Questions & Answers

When did zoster vaccine first become available?
A zoster vaccine (Zostavax by Merck) was licensed on May 25, 2006.

What kind of vaccine is it?
The zoster vaccine is a live, attenuated vaccine. This means the live, disease-producing virus was modified, or weakened, in the laboratory to produce an organism that can grow and produce immunity in the body without causing illness.

How is this vaccine given?
This vaccine is given by an injection, usually in the fat into the back of the upper arm.

Who should get this vaccine?
On October 25, 2006, the Advisory Committee on Immunization Practices recommended that all adults age 60 years and older receive one dose of zoster vaccine, including persons who have already had an episode of shingles. Vaccination can be done during a routine healthcare visit.

On March 24, 2011, the Food and Drug Administration (FDA) approved the use of the zoster vaccine (Zostavax) for the prevention of shingles in individuals 50 to 59 years of age; however, ACIP recommendations for this age group have not yet been determined.

How effective is this vaccine?
Zoster vaccine was studied in approximately 38,000 individuals throughout the United States who were age 60 years and older as part of its pre-licensure testing. Half received the vaccine and half received a placebo. Study participants were followed for an average of three years to see if they developed shingles and, if they did, how long the pain lasted. Researchers found that the vaccine reduced the occurrence of shingles by about 50% among persons age 60 years and older. The vaccine is most effective for those age 60–69 years (64%); effectiveness declined with increasing age to 41% for those age 70–79 years and 18% for those age 80 years and older.

In individuals vaccinated with zoster vaccine who still developed shingles, the duration of pain was a bit shorter than for those who received a placebo. The severity of the pain did not appear to differ among the two groups.

Does the vaccine help prevent post-herpetic neuralgia?
In people who were age 70 years and older who still developed shingles after being vaccinated, the vaccine reduced the frequency of post-herpetic neuralgia. However, the primary benefit of the vaccine in preventing post-herpetic neuralgia is by reducing the risk of developing shingles in the first place.

Who recommends this vaccine?
The vaccine has been recommended by CDC's Advisory Committee on Immunization Practices, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians.

How safe is this vaccine?
In a clinical trial involving more than 38,000 adults, Zostavax was administered to about half of the study participants. The other half received a placebo. The prevalence of serious adverse events was similar in the vaccine and placebo groups (1.9% and 1.3%, respectively). The most commonly reported side effects were redness (36%), pain or tenderness (35%), swelling (26%), and itchiness (7%) at the injection site.

As with all vaccines, the manufacturer will continue to study the vaccine to provide additional safety information.

What side effects have been reported with this vaccine?
The most common reported side effects in vaccine recipients were mild, such as redness, pain and tenderness, swelling and itchiness at the injection site and headache.

Who should NOT receive zoster vaccine?

• People who are allergic to the antibiotic neomycin, or any component of the vaccine (including gelatin) should not receive this vaccine.
• Zostavax is a live vaccine and should not be given to individuals who have a weakened immune system caused by treatments that they are taking such as radiation or corticosteroids, or due to conditions such as HIV/AIDS, cancer of the lymph, bone, or blood.
• Individuals with active, untreated tuberculosis.
• Pregnant women should not receive this vaccine. In addition, people who are in close contact with pregnant women who have not had chickenpox should talk to their healthcare provider before receiving zoster vaccine.

Is the cost of shingles vaccine covered by Medicare?
All Medicare Part D plans cover the shingles vaccine. Your share of payment varies by plan. Medicare Part B does not cover the shingles vaccine. If you have private insurance, your plan may or may not cover the vaccine; contact your insurer to find out.

Does the zoster vaccine cause shingles?
No, there is no evidence that it can at this time; however, the varicella (chickenpox) vaccine sometimes causes a shingles episode. The risk of shingles following vaccination with chickenpox vaccine appears to be less than that following infection with the chickenpox virus. The majority of cases of shingles following chickenpox vaccination have been mild and have not been associated with serious complications.

Can a person who has received the vaccine infect others with this virus?
No. It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. Transmission of the chickenpox virus from a person who has received the shingles vaccine has never been documented. Some people who get the shingles vaccine will develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.

Questions and answers about zoster (shingles) disease

Technical content reviewed by the Centers for Disease Control and Prevention, October 2011