Around one in three people get shingles, an infectious disease that is anything but harmless, at least once in their life. The trigger is the varicella virus, which is known to cause chickenpox. After infection – usually in childhood – some of the pathogens retreat into nerve nodes and “sleep” there, well guarded by the immune system.

Due to certain factors, such as a weakening of the immune system with advancing age, but also stress and anything that challenges the immune system, the viruses can become active again and lead to shingles (herpes zoster).

• Up to 20 percent have massive nerve pain (post-herpetic neuralgia) for months after the illness.
• The risk of stroke and heart attack is increased by more than half in the first few weeks after shingles.
• If you have shingles in the eye (zoster ophthalmicus), you may experience a loss of vision.
• Dizziness and hearing loss can also occur if the ear is affected (zoster oticus).

And not everyone who has already had shingles is safe from getting it again. Around six percent of those affected fall ill a second time study shows.

It is therefore safest not to get shingles in the first place. This is easy to say, but difficult to implement. After all, more than 90 percent of people over 50 had chickenpox in their childhood and therefore carry these “zombie viruses” that can be reactivated at any time.

Who should get vaccinated against zoster

The risk of reactivation can be significantly reduced with a vaccination with a so-called adjuvanted subunit inactivated vaccine.

Stiko generally recommends that all people aged 60 and over receive a standard vaccination with the inactivated vaccine in order to protect themselves against herpes zoster, its possible complications and consequences.

In Germany, the vaccination was previously approved for people aged 50 and over. Because shingles can be particularly dangerous for people with certain chronic diseases, the recommendations since 2026 stipulate that this population group should be vaccinated from the age of 18.

The risk group includes patients with:

• Diabetes mellitus
• chronic obstructive pulmonary disease or bronchial asthma
• chronic kidney failure
• rheumatoid arthritis
• chronic inflammatory bowel disease
• congenital or acquired immunodeficiency or immunosuppression
• HIV infection
• systemic lupus erythematosus

Anyone who has already had shingles should still get vaccinated. Because a repeated infection cannot be ruled out. The health insurance companies cover the costs of the vaccination for people over 60 and the above-mentioned chronically ill people aged 18 and over.

This is how effectively the vaccine protects against shingles

The serum is an inactivated vaccine that contains a specific surface protein of the virus. It stimulates the immune system to develop and maintain special defenses against the virus. This allows the varicella in the nerve nodes to be permanently controlled. In this way, reactivation and thus a herpes zoster infection are prevented in the vast majority of cases.

The vaccine is available as a powder plus solvent, and the serum is made from it shortly before the injection. The inactivated vaccine does not contain any preservatives such as thimerosal.

Different Investigations who closely examined the inactivated vaccine for its effects, attested to its high effectiveness:

• Herpes zoster was prevented by 92 percent in 50 to 69 year olds, and post-herpetic neuralgia by 82 percent
• 90 percent of those over 70 years of age

Calculated very simply for the general population, this means: with vaccination, only three out of 100 adults will develop zoster in the course of their lives, and without vaccination at least 33.

The vaccine is injected twice, at least two to a maximum of six months apart. The full effect is only possible with the second vaccination. By the way, patients with immune deficiency also build up protection against herpes zoster through vaccination.

Refresher zoster vaccination – how long the protective effect lasts

The effect of the vaccination lasts for years. Studies show that vaccination protection decreases slightly after four years; further studies are still ongoing. In this context, effects on T cells and antibodies have been proven for nine years.

Experts assume that immunity exists for at least this period. Whether a booster vaccination will be necessary later is still the subject of investigations – the inactivated vaccine has only been on the market since 2018. Initial long-term data indicate that protection is still active even after ten years in immune-healthy people.

Vaccine reactions: These side effects are possible

No effect without side effects, this also applies to the zoster vaccine. Because when we are vaccinated, the reaction shows that our immune system is reacting to the serum and thus building up future protection against the infection. The following vaccination reactions occur relatively often with inactivated vaccines:

• Local reactions such as pain at the injection site in almost ten percent of those vaccinated; Chickenpox-like, limited skin rash at the injection site in 0.1 percent.
• Systemic reactions such as mild fever, fatigue, headache and muscle pain may also occur.

However, these vaccination reactions usually resolve within one to three days.