Shingles Vaccine: Is it Necessary if You Never Had Chickenpox?

February 29, 2024

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Shingles is a painful rash illness caused by the reactivation of the varicella-zoster virus (VZV) that causes chickenpox. This article addresses whether people who never contracted chickenpox should receive the shingles vaccine that can help prevent shingles and its complications.

Understanding Shingles and Chickenpox

To analyze if the shingles vaccine is applicable to people without prior chickenpox, we first need to understand the relationship between shingles and chickenpox.

What is Shingles?

Shingles, also termed herpes zoster, manifests as a localized, painful skin rash that most often occurs on one side of the face or body. Other symptoms can include fever, chills, and headache.

Shingles results from the reactivation of VZV – the virus that causes chickenpox – that lies dormant in the nerve tissues of those previously infected. So chickenpox is the initial prerequisite before shingles can occur later on.

Complications like vision/hearing loss, facial paralysis, and severe pain can arise from shingles. Prompt treatment with antivirals can reduce duration and complications.

What is Chickenpox?

Chickenpox is a highly contagious viral illness that mainly affects children. Symptoms are fever and a blister-like rash that appears over several days. Most recover within 7-10 days without complications.

Chickenpox arises from an initial or primary VZV infection. The virus then becomes latent in nerve cells and can reactivate after decades to cause shingles. This forms the causative link between the two – they originate from the very same virus.

Routine childhood chickenpox vaccination has made the disease preventable and increasingly rare today.

Shingles Vaccine and Chickenpox History

Now we analyze the relevance of chickenpox history for shingles vaccination purposes.

Can you get shingles if you never had chickenpox?

Yes, it is possible but uncommon to develop shingles without having had a known previous chickenpox infection. The assumption is that they experienced a mild or subclinical chickenpox illness as children that went unnoticed.

In rare cases, being in proximity to someone with active shingles can also transmit VZV and directly lead to shingles without antecedent chickenpox. But this is very rare.

Should you get the shingles vaccine if you never had chickenpox?

Yes, the CDC recommends that everyone 50 years and older receive the shingles vaccine – whether or not they can recall getting chickenpox before.

They estimate over 99% of American adults born before 1980 have already acquired VZV through chickenpox exposure. So even if they don’t remember specific infection, vaccination can still benefit by boosting cellular memory.

Additionally, in the rare cases where grown adults develop first-time chickenpox, the risk of severe illness and complications is higher. The shingles vaccine provides a two-way protective buffer here.

Some key advantages of getting vaccinated despite no chickenpox history:

  • Extra protection if undetected latent VZV is present
  • Shields against primary chickenpox infection
  • Reduces future shingles likelihood by over 90%
  • Decreases severity if post-vaccination shingles occurs

Making an Informed Decision

While public health agencies issue broad guidelines, individual medical considerations differ.

Consulting a healthcare professional

Before getting vaccinated, it is prudent to consult your doctor and discuss factors like:

  • Personal and family medical history
  • Any contradictions for vaccination
  • Potential risk of exposure to VZV
  • Benefit-risk ratio of shingles vaccine

They can best advise on suitability of the vaccine and need for precautions pertaining to your health status and demographics.

In closing, shingles vaccination is now deemed imperative for preventing illness in all older adults. Even individuals without prior overt chickenpox can stand to benefit based on recent evidence and recommendations. However, customization of these recommendations based on personal health profiles is key.


  • Shingles is caused by reactivation of the latent chickenpox virus
  • While uncommon, shingles can still occur without prior chickenpox
  • The CDC recommends shingles vaccine from age 50+, regardless of chickenpox history
  • Consulting a healthcare provider is important before vaccination


What are the potential side effects of the shingles vaccine?

The most common side effects of the shingles vaccine are redness, pain, tenderness, swelling, itching at the injection site, headache, fatigue, muscle pain, fever, nausea, and shivering. Most side effects are mild to moderate and resolve within 2-3 days.

What are the different types of shingles vaccines available?

There are two shingles vaccines currently available:

  • Zostavax – Approved for people 50 years and older. Requires just one dose. About 51% effective.
  • Shingrix – Approved for people 50 years and older. Requires 2 doses, 2-6 months apart. Over 90% effective. Recommended over Zostavax.

Who should not get the shingles vaccine?

People who should avoid the shingles vaccine include:

  • Those with weakened immune systems due to disease or treatment
  • Pregnant women or planning pregnancy within 1 month of vaccination
  • Those allergic to gelatin, neomycin, or any component of the vaccine

How effective is the shingles vaccine?

Shingrix has over 90% efficacy in preventing shingles and long-term nerve pain. Real-world studies show it remains about 85% effective for at least the first 4 years after getting vaccinated.

Zostavax is about 51% effective in preventing shingles and 67% effective in preventing nerve pain in those 60-69 years old.

How long does the protection from the shingles vaccine last?

Based on limited data, protection offered by Shingrix shows barely any decline for at least the first 4 years. Experts expect protection to last at least 10 years.

Zostavax offers protection for about 10 years. Some additional protection may persist for a few years longer. So a booster dose may be needed after this timeframe.

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