August 2026
If you had chickenpox as a child, the virus that caused it never fully leaves your body. Instead, it goes dormant in your nerve tissue. And for roughly one in three Americans, it can reactivate later in life as shingles.
Shingles often appears as a band of painful, itchy, tingly blisters on the torso. Sometimes it can affect the face and eye area too. The blisters are really uncomfortable and typically last for two to four weeks, but complications can last much longer.
An estimated one million people in the U.S. get shingles each year. And while you can develop shingles at any age, your chances rise sharply after age 50. And unlike chickenpox, you can get it more than once.
Here’s what to know about shingles complications — and the best way to prevent shingles.
What are the most common complications from shingles?
The most common complication is postherpetic neuralgia (PHN) — severe nerve pain where the shingles rash occurred. This can affect 10% to 18% of people with shingles. Other potential complications include vision loss if the eye is involved and, in rare cases, facial paralysis.
PHN can last for months or even years after the rash clears, and the pain can be debilitating enough to interfere with sleep and basic daily activities (like bathing and getting dressed). In fact, some people with PHN say the pain is so severe that the feeling of air or clothing moving over their skin can trigger pain.
How can you prevent shingles?
The best way to prevent shingles is vaccination.
The Shingrix vaccine is available to anyone 50+ — and those 19+ with a weakened immune system. To be fully vaccinated, you need two shots — typically two to six months apart.
- In adults 50 to 69 with healthy immune systems, Shingrix is 97% effective in preventing shingles and 91% effective in preventing PHN.
- In adults aged 70+ with healthy immune systems, Shingrix is 91% effective at preventing shingles and 89% effective at preventing PHN.
- In adults with weakened immune systems, Shingrix is 68% to 91% effective at preventing shingles, depending on the underlying condition.
Who should get the shingles vaccine?
The vaccine is recommended for everyone ages 50 or older — regardless of whether you’ve had the chickenpox or the chickenpox vaccine. Here’s why:
If you’ve had the chickenpox
You have the highest risk of developing shingles if you’ve actually had the chickenpox, because the virus is dormant in your body. You need the vaccine to prevent shingles.
If you’ve had the chickenpox vaccine
People who’ve had the chickenpox vaccine can still get shingles. This is true even if you’ve never had a known case of chickenpox and have tested negative for immunity to chickenpox before receiving the vaccine. This may seem surprising until you realize that the chickenpox vaccine contains a live attenuated (weakened) form of the virus that causes chickenpox. And this live attenuated virus can still be dormant in your body.
So, while your risk of developing shingles is much lower if you had the chickenpox vaccine rather than the actual virus, you’re still at risk for developing shingles and should get the Shingrix vaccine.
If you’ve never had the chickenpox or the chickenpox vaccine (or aren’t sure)
First, ask your doctor to confirm, via a blood test, whether you have immunity to chickenpox. Sometimes people get a mild case of chickenpox in their youth but don’t know they had it.
If you’re unvaccinated and have immunity to the chickenpox, this means you’ve had chickenpox in the past. You need a shingles vaccine.
If you’re unvaccinated and do not have immunity to the chickenpox, talk to your healthcare provider about getting the chickenpox vaccine.
Getting chickenpox as an adult can be serious, even life-threatening. Complications for chickenpox in adulthood include:
- Pneumonia
- Encephalitis (swelling of the brain)
- Sepsis
- Birth defects in babies (if the mother contracts chickenpox while pregnant)
The two-dose chickenpox vaccine series is about 90% effective at preventing chickenpox. Once you’ve received the chickenpox vaccine, you’re at risk of developing shingles, so ask your doctor when you should get the Shingrix vaccine.
What if I already had the Zostavax vaccine?
If you received a shingles vaccine in 2020 or earlier, you may have had the Zostavax vaccine instead of the Shingrix vaccine. Ask your healthcare provider which one you received.
If it was Zostavax, you should consider getting the Shingrix vaccine. Immunity from the older Zostavax vaccine wanes over time: The CDC reports that Zostavax efficacy declined to just 41% in people in their 70s and to only 18% for people 80+ within three years of receiving the vaccine. By contrast, the immunity from the Shingrix vaccine is more durable.
Is there anyone who shouldn’t get the Shingrix vaccine?
According to the CDC, the only people who shouldn’t get the Shingrix vaccine are those who have had a severe allergic reaction to the vaccine or any of its components.
You should wait to receive the vaccine if you:
- Have shingles.
- Have a moderate to severe illness.
- Are pregnant.
