Herpes Zoster (Shingles) is caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state. For reasons that are not fully known, the virus can reactivate years later, causing shingles. Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease.
The lifetime risk of developing shingles is 32% for individuals in the United States, and 50% of individuals who live until the age of 85 years will develop singles. Herpes zoster, or shingles, is a reactivation of the latent varicella zoster (chicken pox) virus, which most adults had as children. Herpes zoster is characterized by pain and a typically unilateral rash lasting up to 4 weeks. The most common complication of herpes zoster is postherpetic neuralgia (PHN), a long-term effect of shingles that is characterized by pain that persists in the area where the rash was present after the rash has resolved. While most shingles symptoms clear, 20% of individuals will develop postherpetic neuralgia.
Zoster vaccination data indicate a 51% decrease in the number of cases of shingles with vaccination, a 61% reduced burden of illness due to herpes zoster, and a 67% reduction in the incidence of postherpetic neuralgia. There is only one FDA-approved shingles vaccination. The vaccine is given in a single dose and is recommended for adults aged 60 years or older, including people with chronic medical conditions (unless a contraindication or precaution exists for their condition). Provisional ACIP recommendations advise that the vaccine should be given whether or not the person has had a previous diagnosis of shingles.
As with any live-attenuated vaccine, none of the varicella-containing vaccines should be given to pregnant women. Nonpregnant women who are vaccinated should avoid becoming pregnant for one month following each injection.