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Shingles & Chickenpox: What's the Link?

When to Get Vaccinated

The FDA approved the vaccine as a one-time dose for people 50 and over.  As noted, the rate of shingles increases with age. Medicare part D covers the shingles vaccine, but your contribution to the cost may vary. Private insurance plans or Medicaid may not cover payment for the vaccine. You will need to check with your insurance company about coverage.

What if you have never had chickenpox or have already had a case of shingles? You should still get vaccinated because studies show that nearly all adults 40 years and older have had chickenpox whether they remember having it or not. Also, if you’ve already had shingles, the vaccine can help protect against recurrence.

The vaccine is not safe for all people. People who should NOT get the vaccine include:

  • People who have ever had a life-threatening reaction to or are severely allergic to gelatin, neomycin, or any component of the shingles vaccine.
  • People with a weakened immune system from certain medical conditions or treatments.
  • Pregnant women or those who may be pregnant

The most common side effects reported with getting the vaccine include redness, soreness, swelling or itching at the injection site, and headache. Some people may develop a rash at the injection site that looks like chickenpox.

An Increase in Shingles: What’s the Cause?

As we age, we become more susceptible to shingles, and people who are immune-suppressed, such as people with cancer or HIV, are also at higher risk of the disease. But other hypothesized triggers, such as stress or sunburn, remain unproven, says Stephanie R. Bialek, MD, MPH, leader of the herpes virus unit at the CDC’s Division of Viral Diseases.

A study by the CDC and other scientists confirmed that since 1993, the incidence of shingles has nearly doubled in the adult U.S. population. One explanation for the increase has to do with the universal vaccination of children against chickenpox. According to this theory, because most children no longer get chickenpox disease (which used to be a ritual of childhood), their parents no longer get the immunological “boost” that comes from being exposed to the virus while caring for sick children.

“The best explanation for the increase is that we used to get a subclinical boost when we were exposed to the chickenpox virus as adults,” said William Schaffner, MD, a pediatrician and vaccine expert at Vanderbilt University. “Because of widespread immunization, that’s not happening.”

But there are some reasons to doubt that childhood chickenpox shots are responsible for the uptick in shingles. In their study, Bialek and colleagues found that shingles was on the rise even before the chickenpox vaccine was licensed for children in 1995. Also, adults in states with mandatory chickenpox immunization didn’t have higher rates of shingles than those in states where children weren’t as well-vaccinated, and therefore more likely to get sick and provide immune boosters to parents and grandparents.

It’s possible that as the U.S. population is getting older, more people are seeing their doctors for shingles. “There are probably different factors involved in the increase,” says Bialek. And it may take decades to sort it out. But regardless of whether shots against chickenpox increased the risk of shingles, the shot against shingles is the best way to avoid it.

Reviewed on March 15, 2011

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