Guide to Shingrix (Shingles Vaccine): Side Effects, Cost, Schedule, and More

Shingles is very common - about 1 in 3 adults in the U.S. will get it in their lifetime. And it's unpleasant. Shingles causes an intensely painful, blistering rash that takes weeks to resolve. Sometimes nerve pain lingers for much longer - along with other complications.

The risk of shingles increases with age. Anyone who has had chickenpox can get shingles. Almost all adults have had chickenpox, even if they don't remember it.

The shingles vaccine approved for older adults is called Shingrix. It's the only shingles vaccine available in the U.S. Here's what you need to know about the shingles vaccine, including who needs it, how it works, potential side effects, and more.

What is shingles?

Shingles is a condition that causes a painful blistering rash on one side of the face or body. This rash usually appears in a limited area on the skin, sometimes in the form of a stripe or a patch. In many cases, the rash follows strange sensations, such as tingling or itching, in the same area. The rash turns into blisters and can be intensely painful.

Shingles can also cause:

• Fever

• Chills

• Headache

• Upset stomach

The most common complication of shingles is postherpetic neuralgia (PHN). This is the medical term for the lingering nerve pain after the rash goes away. It can be long lasting and debilitating.

Other complications can occur, depending on which part of your body shingles affects. Complications can include:

• Hearing loss

• Stroke

• Brain inflammation

• Vision changes or blindness

What is Shingrix?

The shingles vaccine (Shingrix) can prevent herpes zoster, otherwise known as shingles. It also prevents the shingles-related complication PHN.

The shingles vaccine can protect against reactivation of the varicella-zoster virus. This is the virus that causes chickenpox, and it stays in the body after you recover. But it doesn't remain active. It's inactive in nerve cells. For unknown reasons, the virus can reactivate later in life and cause shingles.

The vaccine isn't intended to treat shingles or its complications; it prevents them. In people with a healthy immune system, Shingrix has been found to be more than 90% effective at preventing shingles. It is also about 90% effective at preventing PHN.

A different shingles vaccine, called Zostavax, was approved in 2006. But the vaccine was discontinued in the U.S. in November 2020. Shingrix has higher efficacy than Zostavax did.

Who should get the shingles vaccine?

Experts recommend Shingrix for all adults age 50 and older. You should get the vaccine even if:

• You've had shingles in the past (it's possible to get it again)

• You received Zostavax in the past (studies have shown that the efficacy of Zostavaxdeclines over time)

• You've received the chickenpox vaccine in the past

Experts also recommend Shingrix for adults 19 years and older who have weakened immune systems because of other conditions or medication.

Who shouldn't get the shingles vaccine?

You should not get Shingrix if you:

• Currently have shingles

• Are pregnant

• Had an allergic reaction to it in the past or are allergic to any component of the vaccine

It's best to speak with your primary care provider before getting the shingles vaccine if you're currently sick with another illness. In that case, it may be better to wait to get the vaccine.

There's not enough data to know if Shingrix can be transferred to a baby through nursing. If you're nursing or planning to, speak with your healthcare team before getting this vaccine. They can help you decide if it's better to wait.

Shingrix vaccine schedule

Shingrix is given as an injection into the upper-arm muscle in 2 doses that are spaced 2 to 6 months apart. Some people with weakened immune systems may be advised to get the second shot sooner (1 to 2 months after).

How often do you need to get the shingles vaccine?

You need to complete the 2-dose Shingrix vaccine series only once. Additional doses aren't currently recommended.

What happens if you don't get a second Shingrix shot?

Shingrix is over 90% effective at preventing shingles. But this number is based on receiving both doses within the recommended time frame. If you skip your second Shingrix shot, you may not receive full protection from the vaccine.

If you skipped your second Shingrix shot, you can still get it without restarting the series. Just get a second dose as soon as you can.

How long does the shingles vaccine last?

Experts say immunity after 2 Shingrix doses lasts about 7 years. But more recent data suggests it might be as long as 10 years. Expect more information to come as researchers continue to monitor immunity after vaccination.

Shingles vaccine side effects

As with any vaccine, it's possible to have some side effects after receiving Shingrix. In clinical studies, the side effects linked to the shingles vaccine usually lasted 2 to 3 days. The most common ones were:

• Arm pain or soreness (most common)

• Swelling and redness at the injection site

• Muscle pain

• Fatigue

• Headache

• Fever

• Nausea

Severe allergic reactions (such as anaphylaxis) to the Shingrix vaccine are very rare. But if you notice these symptoms in the hours after your vaccination, get medical help immediately:

• Hives

• Itching

• Fast heart rate

• Difficulty breathing

• Swelling of the face or throat

There's also a slightly increased risk of Guillain-Barré syndrome (GBS) after getting Shingrix. But it's not clear if Shingrix actually causes GBS. Experts say that this and any other risks are outweighed by the benefits of getting the vaccine.

Can you still get shingles after vaccination?

Yes, it's possible to still get shingles after receiving Shingrix. The vaccine is very effective, but it doesn't prevent 100% of shingles cases. If you do get shingles, your symptoms may be milder if you've received the vaccine. In this case, medications are available to help lessen pain and speed up healing.

How much does Shingrix cost?

This will depend on what type of insurance you have, if any. For example, Medicare Part Dcovers part of it, but Part B doesn't. Many commercial insurers do cover it, but it's always best to confirm with them first. You may be able to save with a GoodRx coupon or a manufacturer Patient Assistance Program.