Shingles and Chickenpox: How They Relate and What to Know

Medically Reviewed By Raechele Cochran Gathers, MD
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Shingles and chickenpox are viral infections that can cause a skin rash and irritation. They are both the result of infection with the varicella-zoster virus. However, chickenpox and shingles are clinically different due to how each infection occurs and presents. Chickenpox is an illness caused by infection with the varicella-zoster virus. Once a person has contracted the virus and recovered, the virus stays dormant in their body. The virus can later reactivate and cause shingles.

Chickenpox typically occurs in children. It can spread over the entire body.

On the other hand, shingles typically develops in older adults, but it can occur at any age after a person has experienced chickenpox. It usually appears as a rash on one side of the body.

This article explores the relationship between shingles and chickenpox.

Can you get shingles if you have never had chickenpox?

Elderly woman sits and touches hand to the side of her face with concerned expression.
Melika Tursic/Stocksy United

You cannot get shingles if you have never had chickenpox. You can only develop shingles after you have had the original illness.

However, not everyone who has previously had chickenpox will develop shingles.

Shingles tends to occur in people who have weakened immune systems or certain risk factors.

The relationship between shingles and chickenpox

Shingles and chickenpox are two separate infections. However, they do have a linked relationship. 

The same virus, varicella-zoster, causes both shingles and chickenpox. This is because after contracting and recovering from chickenpox, your body does not eliminate the virus. Instead, it lies inactive in the nerves of the body.

After some time, this virus may reactivate within the nervous system. This causes shingles. Certain triggers may cause the virus to become active again and result in shingles.

Learn more about chickenpox here.

Differences

In addition to the differences in how chickenpox and shingles develop from the virus, the two infections also present several other clinical differences, some of which are explained in the table below.

Chickenpox Shingles 
Age and frequencyChickenpox is a common childhood illness, though adults can get it severely. Shingles commonly develops in adults, particularly in those ages 50 years and over.
DurationIt usually lasts about 5–7 days.It can take 3–5 weeks or more to heal.
Transmission

Chickenpox is very contagious.

A person with the infection can easily pass it on to another person via direct contact or through the air.

You cannot give shingles to another person.

However, you can still give the virus to someone, and they can develop chickenpox if they are not immune.

Symptoms

Early symptoms may include a sudden fever, headaches, or tiredness.

A chickenpox rash may first appear as small, red dots, often starting on the head, torso, and limbs before spreading all over the body. Blisters may form and scab over.

Early symptoms often include sensations of itchiness, pain, or tingling on the skin.

The rash may begin as a band or patch of raised dots on one side of the torso, face, or another body area.

How do you get shingles? 

After contracting the varicella-zoster virus as chickenpox, the virus remains dormant in the nerves.

Clinicians do not yet know exactly what causes shingles to reactivate, but some believe that reactivation occurs when the immune system is not able to control the latent replication of the virus.

If the immune system is weak, it may not be able to perform its function of destroying viral cells that replicate before they become numerous enough to cause ill health.

Once the virus has reactivated, it will replicate in the cell bodies of neurons and shed viral particles that will travel down to the nerve area of the skin, causing a rash and other symptoms of shingles infection.

Can you get shingles more than once?

Multiple shingles episodes can happen.

However, according to the Centers for Disease Control and Prevention (CDC), the majority of people who get shingles get it only once in their lifetime. 

Vaccination is available for shingles, and it can be effective. The vaccine can reduce your risk of infection and can prevent shingles in most people.

If you have never had chickenpox, you can also get a chickenpox vaccine.

To avoid infection, try to avoid direct contact with a person who has a blistering rash.

Learn more about shingles and its transmission here.

Risk factors for shingles

Risk factors for the development of shingles often relate to having lowered immunity. They can include:

  • physical and emotional stress
  • the use of certain medications, particularly immunosuppressants
  • HIV or AIDS
  • another acute or chronic illness
  • exposure to the virus
  • cancer
  • old age
  • a recent transplant, surgery, or treatment, such as chemotherapy

Shingles and contagious transmission 

Chickenpox is highly contagious. A person with the infection can easily pass it on to another person via direct contact or through the air.

If you have shingles, however, you cannot give it to another person. Instead, you can transmit the varicella-zoster virus to someone, and they can develop chickenpox if they are not immune to it.

When shingles develops into open blisters, the fluid inside the blisters contains the infectious virus.

Because of this, anyone who comes into direct contact with these blisters or inhales infected droplets can contract the virus if they are not immune to chickenpox. However, the rates of transmission are low.

Experts say that the virus cannot spread when the rash crusts. The risk of spreading also reduces when you cover the rash properly and wash your hands well.

Getting vaccinated against chickenpox and shingles 

Vaccination is available for the prevention of both chickenpox and shingles.

Most insurance plans cover the cost of both vaccines. Medicare Part D and Medicaid may pay for at least part of the cost of shingles vaccination.

If you do not have health insurance or cannot afford vaccination, check for vaccine assistance programs directly with the shingles vaccine manufacturer, GlaxoSmithKline. For chickenpox, contact the Vaccines for Children program to see if you are eligible for help.

Chickenpox vaccination

The CDC indicates that the chickenpox vaccine, available as Varivax or ProQuad, offers a good amount of protection against chickenpox. Two doses are more than 90% effective in preventing the illness.

The CDC particularly recommends chickenpox vaccination for infants older than 12 months old, older children, and adults who are unvaccinated or have never had chickenpox.

The vaccine may cause a few mild, temporary side effects.

The CDC notes that pregnant people and those who have allergies to the vaccine or any of its ingredients should not get this vaccine. Additionally, people who are ill when the vaccine is scheduled should normally wait until they recover to receive it.

People should also check with their doctor before getting a chickenpox vaccine if they:

  • have HIV or another disease that affects the immune system
  • take any kind of immunosuppressant medication
  • have any kind of cancer or receive cancer treatment
  • have recently had a blood transfusion

Shingles vaccination

The shingles vaccine can boost your immunity to shingles and prevent postherpetic neuralgia (PHN), which is a complication of shingles. 

The vaccine, known as Shingrix, is recommended even if you have had shingles before, have previously received vaccination with a vaccine called Zostavax, or have been vaccinated against chickenpox.

The CDC also recommends that adults ages 50 years or older get two doses of Shingrix. Adults older than 19 years of age who have weakened immune systems should do the same.

The CDC reports that the vaccine can provide up to 7 years of strong immunity in most people.

You may experience mild, temporary side effects after vaccination.  

The vaccine is not suitable for:

  • pregnant people 
  • people who have had a severe allergic reaction to any component of the vaccine 
  • those who currently have shingles

Can you get shingles even if you have had the vaccine?

The shingles vaccine can considerably lower your risk of infection, but it remains possible for you to develop shingles.

The CDC states that Shingrix provides up to 90% immunity to shingles in most people over 50 years of age.

When a vaccinated person does get shingles, they typically experience milder symptoms, a shorter duration of illness, and a reduced risk of experiencing complications such as PHN.

Contact your doctor and insurance provider about vaccination.

What happens if you receive the shingles vaccine without having had chickenpox?

It is important to receive the shingles and chickenpox vaccines at the appropriate times.

If you have had chickenpox before, consider getting the shingles vaccine.

Conversely, if you have never had chickenpox, consider getting the chickenpox vaccine.

It may also be worth discussing shingles vaccination with your doctor even if you have never knowingly had chickenpox. This is because many people have chickenpox without knowing it, as they may have been very young, may not have any medical records of the illness, or may have had the illness without displaying any typical symptoms of chickenpox, such as a rash.

In fact, the CDC states that it is OK for most healthy adults to get the shingles vaccine whether or not they remember having had chickenpox before.

Summary

Shingles and chickenpox are both viral infections that cause a skin rash. They are both the result of infection with the same virus. This is called the varicella-zoster virus.

However,

chickenpox and shingles are clinically distinct illnesses due to the different ways in which they develop.

Chickenpox occurs when someone contracts varicella-zoster. Varicella-zoster does not leave the body and instead lies dormant in the body. Later, including up to decades afterward, the virus may reactivate, causing the person to develop shingles. This often happens during periods of weakened immunity.

You cannot get shingles if you have never had chickenpox. However, if you come into contact with someone with shingles, you may instead contract chickenpox.

Contact a doctor promptly for any symptoms of chickenpox or shingles or to discuss vaccination against both illnesses.

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Medical Reviewer: Raechele Cochran Gathers, MD
Last Review Date: 2022 Apr 27
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