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Does Medicare Cover The Shingles Vaccine?

If you've ever had chickenpox in your childhood, chances are you're likely to develop shingles in the future. While people…

If you've ever had chickenpox in your childhood, chances are you're likely to develop shingles in the future.

While people might assume that shingles — a painful, blistering rash — only affects older adults, 1 in 3 adults who have had chickenpox are susceptible to it.

Here's what you need to know about shingles and the vaccine.

What Is Shingles?

Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox.

When a person of any age gets the varicella-zoster virus, some of the virus remains dormant in central nerve cells. When the immune system is challenged by stress, the virus can reactivate as shingles.

Most commonly, shingles causes a painful rash that may appear as blisters across the stomach area. Sometimes, the shingles rash occurs around the eye, neck or face.

[Related:Chronic Pain: Ranking the Most Painful Medical Conditions]

Shingles Vaccination

The Centers for Disease Control and Prevention recommends Shingrix, a recombinant zoster vaccine.

While there is no cure for shingles, the Food and Drug Administration-approved Shingrix shingles vaccine can significantly prevent a shingles outbreak and a painful complication, called postherpetic neuralgia.

"The chance of getting shingles increases with age, which is why shingles vaccination is recommended for all healthy adults 50 years and older," says Dr. Robert H. Hopkins Jr., medical director of the National Foundation for Infectious Diseases in Bethesda, Maryland. "There is also an increased risk for shingles in those with immune suppression, which is why shingles vaccine is also recommended for adults ages 19 years and older who have weakened immune systems because of disease or therapy."

Studies show the vaccine is more than 90% effective at preventing shingles and its complications, including postherpetic neuralgia, across all age groups, including older adults.

[READ: Vaccinations and Immunizations Recommended for Adults]

Shingles Vaccine Side Effects

Common side effects of the vaccine include:

— Redness

— Pain

— Swelling

— Warmth or itching at the injection site

"Individuals may have side effects with the first, the second, both doses or neither dose," Hopkins says. "There are no known risk factors that predict a higher likelihood of side effects."

[READ: Does Medicare Cover the RSV Vaccine?]

Does Medicare Pay for the Shingles Vaccine?

Medicare Part D covers the shingles vaccine with no out-of-pocket costs. Under most private health insurance plans, the vaccine is covered without any costs to members.

If you don't have Medicare prescription drug coverage or don't yet qualify for Medicare, the full price for two doses of the Shingrix vaccine is $395, according to its manufacturer, GSK.

Does Medicare Advantage Pay for the Shingles Vaccine?

Medicare Advantage plans typically cover the shingles vaccine without any out-of-pocket costs to individual members. Medicare Advantage plans vary from state to state on specific coverage benefits, so check your plan's policies before signing up for a shingles shot.

In addition, most pharmacies will be able to tell you whether your shingles shot is covered under your Medicare Advantage plan.

What Age Do I Need the Shingles Vaccine?

Adults 50 years and older should get the Shingrix vaccine to prevent shingles and complications from the disease. The vaccine requires two doses given two to six months apart.

If you have a weakened immune system, the CDC recommends that adults 19 years and older get the shingles vaccine because they have a higher risk of getting shingles and related complications.

Do I Really Need a Shingles Vaccine?

As mentioned, about 1 in 3 people in the U.S. Will develop shingles during their lifetime. The herpes zoster virus stays inactive in the body for life and can reactivate years — or even decades — later, causing shingles. About 99% of U.S. Adults have had chickenpox and are, therefore, at risk for shingles.

"The likelihood of developing shingles increases with age," Hopkins says. "Unvaccinated adults who live to age 80 years have about a 50% chance of developing shingles at some point during their life."

Individuals should get the shingles vaccine even if in the past they have:

— Had the shingles virus

— Received the varicella (chickenpox) vaccine

Where Can I Get the Shingles Vaccine?

The shingles vaccine is available in most neighborhood pharmacies and doctor's offices. You do not need a prescription from your doctor to receive the vaccine from a pharmacist. You can sign up for an appointment online or at the pharmacy in person.

More than 95% of Medicare Part D enrollees receive the shingles vaccine at pharmacies. Most doctors' offices cannot bill for vaccinations for Part D enrollees. If you'd like to receive the vaccine at your doctor's office, ask them if they're able to bill Part D before you're vaccinated.

How Long Does the Shingles Vaccine Last?

The Shingrix vaccine is given in two doses, typically two to six months apart, but on average at about three months between doses.

"Based on the available data, the vaccine lasts very long, and there is no requirement for a booster shot 10 or 15 years later," says Dr. Luis Ostrosky, chief of infectious diseases at UTHealth and Memorial Hermann Healthcare System in Houston. "The second dose maintains the efficacy long term."

How Long After the Shingles Vaccine Are You Contagious?

The shingles vaccine works by reinforcing the immune system to control the latent virus in the body, preventing flare-ups. The shingles vaccine does not contain a live virus.

Contrary to popular belief, individuals are not contagious before a flare-up, but rather have a latent virus that may reactivate. Protection from the vaccine builds up over a couple of weeks after the first dose, with full protection achieved after the second dose.

Can You Still Get Shingles After the Vaccine?

Yes, it is possible, but the risk is very small. In clinical studies, the latest vaccine has been demonstrated to be highly protective — more than 90% reduction in risk for at least five years after completion of the two-dose vaccine regimen.

Based on available data, the vaccine lasts for a long time, and there is no requirement of a booster.

Is Shingles Contagious?

No, shingles is not contagious. It's not possible to "catch" shingles from an individual who has shingles, but it is possible to get chickenpox from someone who has shingles if you:

— Have direct contact with fluid from a shingles rash

— Are immunocompromised

— Never had chickenpox

— Never got vaccinated against chickenpox

How Long Does Shingles Last?

The shingles rash can last two to four weeks. However, shingles can cause nerve pain that can last for months or even years. Even after the rash is gone, some may experience a condition called postherpetic neuralgia, which can cause intense pain where the rash was. The pain can be very difficult to treat, especially in older adults.

Most people who develop shingles only have it one time during their life. However, you can have shingles more than once.

Covering the shingles rash can lower the risk of spreading the virus to others. People with shingles cannot spread the virus before the blisters appear or after the rash scabs over.

Shingles Virus: 49% Of Canadians 50 And Older Are 'unaware' Of Their Risk Of Developing The Painful Virus. Here's What You Need To Know.

A new survey reports Canadians underestimate their risk of developing shingles. (Image via Canva)

People 50 and over "greatly underestimate" their risk of developing shingles, despite the fact that 1 in 3 Canadians are expected to experience the virus at some point in their lives. According to a 2024 national Leger survey, 49 per cent of Canadians aged 50 and older are "unaware" that their risk of developing the painful viral infection increases with age. Additionally, 19 per cent of respondents believe shingles are "harmless" and a "rash with no long-term effects" instead of a painful, blistering rash that can impact your quality of life.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

This article was originally published in 2024.

"Shingles is a prevalent, viral infection impacting a large portion of our older Canadian demographic and the findings of the survey are troubling," says Marni Freeman, Country Medical Director, GSK Canada in a press release. "With Canadians aged 50 and older adding-up to over 15 million and representing almost 40 per cent of the population, the need for improved shingles awareness among older adults is critical to help limit the burden of this disease and its potential complications on individuals, their family and caregivers, as well as our healthcare system."

According to Health Canada, approximately 130,000 new cases of shingles are diagnosed each year. So, what exactly is shingles? Read on to find out more.

What is shingles, and how does it compare to chicken pox?

Shingles, also known as herpes zoster, is a viral illness caused by the varicella-zoster virus, the same virus that causes chicken pox. If you've ever had the chicken pox, the virus remains inactive in your body long after you've healed.

Shingles is a painful virus that experts warn is much different than "adult chicken pox." (Image via Getty Images)

As you age, the virus can reactivate, presenting as shingles — a band of raised red dots that eventually develop into fluid-filled blisters. These bands of shingles can occur anywhere on the body, but most often appear on the torso, trunk or face.

The pain level of shingles can vary but should not be underestimated by any means — and not considered the "adult chicken pox."

In a 2018 interview with Yahoo Canada, Dennis Bowden, who developed shingles at 39, called the virus "the worst pain" they've ever experienced. Bowden compared the pain to an "intense electric shock" and said his initial outbreak that occurred on his jaw felt like a "jolt of intense pain."

What are the signs and symptoms of shingles?

Aside from the tingling, itchy skin or burning that can occur a few days before a shingles outbreak, people experience different symptoms depending on where their band of shingles are located.

For example, if you develop shingles on your face, facial paralysis, hearing loss or even blindness can occur. In some rare instances, the brain can become inflamed, which can be potentially fatal. Experts recommend visiting your doctor or an urgent care clinic if you develop blisters on your face to help prevent any permanent damage to your eyesight.

Shingles (herpes zoster) rash. (Image via Getty Images)

Aside from the blisters that tend to scab over within a few days, people with shingles can experience nausea, fever, chills, vomiting, headache and sensitivity to light.

In a 2018 interview, Dr. John Murray, an emergency physician in Ontario and B.C., told Yahoo Canada that one of the common complications of shingles is a secondary infection.

"Any time there's a break in your skin, you can get a secondary bacterial infection," he explained at the time. "People can get really sick—febrile and needing intravenous antibiotics."

What triggers a shingles flare-up?

While some people may only experience shingles once, others may experience multiple shingles outbreaks over the course of their lifetime.

According to experts, certain medications, a compromised immune system or stress can all contribute to a shingles flare-up.

"I've had patients with shingles who are older and who have had a recent death in family, the loss of a spouse; they're under emotional or psychological stress," Dr. Michael Curry, a Vancouver-based medical doctor told Yahoo Canada in 2018. "I've seen that many times. However it [shingles] begins we don't fully understand, but we know that emotional or psychological stress has an impact on the physical health of the body as well."

How is shingles treated?

Although a shingles outbreak can last from 3-5 weeks, your doctor can prescribe an anti-viral medication that can help shorten the length of your illness. These anti-viral medications work best when taken at the first sign of outbreak, and can help prevent any long-term side effects of the virus, like long-term nerve pain, known as postherpetic neuralgia.

Aside from anti-virals, your doctor may prescribe pain medication or lotions to help ease the shingles rash itself.

Shingles infographic (Image via Getty Images)

Is shingles contagious?

Leger's recent survey findings show that a vast majority of Canadians are unaware of how shingles is transmitted. The survey found that 64 per cent of people surveyed believe shingles is "a little, somewhat, or very contagious." Forty-one per cent of people believe that you can "catch shingles" from someone with shingles while 33 per cent believe you can catch shingles from someone with chicken pox.

Shingles (herpes zoster) is not contagious, but the virus that causes it, varicella-zoster, can be. Although the risk of transmission is low, a person can become infected with the varicella-zoster virus by making direct contact with the fluid inside a shingles blister.

According to the Centers for Disease Control and Prevention (CDC), the varicella-zoster virus can be transmitted from a person with shingles to a person who hasn't had chicken pox before or has never had the chicken pox vaccine. If they become infected with the varicella-zoster virus, they'll develop the chicken pox — not shingles.

Once they then overcome chicken pox, the varicella-zoster virus will remain inactive in their bodies, which means they could later develop shingles when the virus is "reactivated" due to age, stress, compromised immune system or certain medications.

Keeping your shingles rash covered and frequently washing your hands can help prevent transmission of the varicella-zoster virus.

Can you prevent shingles?

In Canada, there is currently only one approved shingles vaccines, Shingrix. Health Canada recommends that individuals over the age of 50 be vaccinated against shingles, even if they've experienced a shingles flare-up before.

You should talk to your healthcare provider about which vaccine is right for you based on your personal medical history.

With files from Gail Johnson.

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Zoster Vaccine Recommended For People With Inflammatory RMD

Herpes zoster (HZ) is common in older people, with a lifetime risk of 25%. The main risk factors are advanced age and immunosuppression. People with a rheumatic and musculoskeletal disease have an overall higher risk of shingles.

EULAR—The European Alliance of Associations for Rheumatology—recommends that HZ vaccination be considered in high-risk patients with an autoimmune and inflammatory RMD. Live vaccines are difficult in patients on immunosuppressive therapies; newer non-live vaccines may replace the live-attenuated version, but when the last recommendations were developed, the safety and efficacy of the subunit zoster vaccine had not yet been investigated in patients with RMD.

New work presented at the 2025 annual EULAR congress in Barcelona focuses on the recombinant zoster vaccine (RZV), which contains recombinant glycoprotein E—the major target of CD4+T-cells. The abstract describes the tolerability and safety of RZV in patients with inflammatory rheumatic and musculoskeletal diseases (iRMD), showcasing interim data from an ongoing study.

In total, 150 adults with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), or giant cell arteritis (GCA) who had an indication of receiving RZV were prospectively included. Of these, 21.3% had a history of HZ, and everyone received RZV at Month 0; 90% also received a dose at Month 2. Safety assessments were performed at Months 2, 3, 6, and 12.

Most adverse events (AE) occurred within a few days after vaccination. In total, 139 (46.8%) localized and 158 (53.2%) generalized AE occurred up to Month 3. At that point, pain at the site of injection was the most frequent AE, reported by 32.7% of patients. This was followed by fever (14.1%), fatigue (9.4%), musculoskeletal pain (8.1%), swelling at the injection site (6.4%) and redness at the injection site (6.4%). Infections (4.7%), worsening of the disease (3.7%) and other AEs (7.7%) were reported until Month 3.

Disease flares were reported by patients at Months 2, 3, 6 and 12, but of these only 1.6–8.6% fulfilled the predefined flare criteria. Hospitalization due to disease flare was needed for 3 patients—2 with GCA and 1 with RA. Lead author Uta Kiltz said "over the observed period of 12 months, this can be interpreted as a low rate of events."

Overall, 10 serious AEs were reported in 9 patients during follow-up (3 flares, 4 malignancies, and 3 comorbidities), but no patient reported an AE of special interest or a breakthrough infection. Of note, the malignancies were considered not to be related to the vaccination.

The authors concluded that the majority of patients tolerated RZV well, with only a few reports of flares and serious AEs. These findings are reassuring for rheumatologists and future vaccine recipients, and support confidence in RZV safety for patients with an iRMD.

More information:Kiltz U, et al. Tolerability and safety of recombinant zoster vaccine in patients with inflammatory rheumatic musculoskeletal diseases—a prospective longitudinal study over 12 months. Presented at EULAR 2025; OP0034. Ann Rheum Dis 2025; DOI: 10.1136/annrheumdis-2025-eular.B293.

Provided by European Alliance of Associations for Rheumatology (EULAR)

Citation: Zoster vaccine recommended for people with inflammatory RMD (2025, June 11) retrieved 13 June 2025 from https://sciencex.Com/wire-news/511113374/zoster-vaccine-recommended-for-people-with-inflammatory-rmd.Html

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