Reduce Your Risk of Shingles Complications With the Vaccine

If you're one of the majority of older adults who have had chickenpox, you're going to want to learn about shingles. Also known as herpes zoster, this is a viral infection known for its painful rash among other symptoms. While the rash usually heals within a few weeks, long-term shingles complications can arise, causing lasting effects in some cases.

Shingles is caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. After a person has had chickenpox, the virus can remain dormant in their body for years and re-emerge later as shingles. The most common symptom of shingles is a painful rash that usually forms over a few days on one side of the face or body. Before the rash appears, people often experience other symptoms such as headache, sensitivity to light and general discomfort. The rash consists of clusters of fluid-filled blisters that can break open and crust over.

Shingles can affect anyone, but certain factors increase the risk of complications. About 1% to 4% of people with herpes zoster require hospitalization due to shingles complications. However, older adults (aged 65 years and older) and those with weakened immune systems are more likely to be hospitalized for complications. Thankfully, through prevention measures and early medical intervention, you can help protect yourself from shingles and its potential long-lasting complications.

Prevention and Treatment

Getting the shingles vaccine* (Shingrix) is the best way to reduce your risk of developing shingles and subsequent shingles complications. Shingrix is a two-dose series, separated by two to six months, that is routinely recommended for most adults aged 50 years and older. Adults 19 years and older who have or will have weakened immune systems due to disease or therapy should also get two doses of the vaccine.

According to the Centers for Disease Control and Prevention (CDC), you can get the Shingrix vaccine even if you have had shingles in the past or previously received the older shingles vaccine called Zostavax. It's also safe to get the shingles vaccine if you've received the chickenpox (varicella) vaccine. Talk to your pharmacist or other healthcare providers to determine if vaccination is right for you.

If you do develop shingles, it's important to wrap or cover the shingles rash to prevent the spread of the VZV to others. People who have not had chickenpox or the chickenpox vaccine can get infected with VZV from someone with shingles. This can happen through contact with the fluid from the shingles rash or breathing in virus particles that come from the blisters. Those who become infected will get chickenpox, not shingles — but they could develop shingles later in life. Note that shingles cannot spread before blisters appear or after they scab over.

In addition to covering the rash, here are additional measures to prevent the spread:

• Avoid touching or scratching the rash.
• Wash your hands often, for at least 20 seconds.
• Avoid contact with the following people until the rash scabs over:
  • Pregnant people who never had chickenpox or chickenpox vaccine.
  • Premature or low birth weight infants.
  • People with weakened immune systems.

Treatment for shingles consists of antiviral drugs, available by prescription only, as well as other medications to help manage the symptoms. When started soon after shingles symptoms appear, antiviral medications can help shorten the duration of the illness and reduce the risk of shingles complications. Antiviral medications prescribed to treat shingles include acyclovir, famciclovir and valacyclovir.

As noted, shingles can lead to various complications down the road, including persistent nerve pain, vision problems, neurological issues, disseminated infection and secondary bacterial infections. These complications can affect individuals of any age.

Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is the most common complication that can arise from shingles. It causes ongoing nerve pain even after the rash is gone. This pain can be intense and feel like burning or an electric shock. PHN is caused by inflammation produced by the body in response to the VZV replicating in the nerve. This inflammation damages the nerve, resulting in pain.

PHN can last for weeks, months or even years and can greatly degrade a person's quality of life. PHN symptoms make it difficult to eat, sleep and do everyday tasks.

According to the CDC, approximately 10% to 18% of people develop PHN following shingles, a risk that increases as you get older. It's rare for people younger than 40 to get PHN. Older adults not only have a higher chance of getting PHN, but they also have more intense and longer-lasting pain than younger people with shingles.

Other factors that raise the risk of developing PHN include the presence of a severe shingles rash, severe shingles-related pain, eye involvement, a weakened immune system and chronic conditions such as diabetes or lupus.

Ophthalmic Shingles

When the disease affects the eye area and related nerves, it's called ophthalmic shingles or herpes zoster ophthalmicus. This can lead to eye infections, vision problems and even blindness if not treated.

Vision loss, especially if long term, can dramatically impact your life and ability to work and perform your usual activities. If you think shingles could be affecting your eyes or vision, it's important to get medical help right away to help prevent serious problems and protect your vision.

Disseminated Shingles

Disseminated shingles, also known as disseminated zoster, occurs when the shingles rash spreads to other parts of your body. The symptoms may appear similar to chickenpox. However, disseminated shingles can lead to serious consequences that require urgent medical attention, including widespread infection and organ damage.

People with weakened immune systems, such as individuals with HIV/AIDS or those receiving cancer treatment, are at a higher risk for complications from shingles, including disseminated shingles. It is important to notify your healthcare provider promptly if you suspect your rash is spreading, especially if you have a medical condition or are taking medication that weakens the immune system.

Neurological Complications

Although very rare, shingles can cause inflammation in the brain, known as encephalitis. It can also cause inflammation in the spinal cord, called myelitis. This inflammation can lead to lasting neurological problems like headaches, seizures and paralysis.

These complications require urgent medical intervention and may have long-term consequences. Immediately notify your healthcare provider if you have any of these symptoms.

Secondary Bacterial Infections

Shingles is caused by a virus, but it can also lead to secondary bacterial infections. The shingles rash is often itchy, and people may have the urge to scratch. However, scratching the rash may create openings in the skin, which can let in bacteria such as Staphylococcus aureus and group A beta-hemolytic streptococcus. These bacterial infections may require treatment with prescription antibiotics to help prevent further complications.

An Effective Way To Reduce Shingles and Its Complications

Getting the shingles vaccine is the most effective strategy for reducing your risk of developing shingles and shingles complications. Talk to your pharmacist or primary care physician to determine if you can receive Shingrix.

Given the severity of potential complications, it is important to seek medical attention right away if you suspect you have shingles. Prompt medical treatment with antiviral medications can help prevent complications and improve outcomes.

Work with your primary care provider or Rite Aid pharmacist to determine if you are up to date on all your recommended vaccines. And remember: Even if you have a busy schedule, it's important to take the time to prioritize your health. Some vaccines can be safely given at the same time for convenience. Schedule online or stop by your local Rite Aid today.

Clinically reviewed on Oct. 9, 2024.

Sources:

• CDC. About Shingles (Herpes Zoster). Shingles (Herpes Zoster). Published May 10, 2024. https://www.cdc.gov/shingles/about/?CDC_AAref_Val=https://www.cdc.gov/shingles/about/transmission.html
• CDC. Shingles Symptoms and Complications. Shingles (Herpes Zoster). Published May 14, 2024. https://www.cdc.gov/shingles/signs-symptoms/?CDC_AAref_Val=https://www.cdc.gov/shingles/about/complications.html
• CDC. Clinical Overview of Shingles (Herpes Zoster). Shingles (Herpes Zoster). Published May 10, 2024. https://www.cdc.gov/shingles/hcp/clinical-overview/index.html
• Saguil A, Kane S, Mercado M, Lauters R. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. American Family Physician. 2017;96(10):656-663. https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html
• CDC. Shingles Vaccination. Shingles (Herpes Zoster). Published 2024. https://www.cdc.gov/shingles/vaccines/?CDC_AAref_Val=https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html