Shingles is a fairly common, painful rash that adults may develop, but is it contagious?

While shingles itself cannot be spread from person to person, adults who have an infectious shingles rash may actually spread chickenpox to others. If someone has never had chickenpox and has not been vaccinated against it, they may contract the disease from an active shingles outbreak.

Shingles (herpes zoster) is caused by the same virus that typically gives us chickenpox (varicella) when we are children. Both illnesses come from the varicella-zoster virus, which can infect us as chickenpox and then lies dormant in our nerve tissue. Sometimes, the virus reawakens in adults and moves back toward the skin. When this happens, a painful rash may form.

About 1 in 3 adults will develop shingles at some point in their lifetime, according to the Centers for Disease Control and Prevention. Roughly 1 million people will have a shingles outbreak per year in the United States. Shingles is characterized by a painful rash of blister-like sores, preceded by pain, itching or tingling in the skin. It may also be accompanied by symptoms like fever, chills, headache and upset stomach. The rash may develop on just one side of the body, near the torso or on the face. It often appears as a continuous stripe.

The pain from the rash can be moderate to intense depending on how sensitive the skin becomes. Long-term nerve pain may also develop, which is referred to medically as postherpetic neuralgia. This occurs in about 10%-18% of people who develop shingles, and the risk increases with age.

Is there anything we can do to prevent shingles?

The CDC’s Advisory Committee on Immunization Practices now recommends all healthy adults 50 years and older be vaccinated against shingles with Shingrix. Shingrix vaccination is a two-dose series separated by two to six months, administered intramuscularly in the upper arm. It provides strong protection against both shingles and postherpetic neuralgia, the painful complication described above. Studies have shown that Shingrix reduced the incidence of shingles by greater than 90% in all age groups.

Zostavax was previously the only shingles vaccination on the market but is no longer available as of Nov. 18, 2020. Anyone previously vaccinated with Zostavax should be revaccinated with Shingrix. You should also be vaccinated even if you have had shingles or chickenpox in the past to help prevent future occurrence of shingles.

Shingrix is not a live vaccine so fewer contraindications exist when compared to Zostavax. Shingrix is a recombinant vaccine that works by targeting a key component of the virus to produce a very strong immune response against shingles. Patients who are immunocompromised or receiving immunosuppressive therapy can be vaccinated for shingles prevention with Shingrix. Another advantage of the Shingrix vaccine is that unlike the Zostavax vaccine, it can be stored in the refrigerator before reconstitution.

Shingrix side effects include muscle pain (myalgia), fatigue, headache, shivering, fever and gastrointestinal symptoms in addition to soreness, pain or reactions to the local injection site where the shot is administered. The vaccine is not designed to prevent primary chickenpox (varicella) infection. Those who are allergic to the vaccine or any of its components should not receive Shingrix, as well as people who are pregnant, breastfeeding or currently have shingles.

If your blood test shows that you are negative for immunity to varicella-zoster virus (the virus that causes chickenpox), you should receive the chickenpox vaccine, not Shingrix.

Shingles vaccination is the only way to protect against shingles and complications like postherpetic neuralgia, the painful condition caused by shingles infection that affects the nerve fibers and skin. Anyone in need of a shingles vaccination should consult your local pharmacy or speak with your healthcare provider.