If I already got the 1-dose shingles vaccine, should I get the 2-dose shingles vaccine now?


If you got the 1-dose shingles vaccine (Zostavax), yes–you should get the newer and more effective 2-dose shingles vaccine (Shingrix) 5 years after your Zostavax shot. The two-dose vaccine has been shown to be much more effective for longer.

Zostavax came onto the US market in 2006 and was recommended for adults 60 years and older. This single-dose vaccination reduced the risk of developing shingles by about 50% and reduced the risk of chronic nerve pain related to shingles by 67%. Protection did start to decline after about 5 years. It was a live attenuated vaccine, which means it contained whole live virus, weakened so that it was unlikely to cause an infection. This meant people who were pregnant or had immunodeficiency could not receive Zostavax. It was also less effective in people over age 75. Since people who are over 75 and people who are immunocompromised are the most likely to get shingles, this really wasn’t ideal. Zostavax was not available or not as effective in the populations that most needed its protection.

In 2017, the FDA approved a second vaccine against shingles and recommended it for adults ages 50 and up. In July 2021, the recommendation for Shingrix was extended to people over age 19 who are immunosuppressed. Shingrix is given in two doses, with the second dose 2-6 months after the first dose. It reduces the risk of getting shingles by up to 97% and the risk of serious complications by 89-92% (depending on the age of the population in the studies).

Protection remains strong for at least 7 years. We don’t actually know how long–it may be much longer, even for life. The vaccine came out in 2017, and monitoring continues on this question. Shingrix is also not a live attenuated virus vaccine, so it is available to people who have weakened immune systems–like those with HIV, undergoing cancer treatment, and so on.

From 2017 to late 2020, both vaccinations were on the market. Then in November of 2020, Zostavax was withdrawn from the US market. The much more effective 2-dose vaccine has replaced it.

CDC now recommends that people who previously got the 1-dose Zostavax vaccine against shingles should be vaccinated again with the newer, more effective vaccine, Shingrix. Safety monitoring data shows that getting revaccinated is safe and effective if it’s been at least 5 years since you had the Zostavax vaccine. Intervals of less than 5 years between these vaccines have not been studied, but CDC notes here that there is no reason to expect any differences in safety or effectiveness with a shorter time interval.

So, if you received a shingles vaccine between 2006 and the middle of 2017, you should consider getting another one now because you very likely did get the less-effective Zostavax shot. The currently recommended 2-dose vaccination will increase your protection quite a bit.

If you received a shingles vaccine between 2017 and late 2020, check your records to see which one you got. Plan to get the Shingrix vaccine 5 years after your Zostavax shot. Or, talk to a pharmacist about getting it even sooner.

Stay safe, stay well,

Those Nerdy Girls