In 2023, Lisa Junker left a holiday party early with an intense earache. She was diagnosed with swimmer's ear and sent home with antibiotic drops. But when she awoke days later with disabling vertigo — vomiting every time she tried to stand — she knew something else was wrong.
"The ENT [ear, nose, and throat doctor] came in and took one look and said, 'This is shingles. Every medication you're taking is not correct,'" says Junker, now 52, a medical journal editor in Centerville, Virginia.
She began antivirals and nerve pain medication, but the virus had already done damage: She lost hearing in one ear and could no longer safely walk without help.
More Than Just a Rash
If you’ve had chickenpox, you can get shingles. The virus that causes chickenpox — varicella-zoster virus — never really leaves your body. Instead, it hides away in the nerve tissue and years or even decades later, it can wake back up in the form of a shingles infection, causing a painful rash that often shows up as a cluster of blisters, just on one side of your body. In rare cases like Junker’s, shingles can cause more serious and lasting complications.
About 1 in 3 people will get shingles at some point in their life, but getting vaccinated is the best way to protect yourself. The CDC recommends the Shingrix vaccine for everyone over the age of 50 — even if you've already had shingles — and for adults 19 and older who have weakened immune systems. Among healthy adults between the age of 50 and 69, it’s about 97% effective at preventing the virus.
“I certainly understand why people just ask extra questions about vaccines these days because there's so much that's changed in the past six years or so, but this one isn’t a new vaccine,” says Sara Moghaddam, MD, a board-certified dermatologist and Mohs surgeon based in Delaware. “It’s been around for a long time and studied very thoroughly.”
Junker was just months away from her 50th birthday when she planned to get the vaccine at her checkup. Her experience highlights just how devastating an unvaccinated shingles episode can be. But research now shows that getting the vaccine — either before or after a shingles episode — has advantages beyond preventing that worst-case scenario. It can also lower your chances of having complications like postherpetic neuralgia, a type of nerve pain that can linger for months after the rash has cleared up.
There may be other benefits, too. Some research shows that by helping the body keep the dormant virus in check, the shingles vaccine may also lower inflammation, which has been linked to age-related conditions like heart disease and cognitive decline. One study, published in the European Heart Journal, found that people who got the shingles vaccination were 26% less likely to die from heart disease or experience a stroke, heart attack, or heart failure. There’s also early evidence that suggests vaccination could help prevent or delay dementia.
The shingles vaccine "is the one I recommend the strongest to my patients who are adults over 50," says Harvard Medical School professor Paul E. Sax, MD. "People may not understand how debilitating a case of shingles can be." On the extreme end, it can lead to blindness, brain swelling, and nerve damage that can turn an otherwise healthy person into a chronic pain patient, he says.
One of the most common spots for a shingles outbreak is on the face, says Moghaddam. That can also include the eye, causing scarring and leading to permanent vision changes. “Sparing yourself of the discomfort and misery that can accompany shingles is definitely worth it,” she says. “I encourage everyone who is eligible to get vaccinated.”
Staying Protected: Doses, Side Effects, and Tips
Junker got the shingles vaccine after her infection.
Around age 50, "your immune system starts to weaken. That's just the normal process of aging, and it makes you more susceptible to getting shingles," says Ankush Bansal, MD, an internal medicine hospitalist in Miami.
Anything that stresses or weakens the immune system can also raise your chances of getting shingles. That can include chronic conditions, a major illness or injury, or a period of severe emotional stress.
"For stress, it doesn't mean, 'I'm stressed because I'm late for work.' This is chronic stress — people close to you have died, you've been really sick, lost your job, or you have a substance use dependency," Bansal says. Conditions like type 2 diabetes also raise your risk. These factors apply to younger adults, too. Even though people under 50 are less likely to get shingles, cases among this age group are becoming more common.
The CDC has recommended the Shingrix vaccine to help prevent shingles since 2017. Moghaddam says that a lot of her patients had the older shingles vaccine, Zostavax, which is no longer offered in the United States because it isn’t as effective as the new vaccine. If you were previously vaccinated with Zostavax, she recommends getting the newer vaccine because it offers better protection over the long term.
Shingrix is given in two doses, usually two to six months apart. Even if you've had one dose but missed the second, you don’t need to start over, Bansal says. Yet fewer than 1 in 4 adults over 50 have completed both doses. That gap matters: a single shot is only about 52% effective after three years, but while the second can boost protection to over 90% and lasts longer.
“You need the two doses to prime your immune system enough to be able to recognize it and to remember it," Bansal says. “The way vaccines work is they create certain kinds of cells in your immune system called memory cells. If they ever see the shingles protein floating around in your blood, they remember and they know to go attack it."
You can get the shots at your doctor's office or a pharmacy. The vaccine can cause some temporary side effects as your immune system responds — including muscle aches, fatigue, or a mild fever — but these usually only last two to three days maximum. For most people, the side effects are mild. Moghaddam says they’re comparable to what you might experience with the flu vaccine.
If you’re worried about side effects, it's fine to take acetaminophen or ibuprofen proactively, says Sax, the clinical director of the Division of Infectious Diseases at Brigham and Women's Hospital in Boston.
"Given how common shingles is, I don't think there's any doubt that the risk of the shingles vaccine is worth taking to prevent a case of shingles," says Sax.
The Lasting Impact — and Why the Vaccine Matters
Junker lost hearing in her "shingles ear" and kept losing her balance even after the vertigo and nausea passed. She went on short-term disability for vestibular nerve damage, which affects the inner ear and balance, and spent five months in physical therapy relearning how to walk.
"I couldn't walk normally anymore. I staggered. The only thing I can compare it to is that it looked like I was drunk walking around. It was nerve-wracking going up and down the stairs because I would suddenly lose my balance," she says, noting that balance depends on equal input from vision, sensation in the feet, and the vestibular nerves.
Now, Junker keeps track of how many people she's told her story to who then got vaccinated. They often compare notes on whether the first or second shot hit harder — though Sax says there's no evidence of a consistent pattern in studies.
If you do get strong side effects after the second shot, "it's telling you that your body is protected and it's ready," Bansal says.
"Even if you've skipped other vaccines, this one seems to protect you from lifelong pain," says Ali Dehghani, DO, a resident doctor at Case Western Reserve University School of Medicine in Cleveland. He calls the benefits "a tangible payoff for the short side effects of a vaccine."
Thankfully, Junker's hearing returned after six months, and her balance has improved.
"I thought shingles basically meant you got a painful rash," she says. "If I could go back and have had the vaccine beforehand, I would do it in a heartbeat. It's worth it."
