Shingles Vaccine: Why Experts Say You Should Get It – Risks & Benefits

The familiar sting of shingles – a painful, blistering rash – affects roughly one in three Americans. Yet, vaccination rates remain surprisingly low, hovering around 35% for adults over 60, a trend mirroring broader hesitancy around preventative shots. But a growing body of research suggests there’s more at stake than just avoiding a week of intense discomfort. Evidence is mounting that the shingles vaccine may offer a surprising benefit: a reduced risk of dementia, stroke, and even heart attack.

What is Shingles?

Shingles isn’t a new infection; it’s a reactivation of the varicella-zoster virus, the same one that causes chickenpox. If you’ve had chickenpox, the virus lies dormant in your body and can re-emerge later in life as shingles, though it’s most common after age 50. Even as both are caused by the same virus, they present differently. Chickenpox is the initial infection, while shingles occurs when the virus travels along nerve pathways to the skin.

The first sign is typically pain, often followed by sensitivity to touch, itching, and a red rash with blisters. Fever, headache, and fatigue can similarly accompany the rash, which usually appears on one or two areas of skin – most commonly as a stripe on one side of the body. While complications are relatively rare, about 1-4% of people with shingles require hospitalization. Older adults and those with weakened immune systems are at higher risk of severe cases, though fewer than 100 people die from shingles annually in the US, according to the Centers for Disease Control and Prevention (CDC).

Why Does the Virus Reactivate?

After the initial chickenpox infection, the varicella-zoster virus settles into a dormant state in the dorsal root ganglion, a cluster of neurons near the spinal cord. What triggers this reactivation isn’t fully understood, but a weakened immune system, stress, and certain medical conditions like diabetes can increase the risk.

Shingles is contagious, spread through contact with the fluid in blisters or inhalation of virus particles. A person is infectious until the blisters are dry and scabbed over, typically within seven to ten days. Importantly, you can’t get shingles directly from someone with shingles; you must have had chickenpox first. If you’ve never had chickenpox, exposure to the shingles rash will give you chickenpox, not shingles.

Vaccination: Prevention and Beyond

Vaccination is a key tool in preventing both chickenpox and shingles. In the US, there are two chickenpox vaccines available, depending on age. The chickenpox vaccine was introduced in 1995, and the hope is that younger generations will be largely protected from both chickenpox and shingles thanks to widespread vaccination.

Even if you were vaccinated against chickenpox as a child, a shingles vaccine is still recommended. While breakthrough cases of shingles are rare in vaccinated individuals, they can occur. A blood test can confirm if you still have immunity to the varicella-zoster virus.

The currently recommended shingles vaccine in the US and the UK is Shingrix. It’s more than 90% effective at preventing shingles in adults 50 and older with healthy immune systems, and can reduce the severity of the illness even if you do get infected. Shingrix also reduces the risk of postherpetic neuralgia, a debilitating nerve pain that can persist for months or even years after the rash clears, affecting 10-18% of those who get shingles, with risk increasing with age.

Potential Side Effects

While Shingrix is generally well-tolerated, it can cause side effects. These typically include pain and swelling at the injection site, and flu-like symptoms such as a low-grade fever and aches. These side effects are usually mild and resolve within a few days, and tend to be less pronounced in adults over 70. According to the CDC, no serious side effects have been linked to Shingrix.

The Emerging Link to Dementia

Beyond preventing shingles and its complications, recent research suggests the vaccine may have a broader protective effect. Several studies have shown an association between shingles and an increased risk of dementia, though the nature of this relationship is complex. Now, evidence suggests that vaccination against shingles may actually *lower* the risk of developing dementia.

A 2026 study led by Emily Rayens at Kaiser Permanente southern California found a 51% reduction in dementia risk among individuals vaccinated with Shingrix, even after accounting for factors like socioeconomic status and lifestyle. Researchers believe this may be due to the virus’s persistent impact on the immune system, creating chronic inflammation that contributes to neurodegenerative diseases. Another theory suggests the vaccine itself may have beneficial effects on the immune system that extend beyond protection against shingles.

“Dementia is complex, and there are likely many contributing factors to its onset and progression,” explains Rayens. “But it’s fair to say there’s strong evidence for the relationship between shingles vaccines and a lower risk of dementia.”

Beyond Dementia: Heart Health and Stroke Risk

The potential benefits of the shingles vaccine may extend beyond neurological health. A review of 19 studies indicated that shingles vaccination was associated with a lower risk of both stroke and heart attack. While more research is needed to confirm these findings, they suggest a potential cardiovascular benefit to vaccination.

What Does This Mean for You?

For adults aged 50 and older, the CDC recommends two doses of Shingrix, spaced two to six months apart. Those with weakened immune systems may receive the second dose one to two months after the first. The vaccine is generally covered by most insurance plans and Medicare Part D. Younger adults who develop shingles before age 50 are typically advised to wait until they turn 50 to get vaccinated, as there’s currently no evidence of benefit from earlier vaccination.

Dr. Andrew Wallach, ambulatory care chief medical officer at NYC Health + Hospitals, emphasizes the importance of considering the shingles vaccine, particularly given the potential for dementia prevention. “If there’s a possibility of it also protecting against dementia, why not?” he says.

While clinical trials are needed to fully understand the mechanisms at play and establish a definitive causal link, the growing body of evidence suggests that the shingles vaccine may be a valuable tool in protecting not only against a painful rash, but also against serious long-term health risks. As research continues, and public health recommendations evolve, staying informed and discussing vaccination with your healthcare provider is crucial.