Last reviewed: June 2018
Last updated: June  2018

US CDC recommends new shingles vaccine for adults aged 50 and above

A new herpes zoster vaccine, Shingrix, was licensed by the US Food and Drug Administration in 2017 and has now been recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. The new vaccine consists of two doses, administered intramuscularly 2 to 6 months apart and has substantially higher efficacy than Zostavax, reducing herpes zoster cases by 97%.

  • The CDC recommends using Shingrix in place of Zostavax for preventing herpes zoster and postherpetic neuralgia in people aged ≥50 years. This represents a lowering of the recommended vaccination age from ≥60 years

  • Shingrix is recommended for immunocompetent adults aged ≥50 years regardless of prior episodes of herpes zoster or receipt of Zostavax

  • Zostavax may still be used in some cases for healthy adults aged ≥60 years, but Shingrix is preferred

See Prevention

Original source of update



History and exam

Key diagnostic factors

  • localized pain in a dermatome
  • pruritus
  • rash
  • corneal ulceration

Other diagnostic factors

  • fever
  • headache
  • malaise
  • fatigue
  • pain without rash

Risk factors

  • >50 years of age
  • HIV
  • chronic corticosteroid use
  • chemotherapy
  • malignancies
  • white ethnicity

Diagnostic investigations

Investigations to consider

  • polymerase chain reaction (PCR)
  • immunohistochemistry
  • vesicular fluid culture
Full details

Treatment algorithm


Authors VIEW ALL

Assistant Professor

Center for Value-Based Care Research

Medicine Institute

Cleveland Clinic




PL declares that she has no competing interests.


Center for Value-based Care Research

Medicine Institute

Cleveland Clinic




MR declares that he has no competing interests.

Dr Phuc Le and Dr Michael Rothberg would like to gratefully acknowledge Dr Kenneth J. Smith and Dr Linda Kalilani, the previous contributors to this topic. KJS and LK declare that they have no competing interests.

Peer reviewers VIEW ALL

Department of Epidemiology

Division of General Medicine and Epidemiology

UNC at Chapel Hill

Chapel Hill



JA declares that he has no competing interests.

Consultant Virologist

Manchester Royal Infirmary




KM declares that he has no competing interests.

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