What's New With the Shingles Vaccine: Updated Guidance and Who Should Get It

Shingles rarely gets the public attention that flu or COVID-19 do, but it remains a common and often severe illness: roughly one in three adults will develop it in their lifetime, and the risk climbs sharply with age. The recombinant zoster vaccine, marketed as Shingrix, has been the recommended option for years now, and a growing body of longer-term follow-up data is reinforcing both its effectiveness and the case for closing persistent gaps in who actually gets it.

What the newer data shows

Shingrix is given as a two-dose series and has consistently demonstrated efficacy above ninety percent against shingles in clinical trials — a notably higher bar than its predecessor vaccine cleared. What has accumulated more recently is durability data: multi-year follow-up studies now show protection remaining strong well beyond the initial trial window, easing earlier questions about whether effectiveness would fade meaningfully over time. This matters directly for guidance, since a vaccine that protects durably changes the calculus around booster timing and lifetime dosing recommendations in ways that shorter-term data cannot.

Who should be getting it

Current guidance recommends Shingrix for adults 50 and older, regardless of whether they recall having had chickenpox, and for adults 19 and older who are immunocompromised — a population at meaningfully elevated risk for both shingles and its complications. That second group is easy to overlook in public messaging that defaults to talking about shingles as an "older adult" issue. Immunocompromising conditions and treatments — from certain cancer therapies to organ transplant medications to some autoimmune treatments — can make shingles more likely and more severe at almost any adult age, which is precisely why the recommendation extends well below 50 for this group.

Where uptake still falls short

Despite a strong efficacy profile and a clear recommendation, Shingrix uptake among eligible adults remains well below target, and the shortfall is not evenly distributed. Older adults in rural areas, adults without a regular primary care provider, and communities of color all show measurably lower vaccination rates — a pattern that tracks closely with the access barriers documented across nearly every other adult immunization. Cost is part of the story: while most Medicare Part D and commercial plans now cover the vaccine, out-of-pocket costs, prior authorization friction, and simple lack of awareness that it requires two visits spaced months apart all create drop-off points along the way.

The access opportunity

Pharmacies have become the dominant setting for shingles vaccination, precisely because they require no separate appointment and no primary care relationship — a meaningful advantage for the same populations who face the steepest access barriers elsewhere in the health system. That makes pharmacist-led outreach, reminder systems for the second dose, and community-based education about eligibility (particularly for younger immunocompromised adults who may not think of themselves as at risk) some of the highest-leverage investments available to close the uptake gap.

AR+D's healthcare practice partners with health systems and public health agencies to design adult immunization outreach that reaches the populations current campaigns are missing — grounded in where people already access care, not where campaigns assume they will look for it.