A new study shows that the shingles vaccine is linked to a lower risk of cardiovascular events such as heart attacks and stroke. Shingles itself is associated with an increased risk of cardiovascular complications, and preventing it should lead to a reduced risk of them.

Shingles vaccination also decreased the risk of herpes zoster ophthalmicus, when the nerve connected to the eye and the skin surrounding it are affected by the virus.

This post will examine the newly published research on the shingles vaccine and its potential to reduce the risk of heart attack and stroke.

Shingles and the vaccine

One of the complications of developing chickenpox, caused by the Varicella zoster virus (VZV), a herpesvirus, is that the body’s immune system does not destroy the virus. Once the symptoms of chickenpox disappear, the virus hides (it does not do this consciously; it’s a virus) in the dorsal root ganglion, a bundle of nerve fibers at the bottom of the spinal column. The virus stays there, hidden from the body’s immune system.

We are unsure why it does this, but it may be an evolutionary adaptation for survival until a later point in time, when it can reproduce and reinfect the victim.

Even though the body generated an immune response to the original zoster virus infection, several years or decades after the initial infection, the adaptive immune response against the virus wanes or disappears. Due to other unknown factors, possibly stress or other infections like COVID-19, the Varicella zoster virus “moves” along the nerve bundles and begins a secondary infection with much more serious consequences to the individual.

This second infection, called herpes zoster, is more commonly known as shingles. This infection usually occurs in adults older than 50, although it can happen at any time, occasionally even in young adults. 

Even though the same virus causes chickenpox and shingles, shingles was given a different name, herpes zoster, probably because it was originally thought to be caused by a similar, but unrelated virus. However, herpes zoster is not a formal name based on biological binomial nomenclature. We now know that the virus Varicella zoster causes both chickenpox and shingles.

Shingles is an entirely unpredictable disease. It appears at random points in time in response to unknown causes. Once shingles appear, they can be painful, depending on the location of the outbreak. It can cause blindness (from herpes zoster ophthalmicus), disfigurement of the infected area, permanent pain (postherpetic neuralgia), and other conditions.

Shingles can be treated with antiviral drugs, but only if the infection is recognized and treated within 24-72 hours, which means that the individual would have to seek out treatment rather quickly.

The initial symptoms may appear like acne or other skin conditions, which many people might ignore. After 72 hours, the disease has to run its painful and dangerous course. Post-herpetic neuralgia pain may last for weeks, months, or even years after the blisters have healed – this is not a trivial disease.

Furthermore, shingles is not a one-time event. Even if you develop shingles, it may return in months or years, so it is important to be vaccinated even if you have had shingles.

Almost all individuals in the US aged 50 years and older have been infected with VZV and are therefore at risk for shingles. There’s a growing body of evidence that herpes viruses, including VZV, can influence cognitive decline.

The only way to prevent a shingles infection is to boost the immune system with a new vaccine against the zoster virus. The CDC recommends Shingrix (also known as the zoster vaccine, available in the USA), a relatively new, safe, and effective vaccine that prevents shingles. Shingrix has replaced the older shingles vaccine, Zostavax, because it is much more effective.

There is another way to prevent shingles — never get chickenpox in the first place. Of course, we have a vaccine for that, the chickenpox (or varicella) vaccine.

The CDC recommends the shingles vaccine for individuals 50 years or older. Additionally, the vaccine should also be given to individuals who are 19 years or older and have a compromised immune system. Other countries have different recommendations, so you should check the public health authorities for your home country.

So let’s be clear about a couple of things. First, you are only at risk for shingles if you contract chickenpox. Second, children who have received the chickenpox vaccine probably will not develop shingles as they age.

Shingles vaccine and heart disease research

In a study published on 9 August 2025 in Clinical Infectious Diseases, Emily Rayens, PhD, MPH, of Kaiser Permanente Southern California in Pasadena, and colleagues, matched 102,766 vaccinated patients (recombinant herpes zoster vaccine, Shingrix) with 411,064 unvaccinated patients based on age, sex, race/ethnicity, and index date. Patients received two doses of the vaccine 4 weeks to 6 months apart from April 2018 to December 2020. The average follow-up time was 2.5 years.

The researchers adjusted for factors such as history of herpes zoster, healthcare utilization patterns, and prior vaccination with the live shingles virus.

Here are the key results:

• Vaccinated individuals had a 72.9% lower risk of herpes zoster ophthalmicus.
• Vaccinated individuals had an 83.7% lower risk of postherpetic neuralgia.
• Vaccinated individuals had a 28% lower risk of hospitalization for acute myocardial infarction.
• Vaccinated individuals had a 42.5% lower risk of hospitalization for stroke.

Summary

I have written previously about how the shingles vaccine reduces the risk of dementia and heart disease. It is becoming clear that these vaccines have benefits far beyond just preventing shingles.

To be clear, no one is saying that the shingles vaccine itself is reducing the risk of heart disease. It has this protective effect because it prevents the disease, shingles, that can lead to cardiovascular events such as stroke and heart attacks.

Importantly, this study examines the cardiovascular effects of the newer shingles vaccines, Shingrix (as opposed to the older vaccine, Zostavax). If you are over 50 (or an adult who is immunocompromised), get the shingles vaccine. It’ll prevent shingles, an unpleasant and dangerous disease (I’ve had it, because the vaccine wasn’t available at my then age). And it might prevent conditions that are complications of shingles, such as heart disease.

Citations

• Rayens E, Sy LS, Qian L, Wu J, Ackerson BK, Luo Y, Zheng C, Cheng Y, Vega Daily LI, Song J, Takhar HS, Ku JH, Cohen RA, Yun H, Oraichi D, Seifert H, Tseng HF. Adjuvanted recombinant zoster vaccine is effective against herpes zoster ophthalmicus, and is associated with lower risk of acute myocardial infarction and stroke in adults aged ≥50 years. Clin Infect Dis. 2025 Aug 9:ciaf440. doi: 10.1093/cid/ciaf440. Epub ahead of print. PMID: 40795767.

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