Shingles, also known as herpes zoster, is a painful viral infection caused by reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. The risk generally increases with age and can also be higher when the immune system is weakened. Understanding the ways to prevent shingles is particularly important for older adults and people at increased risk of complications. Vaccination is the main specific preventive measure, alongside appropriate medical advice and infection-control measures.
What Is Shingles?
Shingles occurs when the varicella-zoster virus, which remains inactive in the body after chickenpox, becomes reactivated later in life. It commonly causes pain, tingling, itching, and a blistering rash that usually appears on one side of the body. Although shingles itself is not spread from person to person, fluid from the blisters can transmit the virus to someone who has never had chickenpox or the chickenpox vaccine, causing chickenpox rather than shingles.
Shingles can involve:
- Pain, burning, itching, or tingling before the rash develops
- A band or cluster of blisters, usually on one side of the body
- Headache, fever, chills, or fatigue in some people
- Persistent nerve pain after the rash has healed
- Eye involvement that can affect vision
- More serious complications in people with weakened immune systems
Why Is Shingles Prevention Important?
Shingles can be more than a temporary skin rash. One of its most common complications is postherpetic neuralgia, a type of nerve pain that can continue for months or even years after the skin has healed. Shingles affecting the area around the eye can also cause eye complications and vision problems. People with weakened immune systems have a higher risk of severe disease and complications.
Prevention matters because it may:
- Reduce the likelihood of developing shingles.
- Lower the risk of postherpetic neuralgia.
- Reduce the likelihood of complications associated with shingles.
- Provide additional protection for people at higher risk.
- Reduce the potential impact of a painful episode on daily activities.
Who Should Consider Shingles Prevention?
Anyone who has previously had chickenpox can potentially develop shingles because the virus remains in the body. However, shingles becomes more common with increasing age, particularly among adults over 50. A weakened immune system can also increase the risk.
In Singapore, the National Adult Immunisation Schedule recommends the recombinant herpes zoster vaccine for:
- Adults aged 60 years and above.
- Immunocompromised adults aged 18 to 59 years.
- People in these groups who may benefit from reducing their risk of shingles and related complications.
The Ministry of Health recommends discussing vaccination with a healthcare professional to determine whether it is appropriate for your circumstances.
Who Should Seek Medical Advice First?
Vaccination is generally well tolerated, but individual circumstances should be considered before receiving a vaccine. Tell your healthcare provider about your medical history, allergies, current medications, and previous vaccinations.
Medical advice is particularly important if you:
- Have a weakened immune system.
- Are receiving medicines that suppress the immune system.
- Have had a serious allergic reaction to a previous vaccine or one of its components.
- Are currently unwell or have an acute illness.
- Have previously received a shingles vaccine.
- Are unsure whether you have received the recommended doses.
Your healthcare provider can determine whether vaccination is suitable and advise on the appropriate schedule.
What Are the Ways to Prevent Shingles?
Vaccination
The most important specific preventive measure for shingles is vaccination. The recombinant herpes zoster vaccine, commonly known as Shingrix, is designed to reduce the risk of shingles and its complications.
The World Health Organization recommends considering a two-dose recombinant herpes zoster vaccine schedule for older adults and people with chronic conditions in countries where shingles represents an important public health problem.
In Singapore, the Ministry of Health has included the recombinant herpes zoster vaccine in the National Adult Immunisation Schedule for adults aged 60 and above and immunocompromised adults aged 18 to 59 years.
Maintaining Overall Health
There is no lifestyle measure that can guarantee prevention of shingles. However, maintaining general health is important, particularly for people with conditions or treatments that affect immune function.
This may include:
- Managing chronic medical conditions appropriately.
- Following prescribed treatment for existing illnesses.
- Maintaining a balanced diet.
- Getting adequate physical activity according to your health status.
- Getting sufficient sleep.
- Avoiding smoking.
These measures support general health but should not be considered substitutes for recommended vaccination.
Reducing Transmission From an Active Rash
If someone develops shingles, preventing contact with blister fluid can reduce transmission of the varicella-zoster virus to people who have never had chickenpox or vaccination.
Recommended precautions include:
- Keep the rash covered where practical.
- Avoid touching or scratching the blisters.
- Wash your hands regularly.
- Avoid direct contact between the rash and people who may be particularly vulnerable.
This is especially important around pregnant people who have never had chickenpox or vaccination, newborns, and people with weakened immune systems.
How Should You Prepare for Shingles Vaccination?
Most people do not need extensive preparation before vaccination. However, your healthcare provider will review your medical history and vaccination history to determine whether the vaccine is appropriate.
Before your appointment:
- Tell the healthcare provider about allergies.
- Mention medicines that suppress the immune system.
- Bring your vaccination records if available.
- Tell the provider if you previously had shingles.
- Ask how many doses are required.
- Discuss any current illness or recent vaccination.
The recombinant herpes zoster vaccine is administered as a two-dose series. The recommended interval between doses depends on the individual’s circumstances and vaccination guidance.
What Happens During Shingles Vaccination?
The vaccine is administered by injection, usually into the upper arm. A healthcare professional will confirm your eligibility and vaccination history before administering the dose.
After vaccination, you may be observed briefly according to the healthcare provider’s usual procedures. Most people can continue their normal activities, although temporary reactions may occur.
A second dose is generally required to complete the recommended two-dose course. Your healthcare provider will tell you when the next dose should be given based on the applicable schedule.
Vaccination reduces the risk of shingles but does not mean that an individual can never develop the condition.
Benefits, Risks, and Possible Side Effects
The main benefit of shingles vaccination is reducing the risk of developing shingles and related complications. The WHO recommends the recombinant herpes zoster vaccine for appropriate populations and notes that vaccination can reduce the risk of shingles and postherpetic neuralgia.
Possible reactions after vaccination may include:
- Pain, redness, or swelling at the injection site
- Fatigue
- Muscle aches
- Headache
- Fever or chills
- General discomfort
These reactions are generally temporary. However, as with any vaccine, serious allergic reactions can rarely occur. Anyone experiencing symptoms after vaccination should seek appropriate medical advice.
Cost or Availability
Shingles vaccination is available through healthcare providers in Singapore. The Ministry of Health introduced subsidies and MediSave coverage for eligible Singaporeans and Permanent Residents receiving the shingles vaccine at public healthcare institutions and eligible CHAS GP clinics.
Current MOH information lists the recombinant herpes zoster vaccine under the National Adult Immunisation Schedule for adults aged 60 and above and adults aged 18 to 59 with certain medical conditions. Subsidy amounts depend on eligibility and healthcare setting.
Patients should check with their healthcare provider about current eligibility, subsidies, MediSave use, and any remaining out-of-pocket costs before vaccination.
What Our Multi-Specialty Clinic Says
Patients often ask whether there are ways to prevent shingles without vaccination. General health measures can support overall wellbeing, but vaccination remains the main specific preventive measure for people who are recommended to receive it. During consultation, we review age, medical history, immune status, previous vaccination, and previous episodes of shingles before discussing whether vaccination is appropriate. We also explain the expected dosing schedule and possible reactions. For people who develop a shingles rash, early medical assessment is important because antiviral treatment may be more useful when started promptly. Prevention and early treatment should therefore be considered as separate parts of shingles care.
Putting This Into Practice
- Check whether you are eligible for shingles vaccination.
- Discuss vaccination with your healthcare provider.
- Keep your vaccination records up to date.
- Manage chronic medical conditions according to medical advice.
- Maintain healthy lifestyle habits that support general wellbeing.
- If shingles develops, keep the rash covered and avoid direct contact with vulnerable people.
When to Seek Professional Help
Seek medical advice if you:
- Develop a painful or blistering rash, particularly on one side of the body.
- Experience significant pain, tingling, or burning followed by a rash.
- Develop a rash near the eye or on the face.
- Have a weakened immune system and develop symptoms.
- Develop significant symptoms after vaccination.
- Have persistent nerve pain after a shingles rash has healed.
A shingles rash involving the eye area requires prompt medical attention because complications can affect vision.
Frequently Asked Questions
Can shingles be completely prevented?
No preventive measure can guarantee that a person will never develop shingles. However, vaccination can significantly reduce the risk of shingles and related complications. The recombinant herpes zoster vaccine is the main specific preventive measure recommended for eligible adults. Maintaining general health is also useful, but lifestyle measures should not be viewed as a replacement for recommended vaccination.
Can I get shingles if I have already had it before?
Yes. Having shingles once does not necessarily provide complete protection against another episode. People who have previously had shingles may still be eligible for vaccination, depending on their age, health status, and local recommendations. WHO notes that the recombinant vaccine is licensed for adults aged 50 and above, including those who have had shingles previously.
Is the shingles vaccine recommended for younger adults?
It may be recommended for certain younger adults who have conditions that weaken the immune system. In Singapore, the National Adult Immunisation Schedule includes immunocompromised adults aged 18 to 59 years. Eligibility should be assessed by a healthcare professional because recommendations depend on medical circumstances and the applicable national schedule.
Can I get shingles from someone who has shingles?
No, you cannot catch shingles itself from another person. However, fluid from shingles blisters can transmit the varicella-zoster virus to someone who has never had chickenpox or the chickenpox vaccine. That person could then develop chickenpox. Keeping the rash covered, avoiding direct contact with the blisters, and practising good hand hygiene can reduce transmission.
What are the most effective ways to prevent shingles?
The main specific preventive measure is vaccination with the recombinant herpes zoster vaccine when it is recommended for you. Other ways to prevent shingles include managing chronic health conditions, maintaining general health, and taking precautions around an active shingles rash to reduce transmission of the virus. A healthcare professional can advise whether vaccination is appropriate based on your age and medical history.
Next Steps
Understanding the ways to prevent shingles is particularly important for older adults and people with weakened immune systems, who may face a greater risk of shingles and its complications. Vaccination is the main specific preventive measure, while maintaining general health and managing chronic conditions can support overall wellbeing. In Singapore, the recombinant herpes zoster vaccine is included in the National Adult Immunisation Schedule for eligible adults aged 60 and above and immunocompromised adults aged 18 to 59 years. If you are unsure whether vaccination is suitable for you, consult a healthcare professional for personalised advice.
