Shingles is a viral infection resulting from the same virus that causes chickenpox. After recovering from chickenpox, the virus stays dormant in a person’s body. It can then reactivate later, causing shingles. It is not possible for a person to get shingles if they have never had chickenpox.

Chickenpox is a highly contagious virus that infected more than 4 million people every year nationally before the release of the chickenpox vaccine. The Centers for Disease Control and Prevention (CDC) now report 92% fewer cases of chickenpox due to the development of the varicella-zoster virus (VZV) vaccine.

After recovery, the virus can hibernate in the body’s nerve cells, where it may remain dormant for years because the body cannot remove it without damaging the nerves. When the virus reactivates, instead of a chickenpox infection, it may cause a shingles outbreak.

In this article, we discuss the relationship between shingles, chickenpox, and the VZV vaccine. We also explore ways to avoid virus transmission.

A person applying cream to stop the discomfort of chickenpox.Share on Pinterest
Evgenij Yulkin/Stocksy

Chickenpox is a highly contagious infection that typically results in a blister-like rash that first appears on the face and torso, then spreads throughout the body.

Before the rash appears, people may notice symptoms such as fever and feeling generally unwell. The severity of the rash can vary, but it usually presents as clusters of small, itchy spots. Blisters can then develop on the spots, which will dry up and form a crust. The crusts then fall off on their own.

Shingles occurs when the dormant virus reactivates. It typically presents as a painful rash that develops on one side of the face or body. Before the rash, people may notice pain, itching, or tingling in the area where the rash will appear.

In addition to the painful rash, shingles may also cause other symptoms such as fever, headache, chills, and upset stomach. Shingles on the face can also affect the eyes and cause vision loss.

The CDC notes that roughly 1 in 3 people in the United States develop shingles during their lifetime. However, people can only develop shingles if they have had chickenpox or previous exposure to VZV.

Most adults with the dormant virus do not develop shingles, but in other cases, the virus can reactivate several times. While rare, children can get shingles.

Although both the chickenpox vaccine and shingles vaccine can offer protection against shingles, people can still be at risk of developing the condition.

Anyone who previously had chickenpox can develop shingles, but it is more common after the age of 50. The incidence increases with age — shingles is 10 times more likely to occur in adults over 60 than in children under 10.

A 2020 meta-analysis suggests that risk factors for the development of shingles may also include:

  • immunosuppression, due to age, health conditions, or medications
  • family history of shingles
  • physical trauma
  • psychological stress
  • female sex
  • comorbid conditions, such as diabetes, rheumatoid arthritis, and systemic lupus erythematosus

These risk factors may also increase the possibility of experiencing complications from shingles. The most common complication is postherpetic neuralgia (PHN), which refers to severe pain in the areas where the rash was present. About 10–18% of people who develop shingles will experience PHN.

Other complications may include:

  • pneumonia
  • hearing problems
  • blindness
  • brain inflammation

The CDC considers chickenpox to be highly contagious, infecting up to 90% of people who come into close contact with someone with the infection. However, shingles is not as contagious as chickenpox, and it is not possible for shingles to spread to another person.

People who have never had chickenpox or have not received the vaccination can acquire VZV after direct contact with the fluid from the rash blisters of a person with shingles. In this case, though, people would develop chickenpox instead of shingles, but they could then develop shingles later in life.

Most people who develop shingles typically only experience one episode during their lifetime, but a person can have shingles more than once. Evidence suggests that recurrent shingles is a rare occurrence and is more common among people with a compromised immune system.

If a person has not had chickenpox or is not vaccinated, they are at a higher risk of contracting VZV. The VZV vaccine can provide protection and decrease the likelihood of developing shingles, but it cannot prevent it.

While there is currently no cure for shingles, the CDC recommends that healthy adults aged 50 years and older take the two-dose Shingrix vaccine to decrease the risk of developing shingles and shingles recurrence.

Shingrix is a recombinant zoster vaccine, meaning it uses specific pieces of the virus to generate a strong immune response. It is also suitable for people with weakened immune systems and long-term health problems. Evidence indicates that two doses of Shingrix are more than 90% effective at preventing shingles.

Previously, the CDC also recommended Zostavax, a live, attenuated single-dose vaccine. However, since November 2020, it is no longer available in the U.S.

A person can prevent spreading VZV to others by:

  • washing hands frequently
  • trying not to touch or scratch the rash
  • covering the rash
  • avoiding contact with vulnerable people

People can also decrease their chances of a shingles recurrence by getting the Shingrix two-dose vaccination and boosting their immune system by exercising, quitting smoking, eating healthy foods, getting good sleep, and managing stress.

Shingles is a viral infection resulting from the varicella-zoster virus, which is the same virus that causes varicella or chickenpox. After a chickenpox infection resolves, the virus lies dormant in the nerve cells of the body. When it reactivates, instead of causing chickenpox, it results in shingles.

Only people with previous exposure to VZV can develop shingles. While shingles is less contagious than chickenpox, people can still spread the virus. People cannot spread shingles, but individuals can acquire chickenpox from a person with shingles if they have not had chickenpox before or did not receive the chickenpox vaccine.