Anyone who has had chickenpox is at risk of developing shingles, a painful blistering rash. The best protection against shingles is vaccination. You are eligible to get a free shingles vaccination for 12 months once you turn 65.
Shingles
Summary
After you recover from chickenpox, the virus stays in your body. It moves to the roots of your nerve cells (near the spinal cord) and becomes inactive (dormant). Later, if the virus becomes active again, shingles is the name given to the symptoms it causes. It is also known as herpes zoster (a different disease from herpes simplex).
You can only get shingles if you’ve had chickenpox in the past (usually as a child). While anyone who has recovered from chickenpox may develop shingles, the risk of shingles increases as you get older or if you have a weakened immune system.
Vaccination is free for 12 months once you turn 65. Talk to your doctor to find out more.
The best protection against shingles is vaccination.
You can’t catch shingles directly from someone else. However, if you’ve never had chickenpox or received the chickenpox vaccine, you can catch chickenpox if you are in close contact with someone who has shingles. This is because the shingles blisters contain the chickenpox virus.
Shingles is less contagious than chickenpox, and the risk of a person with shingles spreading the virus is low if the rash is covered. Once the rash has developed crusts, the person is no longer infectious.
Symptoms
Shingles is a painful rash that develops on one side of the face, body or head. The rash is made up of small blisters that typically scab over after 7 to 10 days.
Before the rash develops, people often have pain, itching or tingling in the area where the rash will develop.
Although shingles can occur anywhere on your body, it most commonly occurs around the back, the upper abdomen or on the face. Usually the rash occurs in a stripe on either the left or the right side of the body. Less commonly, the rash can be more widespread. This generally occurs only in people with a weakened immune system.
Other symptoms of shingles can include:
- fever
- headache
- chills
- upset stomach.
The pain or irritation from shingles will usually go away in 3 to 5 weeks. However, if the virus damages a nerve, you may have pain, numbness or tingling for months or even years after the rash is healed. This chronic condition is most likely to occur in people over 50. Antiviral medicine from your doctor can help reduce some shingles symptoms.
If you have shingles, you should:
- cover the rash
- avoid touching or scratching the rash
- wash your hands regularly to prevent the spread of the virus.
You should also avoid contact with the following high-risk groups until the rash has developed crusts:
- pregnant women who have not had chickenpox or the chickenpox vaccine
- premature or low birth weight infants
- people with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients and people with HIV infection.
Call Healthline 0800 611 116 if you are unsure what you should do.
Other complications
If you get shingles on your head or scalp, you may get headaches and weakness on one side of your face (causing that side of your face to look droopy). This usually goes away, but it may take many months – especially if you’ve had a lot of weakness in your face muscles.
Some people also develop painful eye or ear inflammations and infections with shingles.
Treatment
Go to your doctor as soon as you see the rash, as treatment is most effective if you start it early.
Your doctor may prescribe antiviral medicine, which may help you recover faster and will reduce the chance that the pain will last for a long time.
Your doctor may also give you medicine for pain relief.
See your doctor again if:
- you get any blisters on your face
- your fever or pain gets worse
- your neck gets stiff, you can’t hear properly or you feel less able to think clearly
- you develop new symptoms such as drooping or weakness to one side of your face
- the blisters show signs of infection (eg, they become more sore or red) or if you see milky yellow drainage from the blister sites.
Call Healthline 0800 611 116 if you are unsure what you should do.
Looking after yourself
- Take a painkiller such as paracetamol, and any other medicine your doctor prescribes.
- Put cool, moist washcloths on the rash (wash any used washcloths).
- Rest in bed during the early stages if you have fever and other symptoms.
- Wear loose clothing to reduce friction/rubbing of the blisters.
Prevention
The best way to prevent shingles is to get vaccinated.
The shingles vaccine used in New Zealand is called Shingrix. You need 2 doses, with the second dose given 2 to 6 months after the first.
Note: The brand of funded shingles vaccine used in New Zealand changed in September 2022. The old brand, Zostavax, was a single-dose vaccine. Zostavax is no longer available.
Who can get a free shingles vaccination
If you are age 65
Shingles vaccination is free for 12 months once you turn 65. As long as you receive your first dose when you are 65, your second dose will still be free, even if you get it after you turn 66.
If you are under 65
Shingrix is recommended for anyone aged 50 and over.
If you are not 65 years old, however, you will need to pay. The price will vary depending on the provider, but you can expect it to cost between $600 to $800 for both doses.
If you are over 65
You may have already had a shingles vaccine. If you are not sure, talk to your family doctor.
How funding for vaccines is decided
Pharmac is responsible for deciding which vaccines are funded and what groups are eligible for free vaccines. Pharmac's Pharmacology and Therapeutics Advisory Committee considered the cost and benefits when determining the appropriate age to offer a free shingles vaccine and recommended that free vaccination at 65 years was the best approach.
You can find further information about the funding of shingles vaccine on Pharmac’s website:
Read about Pharmac’s decision to fund Shingrix for people aged 65
Where to get a shingles vaccination
You can get a shingles vaccination from your family doctor or a pharmacy.
If you are eligible for a free vaccination, you must get it from your family doctor. Pharmacies are not funded to provide free shingles vaccinations.
If you are not eligible to get a free vaccination, you will need to pay – whether you visit your family doctor or a pharmacy.
Ask your vaccinator if you are eligible for any other vaccinations at the same time. Shingrix can be safely given at the same time as most other vaccines.
If you are not enrolled with a doctor
Some medical centres offer casual doctor and nurse appointments at a cost for unenrolled patients. There will not be a cost for the shingles vaccine if you are eligible for a free vaccination, but there may be an administration fee.
If you have already had shingles or received the Zostavax vaccine
You may be offered the Shingrix vaccine if you have already had shingles or received the Zostavax vaccine. We recommend you wait 12 months after a shingles infection or Zostavax vaccination before getting Shingrix. Talk to your family doctor for advice.