appearing. Your doctor may also prescribe stronger pain medicines or creams for severe pain. In some cases, medications that affect nerves (like gabapentinoids) or antidepressant-like medicines are used for long-lasting pain.

When is surgery considered?

Surgery is not used for shingles. Rarely, a procedure called a nerve block or spinal cord stimulation may be considered for severe, long-term pain that does not improve with other treatments.

Living with this condition

Shingles usually clears up in 2 to 4 weeks. During this time, rest and avoid stress. Keep the rash covered to lower the risk of spreading chickenpox to others. Pain may last longer, but most people recover fully.

Lifestyle tips

• Rest and get enough sleep
• Avoid scratching the blisters – trim nails if needed
• Wash your hands often, especially after touching the rash
• Avoid close contact with people who may be vulnerable until the rash has crusted

Diet and exercise

Eat a balanced diet with plenty of fruits and vegetables to support your immune system. Gentle exercise, like walking, can help you feel better, but avoid anything that irritates the rash. Ask your doctor before starting new activities.

Mental health and emotional wellbeing

Shingles can be very painful and stressful, which may affect your mood. It is normal to feel frustrated or anxious. Pain that lasts a long time can also affect sleep and cause low mood. Talk to your doctor if you are struggling emotionally.

Prevention

Yes, getting the shingles vaccine is the best way to prevent shingles and its complications. Even if you have had shingles before, the vaccine can help stop it from coming back.

Vaccines

The shingles vaccine is recommended for adults aged 50 and over, and for those 18 and over with a weak immune system. It is given as an injection, usually in your upper arm. You will need one or two doses depending on the type your doctor recommends. The vaccine is very safe and effective. Common side effects include soreness, redness, or swelling at the injection site, headache, and tiredness. These usually go away in a few days.

Screening programmes

There is no routine screening test for shingles. The best prevention is vaccination. If you are eligible, ask your doctor or pharmacist about getting vaccinated.

Complications

If left untreated

• Postherpetic neuralgia (PHN) – long-term nerve pain that can last months or years after the rash heals
• Vision loss if shingles affects the eye
• Skin infections from scratching blisters
• Hearing loss or facial paralysis if shingles affects the ear
• Rarely, inflammation of the brain (encephalitis) or spinal cord

Long-term outlook

Most people recover from shingles without serious problems. The shingles vaccine dramatically lowers your risk of getting shingles and its complications. If you do get shingles, early treatment with antiviral medicine can shorten the illness and reduce pain. Even with complications, good medical care can help you manage symptoms and maintain a good quality of life.

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