There is a live vaccine for VZV, marketed as Zostavax. It must be maintained at a temperature not exceeding -15 °C during shipping and storage, although it can be stored and transported at refrigerator temperature for up to 72 continuous hours before reconstitution. The incidence of side effects is low. There is no recommended upper age limit.
A systematic review by the Cochrane Library concluded that Zostavax can reduce the absolute risk of
shingles by 1.75%, i.e. 1 episode of
shingles prevented for every 70 patients vaccinated. This equates to a 50% relative risk reduction. The vaccine reduced incidence of persistent, severe pain after
shingles (i.e., PHN) by 66% in people who contracted
shingles despite vaccination.
Duration of protection was not known as of 2013. In the
Shingles Prevention Study (SPS), vaccine efficacy was maintained through four years of follow-up, and a larger and longer study was in progress; evidence suggested that protection persists for up to 7 years. The need for revaccination had not been defined. An episode of HZ has an immunizing effect, greatly reducing the probability of a subsequent recurrence. However, patients with a history of severe HZ are often insistent on receiving the vaccine, and there have been concerns about the validity of patient histories of HZ. Both the Centers for Disease Control and Prevention and the ACIP recommended the vaccination of adults regardless of a previous episode of HZ.
It has been recommended that people with primary or acquired immunodeficiency should not receive the vaccine.
The likelihood of vaccination causing a case of HZ appears to be very low.
A 2007 study found that the
shingles vaccine is likely to be cost-effective in the U.S., projecting an annual savings of $82 to $103 million in healthcare costs with cost-effectiveness ratios ranging from $16,229 to $27,609 per quality-adjusted life year gained. In October 2007 the vaccine was officially recommended in the U.S. for healthy adults aged 60 and over. The Centers for Disease Control and Prevention recommends shingle vaccine for use in people 60 years old and older to prevent
shingles, but it is not recommended to treat active
shingles or postherpetic neuralgia (pain after the rash is gone) once it develops. Adults also receive an immune boost from contact with children infected with varicella (chicken pox), a boosting method that prevents about a quarter of
shingles cases among unvaccinated adults, but that is becoming less common in the U.S. now that children are routinely vaccinated against varicella.
In the United Kingdom and other parts of Europe, population-based varicella immunization is not practiced. The rationale is that until the entire population could be immunized, adults who have previously contracted VZV would instead derive benefit from occasional exposure to VZV (from children), which serves as a booster to their immunity to the virus, and may reduce the risk of
shingles later on in life.The UK Health Protection Agency states that, while the vaccine is licensed in the UK, there are no plans to introduce it into the routine childhood immunization scheme, although it may be offered to healthcare workers who have no immunity to VZV.
From 2013 the UK National Health Service started offering
shingles vaccination, with Zostavax, to elderly people. People aged either 70 or 79 on 1 September 2013 were offered the vaccine. People aged 71 to 78 on that date would only have an opportunity to have the shingles vaccine after reaching the age of 79. The original intention was for people aged between 70 and 79 to be vaccinated, but the NHS later said that the vaccination programme was being staggered as it would be impractical to vaccinate everyone in their 70s in a single year.
