Shingles vaccination in older adults: is it effective and safe?

Sarah Chapman revisits this blog to look at the latest Cochrane evidence, from November 2019, on the safety and effectiveness of the shingles vaccination for older adults.

Page last updated 12 November 2019 and last checked 21 April 2023

Herpes zoster or ‘shingles’ is a painful condition caused by the reactivation of varicella zoster virus (VZV), the virus that causes chicken pox. Older adults are particularly susceptible to shingles, which can last for weeks or months and have a significant impact on quality of life.

NHS shingles vaccination programme

Here in the UK, the NHS offers vaccination against shingles to people in their 70s, whether or not they have had shingles before. The NHS uses the attenuated live zoster vaccine (LZV). It is given as a single injection into the arm and, unlike the flu jab, it is given once only and at any time of year. There is also a newer vaccine against shingles, the recombinant zoster vaccine (RZV), which is given in two doses, two to six months apart. Both LZV and RZV have been approved for clinical use.

The latest evidence on shingles vaccination

A Cochrane Review looking at the effectiveness and safety of vaccination to prevent herpes zoster in older adults was updated in November 2019. The review now includes 24 studies with 88,531 people, most aged sixty and over. The studies only included people who had no illnesses which compromise the immune system. The two shingles vaccines tested were LZV and RZV.

What does the research show?

There is evidence from one large study with 38,546 people comparing LZV with placebo (a fake vaccine without the active ingredient) and from two studies with almost 30,000 people comparing RZV with placebo. People in the studies were followed up for around three years.

For both LZV and RZV, there is moderate-certainty evidence that:

  • older adults vaccinated with LZV or RZV are probably less likely to get shingles than those vaccinated with placebo, for up to three years (and possibly longer, though this is uncertain).
  • there are probably more adverse effects (such as soreness at the injection site or headache) associated with vaccination with LZV and RZV than with placebo, but that these are mostly mild to moderate and short-lived, lasting for one to three days
  • people vaccinated with LZV or RZV are probably no more or less likely to experience serious adverse events than those who have a placebo vaccination

There is more information about shingles and the shingles vaccination on this NHS website.

Gagliardi  AMZ, Andriolo  BNG, Torloni  MR, Soares  BGO, de Oliveira Gomes  J, Andriolo  RB, Canteiro Cruz  E. Vaccines for preventing herpes zoster in older adults. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No.: CD008858. DOI: 10.1002/14651858.CD008858.pub4.

Sarah Chapman has nothing to disclose.


Shingles vaccination in older adults: is it effective and safe? by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

2 Comments on this post

  1. I had shingles about 3 years ago. It went over my left eye and also on the whole of the top half of my body. It also crossed the “centre line” which I believe it does not usually do. I did not seek treatment immediately but when I did, I was fortunate to stop any more damage to the eye area. I also received the shingles vaccination when it was safe to do so. Strangely enough, I do not remember having chicken pox as a child. I still suffer from unbelievable itching over my forehead and scalp. I take Gabapentin which eases the symptoms but does not stop it. Nothing the doctor has tried helps. Two years later I developed Balls Palsy on the opposite side which also had some lasting facial paralysis.

    cassander kendrick / Reply
    • Hi, I have removed your reference to a website selling herbal treatment as we don’t allow commercial links.
      Best wishes,
      Sarah Chapman [Editor]

      Sarah Chapman / (in reply to cassander kendrick) Reply

Leave a Reply

Your email address will not be published. Required fields are marked *