Shingles vaccines can spare you a painful illness : NPR

Pain and itching can be early symptoms of shingles.

trioocean/iStockphoto/Getty Images

hide caption

toggle caption

trioocean/iStockphoto/Getty Images

Chad Bernhard knows the pain of shingles firsthand.

The New York-based audio instructor was in his 30s when he noticed a rash on the left side of his body and around part of his chest and back.

It was itchy, and it didn’t take long for the itch to turn into a sharp, shooting pain, “kind of like the whole side of your body was being stung by hornets, all the time,” he says.

Shingles is a reactivation of chickenpox-zoster virus that causes chickenpox. This virus remains dormant in our bodies for years after an infection, hidden in the root of a nerve.

When it reappears, the virus inflames that nerve, says Dr. Maria Carney, a geriatrician and executive director of the Northwell Aging Institute on Long Island. “And then it goes through the skin and you get blisters and itches and burns and it can be very, very painful.”

About one-third of Americans will get shingles in their lifetime, but a vaccine can prevent much of that suffering. Some people are reluctant to get the shingles vaccine because they have heard it has side effects. According to 2022 data, only 36% of adults over the age of 50 have received at least one injection of the shingles vaccine. The vaccine requires two injections over several months.

But doctors say it’s not a vaccine to ignore. Shingles pain can be debilitating for days or weeks, and infection can have long-term effects.

Here are four things to know about the disease, the vaccine and the treatment.

1. Shingles May Strike Younger Than You Think

Doctors recommend getting vaccinated at age 50, and that’s usually when insurance covers it, because our immune systems start to weaken around this time.

But many people get shingles much younger. Bernhard, who has had shingles twice, says that both times it happened while he was engaged in “intense physical activity,” participating in Century Bike Rides, where participants covered 100 miles in a day. He got vaccinated shortly after his 50th birthday.

Dr. Sheryl Clark, a dermatologist in New York, says emotional and physical stress can cause shingles to flare up.

“When you really put your body through intense physical training, it negatively affects your immune system,” she says, allowing the virus to take hold. Trauma to the skin, such as a scrape or burn, can also trigger symptoms there, she adds.

The number of people with shingles quadrupled between the 1940s and the early 2000s. Clark says no one knows exactly why, but she thinks increased stress and changes in the American diet are part of it.

“We have very busy lives and expect so much of ourselves, and we don’t have time to prepare whole foods” that boost our immune systems, she says.

Recent research shows that certain chronic conditions may put young people at increased risk of shingles, including diabetes and asthma.

For people who received the chickenpox vaccine as children (vaccines became widely available in 1995), the risk of shingles appears to be lower. But because the chickenpox vaccine contains a trace of live virus, there is a small risk that it will reactivate later and cause shingles. “It’s still possible, but it’s less [likely]” says Carney.

2. The vaccine could do more than prevent shingles

Emerging research on the vaccine suggests another reason to get vaccinated.

In a study published in December, researchers found that the shingles vaccine may help protect against dementia. A separate study, published in the Gerontology journals in January, showed slower biological aging in those who had received the vaccine, compared to those who had not received it.

“The vaccine appears to have the broader benefit of helping control aging,” says Eileen Crimmins, co-author of the aging study and professor of gerontology at the University of Southern California.

She studied aging at the molecular level and discovered, among other things, that there was less inflammation in those who were vaccinated.

“Many people believe that inflammation is one of the most fundamental mechanisms of aging,” says Crimmins, “that it both occurs in response to and causes various diseases.”

Her research was conducted on people who had received the previous shingles vaccine, Zostavax, which was discontinued in the United States in 2020. But she says that because the current vaccine, Shingrix, is stronger and more effective against shingles than its predecessor, “one might expect even greater effects on underlying aging.”

Although the USC study shows a correlation, not cause and effect, Crimmins is excited to investigate further. In a commentary published alongside Crimmins’ article, Dr. Nicola Veronese, a researcher at Saint Camillus University in Rome, wrote that the findings add to a growing body of research showing that the shingles vaccine can help prevent dementia and slow aging, while calling for more studies to better understand why it may have this protective effect.

3. Recognize symptoms and get early treatment

Doctors urge people to watch for the warning signs of shingles so they can be treated right away. A tingling sensation can be an early symptom, as can skin sensitivity, a rash, or severe pain.

Five years ago, Alison Meadow, a college professor in Tucson, Arizona, went for a run, fell and scraped her knee.

“After about a day, I noticed it hurt more than just a scratch,” she says. “Wow, that really hurt. I thought, oh, I must have changed something. And it still took a few days before I got a rash.”

This happened during the pandemic, when people were staying away from each other. Meadow was initially hesitant to see a doctor in person, but eventually made an appointment.

Her doctor diagnosed her with shingles and prescribed an antiviral medication, but said it may be too late for the medication to be fully effective.

“You really need to get it within the first few days of the outbreak,” Carney says. “The sooner you can get it, as soon as that nerve starts activating, the better.”

4. Shingles Symptoms May Persist

Meadow, an athlete who was 47 at the time, says the pain in her leg never went away. She is one of a small group of people with shingles who suffer from postherpetic neuralgia, or persistent nerve pain caused by shingles. It changed his life.

“I was there for a while over the last five years where even walking the dog around the neighborhood was difficult,” she says. “It would hurt, I would be exhausted. I mean, a few blocks of walking with my very slow dog would destroy me.”

Meadow paid out of pocket to get vaccinated before she turned 50 because she couldn’t bear the thought of getting shingles again. According to a 2024 study, between 1% and 10% of people with shingles will experience a recurrence at some point.

The first painkiller she tried several years ago caused side effects so severe — constant headaches and brain fog — that she gave up. But she recently started taking a new medication, and it’s working. The side effects are manageable and its pain is reduced.

“I sleep better and have much less pain during the day,” she told NPR in an email. “I was even able to start jogging again!”

She is delighted to have found a medication that works for her. And she’s still urging everyone she knows over 50 to get vaccinated.