What is the Shingles Vaccine, and Why Isn't it Annual?
The current shingles vaccine used in the United States is Shingrix, a recombinant zoster vaccine that was approved by the FDA in 2017. This vaccine is highly effective at preventing shingles and its most common complication, postherpetic neuralgia (PHN), a form of long-term nerve pain. Unlike annual vaccinations like the flu shot, Shingrix is not needed every year because it is designed to create a powerful, long-lasting immune response with just two doses.
The varicella-zoster virus (VZV), which causes both chickenpox and shingles, lies dormant in the nerve tissue of people who have had chickenpox. The Shingrix vaccine works by stimulating the body's immune system to build a stronger defense against VZV reactivation. The two-dose regimen ensures that the immune system is primed with an initial dose and then boosted with a second, leading to a robust and durable protective effect that persists for many years.
Comparing Shingrix to the Older Zostavax Vaccine
For those who may remember a previous shingles vaccine, it's important to understand the differences between the new and old versions. The Centers for Disease Control and Prevention (CDC) no longer recommends the older, live vaccine, Zostavax, and it has not been available in the U.S. since 2020. Shingrix offers superior protection and longevity, addressing some of the shortcomings of its predecessor.
| Feature | Shingrix (Recombinant) | Zostavax (Live Attenuated, Discontinued) |
|---|---|---|
| Effectiveness (Age 50-69) | ~97% at preventing shingles | ~67% in the first year, decreasing rapidly |
| Number of Doses | Two doses (2-6 months apart) | Single dose |
| Duration of Protection | At least 7-10 years, and potentially longer | Decreases substantially over time |
| Recipients | Adults 50+; immunocompromised adults 19+ | Recommended for adults 60+ when available |
| Virus Type | Non-live vaccine | Live attenuated virus |
Who Should Get the Shingles Vaccine and When?
- Healthy adults 50 years and older: The CDC recommends a two-dose series of Shingrix for this population.
- Adults 19 years and older who are immunocompromised: Due to a higher risk of shingles and its complications, these individuals should also receive the two-dose series. In some cases, the second dose may be given on a shorter schedule (1 to 2 months after the first).
- If you have had shingles before: You should still get the vaccine to help prevent future outbreaks. It is best to wait until the rash has cleared before getting the shot.
- If you received Zostavax in the past: You should still receive the Shingrix series, as it provides stronger and more durable protection.
What About Shingles Vaccine Booster Shots?
Currently, there is no official recommendation from the CDC or any medical body for an additional booster shot after completing the initial two-dose Shingrix series. The vaccine's effectiveness has been shown to remain high for many years, with studies indicating significant protection lasting for at least seven to ten years.
However, it is possible that future research may lead to updated recommendations regarding boosters. The duration of vaccine protection can vary by individual due to factors like age, overall health, and immune system strength. For now, completing the two-dose series is the standard for long-term protection.
The Importance of Completing the Full Series
Receiving both doses of the Shingrix vaccine is crucial for achieving maximum protection. Clinical trials demonstrated the vaccine's high efficacy when administered as the full two-dose series. Skipped doses or incomplete series can leave you with significantly reduced protection, increasing your risk of developing shingles and suffering from its painful, lasting effects. For most adults, the second dose should be given 2 to 6 months after the first.
Conclusion
The simple answer to the question, do we need a shingles vaccine every year?, is no. The modern Shingrix vaccine is administered as a two-dose series that provides robust, long-lasting protection against shingles for many years. While annual shots are necessary for some viruses like the flu, shingles protection works differently. By getting the two recommended doses, individuals can effectively protect themselves from the painful rash and potential long-term nerve complications. For the most current recommendations, it is always best to consult with a healthcare provider or check the latest guidelines from the CDC, who continually monitor vaccine efficacy and update guidance as needed.
