Shingles Vaccination Leaflet
Pain Concern have created a selection of key resources about shingles, which you can find all in one place on our Shingles, Post-herpetic Neuralgia and Chronic Pain Resources page.
Shingles, or herpes zoster, is caused by the varicella zoster virus which causes chickenpox. After you have had chickenpox, the virus stays inactive in your nerve cells. Shingles begins when the virus becomes active again and spreads down the nerve to the skin. You may feel a tingling, stabbing or burning sensation before the shingles rash appears.
The shingles rash will be a patch or line of blisters within the area affected by an infected nerve. It will be on one side of the body only. It may be mild and heal in two to three weeks in healthy young adults. However, in people over the age of 50 and patients with weakened immune systems, it can take longer and complications are more likely to develop. The most common complication is post-herpetic neuralgia (PHN), which is described as pain in the nerve (neuropathic pain) and which continues at least three months after the shingles rash appears.
About half of us who live to the age of 85 will develop shingles, and cases are increasing.
You are more likely to suffer from post-herpetic neuralgia if you:
- are older (people over 50 are 15 times more likely to get post-herpetic neuralgia than those under 50);
- have other conditions, such as diabetes;
- are taking medications that weaken the immune system, such as steroids and other immunosuppressants;
- have an injury, which can reactivate the virus and cause a shingles rash at the site of the injury; or
- are suffering from stress.
Treating post-herpetic neuralgia is difficult. Although there are various treatments, most patients with severe post-herpetic neuralgia are never fully without symptoms.
The UK vaccination programme was introduced in 2013 for adults in their 70s. GPs can give a single-dose vaccination known as Zostavax (or ZVL) to anyone in this age group. In the first three years of the programme, cases of shingles fell by 35% and cases of post-herpetic neuralgia by 50%.
There is now a second vaccine called Shingrix, or ZSV, which is a two-dose vaccine and was approved for use in the NHS from 1 September 2021. This is given to people with immunity problems (such as people who have had cell transplants, those with HIV and those on immunosuppressants) who cannot have the Zostavax vaccine and who are at greater risk of developing shingles.
The arrival of the new shingles vaccine is welcome. It will prevent many cases of shingles and reduce the possibility of post-herpetic neuralgia in older adults.
If you have had chickenpox, we would strongly recommend you have a shingles vaccination. Side effects are generally limited to a mild reaction at the site of the injection (for example pain, redness, swelling and itching).
How to get vaccinated
Your GP or practice nurse will offer you the Zostavax vaccine when you’re eligible (between the ages of 70 and 79). It is not available on the NHS to anyone aged 80 and over. If Zostavax is not suitable for you, your GP will decide whether to offer you Shingrix instead.
If you have not been offered a shingles vaccination, contact your GP surgery to arrange an appointment.
You can have the shingles vaccination at any time of year and at the same time as most other vaccines. However, try to leave seven days between the shingles vaccine and a Covid-19 vaccine.
For more information, please visit nhs.uk/conditions/vaccinations/who-can-have-the-shingles-vaccine/
Mick Serpell is a Consultant in Anaesthesia and pain medicine for Greater Glasgow and Clyde NHS, and a Senior Lecturer at Glasgow University. He is Series Editor for Anaesthesia and Intensive Care Medicine, Associate Editor for Pain Management, sits on the Advisory Board for European Journal of Pain and reviews articles for several other pain-related journals. He is Examiner for the Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA).
Thanks go to the Shingles Support Society and healthcare professionals who advised us on the content of this leaflet and peer reviewed it. Shingles Support Society is a UK-based patient support group. If your pain is a result of shingles, you can see the treatment that doctors will use to treat post-herpetic neuralgia and also read self-help suggestions from other sufferers: shinglessupport.org.uk
Shingles vaccination leaflet © 2022 Mick Serpell. All rights reserved. First published July 2022.