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Your Guide to Preventing and Managing Shingles

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The Reality of Shingles: What Immunocompromised Adults Need to Know

Medically Reviewed By William C. Lloyd III, MD, FACS
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Immunocompromised adults are at higher risk of shingles and its complications. If you have a weakened immune system, getting the shingles vaccine can prevent you from getting shingles and its complications.

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Shingles is an infection that causes a painful, blistery skin rash. The same varicella-zoster virus that’s responsible for chickenpox also causes shingles. After you have chickenpox, the virus lies dormant in your body for many years. It can re-emerge as shingles when you get older, because your immune system weakens with age. It can also re-emerge in people who have a compromised immune system that isn’t strong enough to fight it off. About 1 in 3 Americans will get shingles in their lifetime.

The virus can lead to serious complications like nerve pain and vision loss. The best way to prevent an infection is by getting the shingles vaccine, called Shingrix.

Who should get the shingles vaccine?

The shingles vaccine has been approved for anyone age 50 or older since 2017. In July 2021, the Food and Drug Administration (FDA) expanded the approval to include immunocompromised adults.

Then, in October 2021, the Centers for Disease Control and Prevention (CDC) announced their Advisory Committee on Immunization Practices (ACIP) voted to recommend the shingles vaccine for people ages 19 and older who are immunocompromised because they:

  • had a stem cell transplant
  • have cancer
  • had a kidney transplant or other organ transplant
  • have HIV
  • have a compromised immune system because of a medical condition or a medication they take

Usually, the two vaccine doses are spaced 2 to 6 months apart. However, anyone with a compromised immune system can get the second dose 1 to 2 months after the first dose.

What are the risks of shingles?

The main symptom of shingles is a painful rash, often on one side of the body. It can appear on your torso, or on one side of your neck or face. Fluid-filled blisters may form on the rash. Eventually, those blisters break open and crust over.

While the pain alone is reason enough to be concerned about shingles, the main worry is that it can lead to more serious complications. The most common complication is a type of nerve pain called postherpetic neuralgia (PHN). PHN develops when shingles damages the nerves and causes them to keep firing. The pain continues long after the rash clears up. It can be intense enough to disrupt your daily life.

A shingles rash around the eye can also cause serious eye infections that may lead to permanent vision loss. Hearing loss, balance problems, and paralysis of the face are other possible complications. Immunocompromised adults are at higher risk of developing shingles, and they’re at higher risk of developing shingles complications. If you have a weakened immune system, getting the shingles vaccine can prevent you from getting shingles and its complications.

How effective is the shingles vaccine?

The shingles vaccine is the only way to protect yourself against shingles. It also protects against shingles complications like PHN. It is 90% effective against both shingles and PHN. To get the full benefit from the vaccine, you need to get two doses.

Studies indicate that the shingles vaccine is safe for people with a compromised immune system. Vaccine side effects are usually mild, such as:

  • pain, redness, and swelling at the injection site
  • tiredness
  • muscle aches
  • headache

Usually, these side effects will go away within a few days after you get the shot.

If you’re wondering if you need the shingles vaccine, talk to your doctor. The vaccine is recommended for anyone age 50 or older and for those with a compromised immune system. Getting it could protect you against a painful case of shingles and spare you long-term complications.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Feb 25
View All Your Guide to Preventing and Managing Shingles Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Frequently asked questions about Shingrix. (2021). https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/faqs.html
  2. López-Fauqued, M., et al. (2021). Safety profile of the adjuvanted recombinant zoster vaccine in immunocompromised populations: An overview of six trials. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217041/
  3. Shingles (Herpes zoster). (n.d.). https://www.cdc.gov/shingles/index.html
  4. Zoster vaccines session: Introduction. (2021). https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-09-29/01-ZosterVaccines-Kotton-508.pdf