If you have cancer, you are at high risk for shingles, a painful rash caused by the same virus as chickenpox. The shingles vaccine is safe and helps protect you. We strongly recommend the shingles vaccine for people in our care with cancer.
Mini Kamboj, MD, MSK’s Chief Medical Epidemiologist, explains what you need to know about shingles and the shingles vaccine.
What is shingles?
Shingles is a painful rash with blisters caused by the same virus that causes chickenpox (called varicella-zoster virus). Shingles (the rash) does not spread from person to person. If you had chickenpox or got the vaccine as a child, the virus stays in your body. It can become active years later and cause shingles. People are at higher risk for shingles and health problems from shingles if they have a weakened immune system. This includes people who have cancer or who are getting treatment for it.
If I get shingles, will it delay my cancer treatment?
Possibly. If you have shingles, you may need to delay your cancer treatments, such as chemotherapy, until the rash heals, so your body can focus on fighting the shingles virus. Some people with shingles can have pain even after the rash heals, and that pain can make it hard to do everyday things. The vaccine greatly lowers your risk of long-term pain and other health problems from shingles.
I think I have shingles. What should I do?
If you think you have shingles, call your primary care doctor or MSK care team right away. Starting medicine that fights viruses (called antivirals) early can help the rash heal faster and hurt less.
How does the shingles vaccine work? Is it a ‘live’ virus?
The shingles vaccine (Shingrix) is not a live vaccine. A live vaccine uses a weak form of a virus or bacteria to teach the immune system how to fight it. But the shingles vaccine is made from a very small part of the virus. The shingles vaccine cannot give you shingles, but it still trains your immune system to recognize and fight the virus. It’s safe for people with weak immune systems.
Is the shingles vaccine safe?
Yes. The shingles vaccine is safe for people with cancer. The most common side effects are mild and go away quickly.
What are the possible side effects of the shingles vaccine?
Side effects are often mild and last for a few days. They can include:
- Pain, redness, and swelling where you got the shot
- Muscle pain
- Tiredness
- Headache
- Chills or fever
- Stomach pain or nausea
In very rare cases, the vaccine has been linked to Guillain-Barré syndrome (GBS), which causes muscle weakness. The risk is very small — about three extra cases for every 1 million doses.
I’ve had shingles before. Do I still need the vaccine?
Yes. You should get the shingles vaccine even if you’ve had shingles before. The vaccine helps lower your risk of getting shingles again. About 5 to 8 people out of 100 who have shingles will get it again within 8 to 10 years. The risk can be even higher if you have a weakened immune system. The shingles vaccine can help prevent this. There is no set waiting time to get the vaccine after having shingles. You can get the vaccine after the shingles rash has healed and you feel well.
Should I get the shingles vaccine if I have cancer or have been treated for cancer?
Yes. We strongly recommend the shingles vaccine for people with cancer. Studies show the vaccine is safe and works well for people getting cancer treatment. You can safely get the vaccine at any time during your cancer treatment, but it protects you best when you get it before starting chemotherapy. The Centers for Disease Control and Prevention (CDC) recommends the shingles vaccine for adults 19 and older with weak immune systems from any type of cancer treatment. This includes people with leukemia, lymphoma, and other cancers, as well as those who have had a stem cell transplant.
I got the shingles vaccine, but then I had a cancer treatment that weakened my immune system. Should I get the vaccine again?
Sometimes people need to get the vaccine again (called revaccination) after certain treatments, such as a stem cell transplant. For most other types of cancer treatment, you do not need another dose if you’ve already gotten both doses of the Shingrix vaccine at least two months apart. You should talk with your care team about whether you need another dose.
I got the old shingles vaccine (Zostavax) before my cancer diagnosis. Should I still get Shingrix?
Yes. Zostavax has not been available in the United States since 2020. If you got Zostavax in the past, you should still get Shingrix. Protection from Zostavax does not last more than a few years.
Can I get the vaccine if I’m taking acyclovir or another antiviral medicine?
Yes. Because Shingrix is not a live vaccine, antiviral medicine does not affect how the vaccine works.
How well does the shingles vaccine work for people with weakened immune systems?
The shingles vaccine works well to prevent shingles in people with weakened immune systems. You can still get shingles after getting the vaccine, but it is often less severe. It also lowers your risk of shingles pain and other serious problems from the virus.
Should my caregiver(s) get the shingles vaccine?
It makes sense for your caregivers and family to be up to date on their vaccines, including the shingles vaccine, if they are eligible. This helps protect them and you.
Can I get the shingles vaccine at the same time as other vaccines (flu, COVID)?
Yes. You can get the shingles vaccine at the same time as other adult vaccines, including the flu shot and COVID-19 vaccine.
Will my health plan cover the shingles vaccine?
Most health plans cover the shingles vaccine. Call the number on the back of your insurance card to make sure.
Where can I get a shingles vaccine?
You can get the shingles vaccine at many pharmacies. You can use the Shingrix Vaccine Locator to find a location near you.