What is Herpes Zoster (Shingles)?

Herpes zoster, also known as shingles, is caused by the reactivation of the varicella-zoster virus — the same virus that causes chickenpox. After recovering from chickenpox, the virus remains dormant in the nerve cells. When the immune system weakens, the virus can reactivate later in a person’s life and cause shingles.
 

Symptoms and Complications

Common Symptoms

• Skin has a burning or tingling sensation

• Red rash with clusters of fluid-filled blisters

• Fever, headache, chills, or general discomfort

Common Complications

• Postherpetic Neuralgia (PHN): Persistent nerve pain in the affected area even after the rash has healed

• Pain may last for weeks, months, or in some cases, years

• Can significantly impact quality of life

Who is at Risk?

• Adults aged 50 years and older

• Individuals with weakened immune systems, such as those who have HIV, are undergoing chemotherapy, are taking immunosuppressive drugs, or have undergone an organ transplant

• Patients with chronic conditions such as diabetes, chronic kidney disease, heart disease, or lung disease

• Individuals with a history of chickenpox or shingles

Is Shingles Contagious?

Yes, shingles can be transmitted through direct contact with the fluid of the blisters. The virus (varicella-zoster) can spread to others, especially those who have never had chickenpox or have not been vaccinated. People at higher risk include older adults and those with weakened immune systems.
 

How is Shingles Treated?

Shingles is treated with antiviral medications, which help:

• Reduce pain and inflammation

• Limit the number of blisters

• Shorten the duration of the disease

Treatment should begin within 72 hours after the rash appears to reduce severity and complications such as PHN.
 
Additional treatments may include:

• Pain relief medications

• Anti-itch medications

• Antibiotics (if a secondary infection occurs)

Why Prevention is More Important Than Treatment

Although shingles can be treated, complications — especially chronic nerve pain — cannot always be completely prevented.
Vaccination is the most effective way to:

• Reduce the risk of infection

• Reduce the severity of symptoms

• Prevent long-term complications

 
Prevention and Vaccination
Effective prevention includes:

• Maintaining a strong immune system through a healthy lifestyle

• Receiving the shingles vaccine

 
Who Should Receive the Shingles Vaccine?

• Adults aged 50 years and older (even if they do not have a history of chickenpox)

• Adults aged 18 years and older with weakened immune systems

Age and declining immunity are key risk factors for shingles and PHN.
 
 

Understanding the Recombinant Zoster Vaccine (RZV)

Additional Information

• Full immunity develops approximately 4 weeks after completing the vaccine doses

• Protection may last up to 10 years

• Currently, no booster dose is recommended

Important Considerations

Consult a healthcare professional before vaccination if you are:

• Severely immunocompromised (not suitable for live vaccine)

• Allergic to vaccine components

• Currently experiencing shingles

• Pregnant

Frequently Asked Questions (FAQs)

What are the side effects of the shingles vaccine?

Common side effects include:

• Pain, redness, or swelling at the injection site

• Fatigue, muscle pain, headache

• Fever, chills, nausea, or stomach discomfort

Can I get vaccinated if I had shingles before?

Yes. You should wait at least 3–6 months after recovery before getting vaccinated.
 

If I previously received the live vaccine, can I get the recombinant vaccine?
Yes.

• Wait at least 2 months after receiving the live vaccine, then receive 2 doses of the recombinant vaccine

What is the difference between recombinant and live vaccines?

The recombinant zoster vaccine (RZV):

• More effective

• Does not contain a live virus

Frequently Asked Questions (FAQs) about Herpes Zoster (Shingles)

 
Q: What side effects may occur after receiving the shingles vaccine?
A: The most common side effects include pain, redness, or swelling at the injection site. Other possible side effects include fatigue, muscle pain, headache, chills, fever, abdominal pain, and nausea.
 
Q: If I have had shingles before, how long should I wait before getting vaccinated?
A: Individuals who have previously had shingles can still receive the vaccine. It is recommended to wait at least 3–6 months after recovery before getting vaccinated. The recombinant zoster vaccine (RZV) should be administered as 2 doses spaced apart, based on the doctor’s recommendations.
 
Q: If I previously received the live zoster vaccine, how long should I wait before receiving the recombinant vaccine?
A: Individuals who have previously received the live zoster vaccine can receive the recombinant zoster vaccine (RZV). The RZV should be given as 2 doses spaced apart, based on the doctor’s recommendations, with a minimum interval of at least 2 months after the live vaccine.
 
Q: What are the side effects of the shingles vaccine?
A: Side effects may include pain, swelling, or redness at the injection site, as well as mild fatigue or low-grade fever.
 
Q: Can I get vaccinated if I have had shingles before?
A: Yes, vaccination is still recommended. You should wait at least 3–6 months after recovering.
 
Q: What is the difference between the recombinant vaccine and the live vaccine?
A: The recombinant zoster vaccine (RZV) is more effective and does not contain the live virus, making it suitable for a broader range of individuals.
 


References;

1. Janniger c., et al Herpes Zoster: Practice Essentials, Background, Pathophysiology [Internet]. Emedicine.medscape.com. 202. Available from: https://emedicine.medscape.com/article/1132465-overview [Assessed 5 Mar 2026]
2. Centers for Disease Control and Prevention. Shingles (Herpes Zoster). Available from: https://www.cdc.gov/shingles/hcp/clinical-overview/?CDC_AAref_Val=https://www.cdc.gov/shingles/hcp/clinical-overview.html [Assessed 5 Mar 2026].
3. The Immunization Action Coalition. Recombinant Zoster (Shingles) Vaccine: What You Need to Know. Available from: https://www.immunize.org/wp-content/uploads/vis/zoster_recombinant.pdf [Assessed Assessed 5 Mar 2026]
4. Centers for Disease Control and Prevention. Update on recommendations for use of herpes zoster vaccine." MMWR. Morbidity and mortality weekly report (2014). Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6333a3.htm [Assesses 1 September 2023]
5. Centers for Disease Control and Prevention. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR. Morbidity and mortality weekly report (2018). Available from: https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a5.htm [Assesses 1 September 2023]
6. Shingrix® [package insert]. GlaxoSmithKline; 2023. Available from: https://www.fda.gov/media/108597/download?attachment [Assesses 1 September 2023]
7. Shingrix. GlaxoSmithKline; 2025. Available from: https://www.shingrix.com/shingrix-faqs/ [Assesses 5 Mar 2026]
8. Infectious Disease Association of Thailand. Recommended Adult and Elderly Immunization Schedule 2023. [Internet] Available from: https://idthai.org/2015/files_upload/files/Recommended%20Adult%20and%20Elderly%20Immunization%20Schedule%202025%20Web.pdf [Assesses 5 Mar 2026]