Learn about shingles and the varicella-zoster virus, tips on how to treat postherpetic neuralgia, and the shingles vaccine.
What is shingles?
Shingles, also called herpes zoster, is a disease that triggers a painful skin rash. It is caused by the same virus as chickenpox, the varicella-zoster virus. After you recover from chickenpox (usually as a child), the virus continues to live in some of your nerve cells.
For most adults, the virus is inactive and it never leads to shingles. But, for about one in three adults, the virus will become active again and cause shingles.
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What are the symptoms of shingles?
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. It’s important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain (encephalitis) can also occur.
How is shingles diagnosed and treated?
If you think you might have shingles, talk to your doctor as soon as possible. It’s important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.
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How long does shingles last?
Most cases of shingles last three to five weeks.
Long-term pain
After the shingles rash goes away, some people may be left with ongoing pain called postherpetic neuralgia, or PHN. The pain is felt in the area where the rash occurred. The older you are when you get shingles, the greater your chances of developing PHN.
The PHN pain can cause depression, anxiety, sleeplessness, and weight loss. Some people with PHN find it hard to go about their daily activities, such as dressing, cooking, and eating. Talk with your doctor if you are experiencing PHN or have any of these symptoms. Usually, PHN will lessen over time.
Is shingles contagious?
If you are in contact with someone who has shingles, you will not get the symptoms of shingles yourself. However, direct contact with fluid from a shingles rash can still spread the varicella-zoster virus, which can cause chickenpox in people who have not had chickenpox before or the chickenpox vaccine. The risk of spreading the virus is low if the shingles rash is kept covered.
Am I at risk for shingles?
Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:
Most people only have shingles one time. However, it is possible to have it more than once.
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When should I get the shingles vaccine?
The current shingles vaccine (brand name Shingrix) is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctor’s office and at some pharmacies.
You should get the shingles vaccine if you:
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
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Vaccines for older adults
Vaccines can help protect you against several serious diseases, including COVID-19, flu, pneumonia, tetanus, shingles, and whooping cough. Learn more about vaccines recommended for older adults.
Tips for coping with shingles
If you have shingles, here are some tips that might help you feel better:
Read and share this infographic & to learn more about shingles.
Also, you can limit spreading the virus to other people by:
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Learn all about flu—how it spreads, symptoms and treatment, the difference between cold, flu, and COVID-19, and the importance of getting a flu shot.
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Each year, millions of people suffer from seasonal influenza, which is often called the flu. Flu is a respiratory illness caused by viruses that infect the nose, throat, and sometimes the lungs.
Flu is a mild illness for some people. But for others, including older adults and those with chronic (long-lasting) health conditions, the flu can be very serious and even life-threatening. Getting a flu vaccine every year can help prevent the flu. The vaccine is safe, effective, and available for little to no cost to you.
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How serious is the flu?
Most people who get the flu feel better after a few days to two weeks. However, the flu can make you seriously ill. Some people develop other health issues, called complications, because of the flu. Complications can be mild, such as a sinus or ear infection, or more serious, like pneumonia.
Anyone can get sick from the flu, but some people are more likely to have complications. You are more at risk for flu and its complications if you:
Pregnant people and children younger than five years old are also more likely to get very sick from the flu. Flu vaccination is especially important for people in these higher-risk groups. Learn more about people at increased risk for flu and its complications.
Why is the flu more dangerous for older adults?
The flu is more dangerous for older adults for a few reasons. One reason is that the immune system — which helps your body fight infections — weakens as you age. For example, because your body is busy fighting off the flu, you might pick up a secondary infection such as pneumonia. A second reason is that older adults are also more likely to have other health conditions, like diabetes, that increase their risk for complications from the flu.
The good news is the flu vaccine reduces your risk of getting the flu and of getting seriously ill if you do get sick with the flu. Flu vaccination is especially helpful for people with chronic health conditions. For example, it has been linked to lower rates of heart problems (cardiac events) among people with heart disease and fewer hospitalizations among people who have chronic lung disease or diabetes. Learn more about the benefits of flu vaccination.
How does the flu spread?
The flu is contagious, which means it spreads from person to person. It mostly spreads through droplets in the air when people with flu cough, sneeze, or talk. It can spread from up to six feet away. Although it isn’t as common, the flu can also spread from surfaces — for example, if you touch something the virus is on and then touch your nose, mouth, or eyes.
It’s possible to spread the flu before you feel sick and when you have symptoms. Typically, people with the flu can spread it a day before, and up to a week after feeling sick. Young children and people with weakened immune systems may be able to spread the flu for even longer. If you or someone you know is sick with the flu, take steps to help prevent spreading the disease
Is it the flu, a cold, or COVID-19?
The common cold, flu, and COVID-19 are respiratory illnesses caused by different viruses. They can all cause similar symptoms. If you have symptoms, a health care provider can determine the cause of your illness and help you take steps to feel better.
A cold is often milder than the flu. The flu and COVID-19 have similar symptoms, but COVID-19 spreads more easily and symptoms tend to be more severe. It’s also more common to have a change in your sense of smell or taste with COVID-19.
People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza. Learn more about the differences between the flu and a cold and flu and COVID-19.
Average normal body temperatures in older adults are slightly lower than in younger adults. So when an older adult is sick, their fever temperatures may also be lower. According to the CDC, the following temperatures in older adults may be signs of an infection, such as COVID-19 or the flu:
If you are concerned that you may have a fever, talk with a health care provider to find out what steps you can take to feel better.
Common symptoms of a cold, the flu, and COVID-19
The chart below shows common symptoms of the three illnesses. Not everyone will have these symptoms. Your symptoms may be more or less severe, or you may only have a few. If you feel sick, stay home and call a health care provider.
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How can you prevent the flu?
The most effective way to prevent the flu is to get a flu vaccine every year. Everyone 6 months and older should get a flu vaccine. It makes it less likely that you will get the flu. It also reduces your chances of being hospitalized or dying if you do get sick with the flu.
In addition to getting your flu vaccine, you can help stop the spread of flu by:
Who should get a flu vaccine and which one should you choose?
You can get the flu at any time of year, but it’s most common in the fall and winter. It usually starts to spread in October and peaks between December and February. That’s why this time is called the flu season.
It takes at least two weeks for your flu vaccine to start working, so try to get vaccinated by the end of October. However, getting vaccinated after October can still help protect you from the flu. Because older adults may lose protection from a flu vaccine more quickly, try to avoid getting vaccinated too early (before September).
There are flu vaccines designed specifically for older adults. The CDC recommends that people age 65 and older receive a higher-dose flu vaccine or an adjuvanted flu vaccine (one with an additional ingredient called an adjuvant that helps create a stronger immune response). These vaccines are potentially more effective than the standard flu vaccine for people in this age group. Talk with a health care provider or pharmacist about which vaccine is best for you.
Where can you get a flu vaccine?
You can get your flu vaccine at a doctor’s office or from your local health department. Many grocery stores, drug stores, and pharmacies also offer flu vaccines. Visit Vaccines.gov to find a location near you.
Why do you need a flu vaccine every year?
You need a flu vaccine every year for two reasons. First, flu viruses change and the flu vaccine is updated each year to target the flu viruses that are anticipated to spread that year. Second, the protection you get from a flu vaccine lessens with time, especially in older adults. Getting your flu vaccine every fall gives you the best protection from that year’s flu viruses.
What are the side effects of flu vaccines?
The flu vaccine is safe and cannot give you the flu. Most people have no problems after getting a flu vaccine.
When side effects occur, they are generally mild and go away on their own. The most common side effects are soreness, redness, or swelling at the site where you got the shot. Some people also get a headache, fever, nausea, or muscle aches. These side effects start shortly after getting the vaccine and can last up to two days. They typically do not get in the way of daily activities.
If you have allergies, talk with a health care provider about your options for flu vaccines. Even people with mild egg allergies can safely get most flu vaccines. Egg-free flu vaccines are also available. You should not get vaccinated if you have had a severe allergic reaction to the flu vaccine in the past.
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How much does getting a flu vaccine cost?
Most people can get a flu vaccine for little to no out-of-pocket cost. Medicare and most private health insurance plans will cover the cost of your flu vaccine. However, some insurance plans require that you receive your vaccine at a specific location. Check with your insurance company. If you do not have health insurance, contact your local or state health department.
What can you do if you get the flu?
If you get the flu, there are steps you can take to feel better. Act fast! First, talk with a health care provider. The flu and COVID-19 have similar symptoms, so you may need to get tested for an accurate diagnosis. This will also help determine which medications might make you feel better.
There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after flu symptoms begin, these drugs can make you feel better more quickly. Antivirals can also help reduce your risk of complications from flu. Antibiotics do not help you recover from the flu. However, they are sometimes prescribed to treat a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.
If you are sick, rest and drink plenty of fluids like juice and water, but not alcohol. Over-the-counter medicines, such as acetaminophen or ibuprofen, can bring down your fever and might help with the aches and pains.
It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs as well as your nasal passages. These same areas are also affected by smoking.
Monitor your symptoms and talk with a health care provider if you start feeling worse. For example, contact your provider right away if you:
Read about shots for COVID-19, flu (influenza), pneumonia, shingles, tetanus, diphtheria, and pertussis (whooping cough). Learn how these vaccines can keep you well.
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Which vaccines do older adults need?
As you get older, a health care provider may recommend vaccinations, also known as shots or immunizations, to help prevent certain illnesses.
Talk with a doctor or pharmacist about which of the following vaccines you need. Make sure to protect yourself as much as possible by keeping your vaccinations up to date.
COVID-19 vaccines
COVID-19 is a respiratory disease that causes symptoms such as fever, cough, and shortness of breath. Older adults are more likely than younger people to get very sick from COVID-19. The disease can lead to serious illness and death.
Studies show that COVID-19 vaccines reduce the risk of getting this disease. The vaccine will also help keep you from getting seriously ill or having to go to the hospital if you do get COVID-19. We are still learning how effective COVID-19 vaccines are against new variants of the virus. Read more about COVID-10 vaccine effectiveness.
The Centers for Disease Control and Prevention (CDC) recommends that older adults stay up to date with COVID-19 vaccines, including booster shots. Read more about COVID-19 vaccines from the CDC. Contact your local health department or visit Vaccines.gov to find out where you can get vaccinated.
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Flu vaccine for older adults
Flu — short for influenza — is a virus that can cause fever, chills, sore throat, stuffy nose, headache, and muscle aches. Flu is very serious when it gets in your lungs. Older adults are at a higher risk for developing serious complications from the flu, such as pneumonia.
The flu is easy to pass from person to person. The virus also changes over time, which means you can get it again. To ensure flu vaccines remain effective, the vaccine is updated every year.
Everyone age 6 months and older should get an annual flu vaccine, but the protection from a flu vaccine can lessen with time, especially in older adults. Still, you are less likely to become seriously ill or hospitalized with the flu if you get the vaccine. A flu vaccine is especially important if you have a chronic health condition such as heart disease or diabetes.
Ideally, you should get your vaccine by the end of October each year so you are protected when the flu season starts. It takes at least two weeks for the vaccine to be effective. However, if you have not received your flu vaccine by the end of October, it’s not too late — flu season typically peaks in December or January. As long as the flu virus is spreading, getting vaccinated will help protect you.
There are flu vaccines designed specifically for older adults. The CDC recommends that people age 65 and older receive a higher-dose flu vaccine or an adjuvanted flu vaccine (one with an additional ingredient called an adjuvant that helps create a stronger immune response). These vaccines are potentially more effective than the standard flu vaccine for people in this age group. Talk with a health care provider or pharmacist about which vaccine is best for you.
Medicare will pay for the flu vaccine, and so will private health insurance plans. You can get a flu vaccine at a doctor’s office or local health department, as well as at some grocery stores, drug stores, and pharmacies. The ingredients of a specific vaccine are the same wherever you receive it.
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Vaccines to help prevent pneumonia
Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs and it can affect other parts of the body. Older adults are at higher risk than younger people of getting very sick or dying from pneumococcal disease.
The CDC recommends that all adults age 65 and older get pneumococcal vaccination. This vaccine will help protect you from getting a serious infection, including pneumonia. There are multiple forms of the pneumococcal vaccine: Talk to a health care provider to find out which is best for you. You can also visit the CDC’s Pneumococcal Vaccination webpage to learn more about the types of vaccines that are available.
Tetanus, diphtheria, and pertussis (whooping cough) vaccines
Tetanus, diphtheria, and pertussis are diseases caused by bacteria that can lead to serious illness and death.
Getting vaccinated is the best way to prevent tetanus, diphtheria, and pertussis. Most people get vaccinated as children, but you also need booster shots as you get older to stay protected against these diseases. The CDC recommends that adults get a Tdap (tetanus, diphtheria, and pertussis) or Td (tetanus, diphtheria) booster shot every 10 years. Ask a health care provider when you need your booster shot.
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Shingles vaccine for older adults
Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. As you get older, the virus could become active again and cause shingles.
Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well as a rash with fluid-filled blisters. Even when the rash disappears, the pain can remain. This is called post-herpetic neuralgia, or PHN.
The shingles vaccine is safe, and it may keep you from getting shingles and PHN. Healthy adults age 50 and older should get vaccinated with the shingles vaccine, Shingrix, which is given in two doses. (Zostavax, an earlier shingles vaccine, is no longer available in the United States.)
You should get a shingles vaccine even if you’ve already had chickenpox or the chickenpox vaccine, or if you don’t remember whether you had chickenpox. You should also get the shingles vaccine if you’ve already had shingles or received Zostavax. However, you should not get a vaccine if you currently have shingles, are sick or have a fever, have a weakened immune system, or have had an allergic reaction to Shingrix. Check with a health care provider if you are not sure what to do.
You can get the shingles vaccine at a doctor’s office and at some pharmacies. Medicare Part D and private health insurance plans may pay some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
Travel vaccines
Check with a doctor, a pharmacist, or your local health department about vaccines you need if you’re planning to travel to other countries. The vaccines that are required and recommended are based on your destination, planned activities, and medical history. Sometimes multiple vaccines or doses are needed. It’s best to get them at least four to six weeks before you travel to allow time to build up immunity and get the best protection, particularly from those that may require multiple doses. For more information, visit the CDC website or call its information line at 800-232-4636.
Vaccine safety and side effects
Vaccines are very safe, and they can help keep you from getting serious or life-threatening diseases. The most common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given.
Before getting any vaccine, talk with a doctor or pharmacist about your health history, including past illnesses and treatments, as well as any allergies. A health care provider can address any concerns you have.
It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.
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