Live Zoster (Shingles) Vaccine, ZVL - what you need to know

What is shingles?

Shingles (also called herpes zoster, or just zoster) is a painful skin rash, often with blisters. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body and can cause shingles later in life.

You can't catch shingles from another person. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.

A shingles rash usually appears on one side of the face or body and heals within 2 to 4 weeks. Its main symptom is pain, which can be severe. Other symptoms can include fever, headache, chills, and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

For about 1 person in 5, severe pain can continue even long after the rash has cleared up. This long-lasting pain is called post-herpetic neuralgia (PHN).

Shingles is far more common in people 50 years of age and older than in younger people, and the risk increases with age. It is also more common in people whose immune system is weakened because of a disease such as cancer or by drugs such as steroids or chemotherapy.

At least 1 million people a year in the United States get shingles.

Shingles vaccine (live)

A live shingles vaccine was approved by FDA in 2006. In a clinical trial, the vaccine reduced the risk of shingles by about 50% in people 60 and older. It can reduce the likelihood of PHN, and reduce pain in some people who still get shingles after being vaccinated.

The recommended schedule for live shingles vaccine is a single dose for adults 60 years of age and older.

Some people should not get this vaccine

Tell your vaccine provider if you:

Have any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of live shingles vaccine, or has a severe allergy to any component of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components.

Are pregnant, or think you might be pregnant. Pregnant women should wait to get live shingles vaccine until they are no longer pregnant. Women should avoid getting pregnant for at least 1 month after getting shingles vaccine.

Have a weakened immune system due to disease (such as cancer or AIDS) or medical treatments (such as radiation, immunotherapy, high-dose steroids, or chemotherapy).

Are not feeling well. If you have a mild illness, such as a cold, you can probably get the vaccine today. If you are moderately or severely ill, you should probably wait until you recover. Your doctor can advise you.

Risks of a vaccine reaction

With any medicine, including vaccines, there is a chance of reactions.

After live shingles vaccination, a person might experience:

• Redness, soreness, swelling, or itching at the site of the injection
• Headache

These events are usually mild and go away on their own.

Rarely, live shingles vaccine can cause rash or shingles.

Other things that could happen after this vaccine:

• People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
• Some people get shoulder pain that can be more severe and longer-lasting than routine soreness that can follow injections. This happens very rarely.
• Any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

The safety of vaccines is always being monitored.  For more information, visit: www.cdc.gov/vaccinesafety.

What if there is a serious problem?

What should I look for?

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior.

Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would usually start a few minutes to a few hours after the vaccination.

What should I do?

If you think it is a severe allergic reaction or other emergency that can't wait, call 9-1-1 or get to the nearest hospital. Otherwise, call your health care provider.

Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor should file this report, or you can do it yourself through the VAERS website, or by calling 1-800-822-7967.

VAERS does not give medical advice.

How can I learn more?

• Ask your health care provider. He or she can give you the vaccine package insert or suggest other sources of information.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC) by calling 1-800-232-4636 (1-800-CDC-INFO) or visit the CDC's vaccines website.

Centers for Disease Control and Prevention website. Live zoster (shingles) vaccine, ZVL. www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles.html. Updated February 12, 2018. Accessed February 13, 2018.

Updated by: David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 10/30/2018.