Shingles is one of the more common and painful conditions of later life, yet it is also among the most preventable, thanks to a vaccine that public health authorities say offers strong and durable protection. Physicians warn that older adults who forgo the two-dose shot are gambling with a burning, blistering rash and a risk of long-lasting nerve pain that can outlast the infection by months or even years.
What shingles actually is
Shingles, known medically as herpes zoster, is caused by the same virus responsible for chickenpox, varicella-zoster. After a childhood bout of chickenpox, the virus does not leave the body; it retreats into nerve tissue and lies dormant, sometimes for decades. Later in life it can reactivate, traveling back along a nerve to the skin and erupting as a painful rash, usually a band of blisters on one side of the torso or face.
Because nearly everyone who lived through chickenpox carries the dormant virus, the population at risk is enormous. Health officials estimate that about one in three people in the United States will develop shingles at some point, with the odds climbing steadily as the immune system weakens with age.
Why the pain can linger
The rash itself typically clears within a few weeks, but the most feared consequence is a complication called postherpetic neuralgia, in which damaged nerves keep sending pain signals long after the blisters heal. According to the Centers for Disease Control and Prevention, this lingering nerve pain is the most common complication of shingles and can persist for months or years, described by sufferers as burning, stabbing or an unbearable sensitivity to the lightest touch.
Postherpetic neuralgia grows more likely and more severe with age, which is exactly why the vaccine’s value rises for older adults. A younger person may shrug off a case of shingles; a person in their seventies faces a far greater chance that the aftermath will linger and disrupt daily life. Less commonly, shingles affecting the eye can threaten vision, and other rare complications can involve hearing or the nervous system.
How well the vaccine works
The vaccine now used in the United States is a recombinant formulation given as two doses spaced two to six months apart. Its effectiveness is unusually high for a vaccine aimed at older adults. Guidance from the CDC’s shingles vaccination program reports that it was about 97 percent effective at preventing shingles in adults aged 50 to 69 with healthy immune systems, and roughly 91 percent effective in those 70 and older, with strong protection against the painful nerve complication as well.
Protection also appears to hold up well over time, remaining high for years after vaccination in the populations studied. That durability matters because the risk of shingles does not fade with age; it grows, so a vaccine that keeps working into a person’s later decades addresses the threat precisely when it peaks.
Who the recommendation covers
Federal advisers recommend the two-dose series for healthy adults beginning at age 50, which means anyone past 60 who has skipped it falls squarely within the group meant to be protected. The recommendation applies even to people who received an older shingles vaccine years ago and even to those who have already had a bout of shingles, since a prior case does not prevent future ones. There is no maximum age cutoff.
The vaccine is also recommended for certain younger adults, those 19 and older whose immune systems are weakened by disease or medical treatment, because they face an elevated risk of severe shingles. For most people, the main deterrents are temporary: the shot can cause a sore arm, fatigue, muscle aches or a low fever for a day or two, side effects that clinicians describe as a modest trade for avoiding weeks of rash and the possibility of chronic pain.
Why doctors press the point
The frustration voiced by physicians is that shingles is both common and, in large part, avoidable, yet many eligible older adults never complete the series. Some are unaware they qualify, some received an earlier, less effective vaccine and assume they are covered, and some are deterred by the temporary side effects of the second dose. The result is a preventable burden of suffering.
Cost and access have historically been additional hurdles, though the vaccine is covered without cost sharing under many insurance plans and Medicare’s prescription drug benefit for those who qualify, removing one of the practical reasons people delay. Pharmacists in most states can administer the series directly, meaning a person does not necessarily need a separate physician visit to complete both doses.
The message from health authorities is straightforward: the dormant virus is already present in most older adults, its reactivation becomes more likely and more punishing with each passing decade, and a highly effective vaccine exists to blunt that risk. Leaving the shot undone, doctors caution, is leaving real and lasting harm on the table.
This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.
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