No one who has experienced the burning, stabbing, painful misery of shingles wants to think about it again. But they should. Why? Because shingles can strike twice, or rarely, even a third time. A shingles vaccine can reduce the chances of a recurrence.
There’s some disagreement about how often recurrence occurs. In one study, researchers examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of these patients were treated for a second episode within an average of eight years. That’s about as likely as getting shingles in the first place if you’re age 60 or older. Other studies have shown the recurrence rate to be much lower.
But the bottom line is the same: having shingles once doesn’t protect you from ever having it again.
Virus can sleep, reactivate
Shingles is caused by the same virus — the varicella zoster virus — that causes chickenpox. Once you have had chickenpox, the virus that caused it remains alive inside your nerves. It is inactive, but it can be reactivated later in life. This causes shingles.
When the virus reactivates, the infected nerves, and the skin the nerves go to, become inflamed, causing a burning or stabbing pain. A few days later, when the virus reaches the skin, a rash of blisters appear along the affected nerve. The skin may be very sensitive, unable to tolerate even the lightest touch.
Up to 10% of adults who get shingles experience long-term pain, even after the rash has healed completely. This condition is called post-herpetic neuralgia. It may last for months, or even years. And it can be debilitating.
After causing shingles, the virus again goes “back to sleep” inside your nerves. But it can still flare up again.
Your chances of getting shingles increase as you get older. The U.S. Centers for Disease Control and Prevention (CDC) recommends that adults age 60 and older get the shingles vaccine. This is a one-time vaccine called Zostavax.
Zostavax isn’t guaranteed protection against shingles. But in the large clinical trial that led to its approval by the FDA, the vaccine cut the risk of getting shingles by 51% and the risk of postherpetic neuralgia by 67%.
The CDC recommends the shingles vaccine even for people who have already had shingles. There is no specific time that you must wait after having shingles before receiving the shingles vaccine. But it’s probably best to hold off until the shingles rash has disappeared before getting vaccinated. That’s because when you have an attack of shingles, your immune system is actively waging war against it. There is some evidence that the immune system responds more vigorously to the vaccine when it is “at rest.”