Reply to I've had shingles decades ago, no vaccine since. QUESTION:

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[quote=Anonymous]PP here (working in academia on infectious diseases) - a few things:

1) the question about getting a second dose after four years elapsing since the first dose is a really good one and I imagine quite common. It looks like we do not yet have a published real-world effectiveness study on dose durability that covers your situation specifically (I'm only seeing shorter follow-up windows) partly because it is a "newer" vaccine, but based on the shorter-term effectiveness evidence on two doses being better, I'd trust the CDC's prior recommendation that you should still get a follow-up dose as soon as possible, especially if you tolerated the first well (ask your PCP though, of course!)

2) "Herpes" as people commonly refer to it is indeed a different condition; however, the virus that causes shingles and chickenpox (varicella zoster) is in the family of herpesviruses. This why shingles behaves similarly to other herpesviruses, like those that cause cold sores: you could always have a flare-up once initially infected, but there are things you can do do mitigate those flare-ups. I really wish we had different terminology for herpesviruses because it is indeed confusing. FYI Epstein-Barr is also a herpesvirus: https://en.wikipedia.org/wiki/Herpesviridae#Human_herpesvirus_types

3) If you have *ever* had chickenpox or shingles, you are already infected and will always be at some risk for shingles because the virus stays in the body after initial infection and camps out dormant near your nerve endings. This is also why shingles is so very painful, because it targets nerve endings specifically. The vaccine boosts your immune system's defenses against flare-ups of the dormant virus.

This is a really good summary:
https://www.ama-assn.org/public-health/prevention-wellness/what-doctors-wish-patients-knew-about-shingles-virus[/quote]

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