Herpes zoster, which results from reactivation of latent varicella (chicken pox) virus infection within the sensory ganglia, usually causes painful unilateral vesicular rashes in a dermatomal distribution. The lifetime risk of herpes zoster infection is about one in three, and is higher for women than for men. Up to one in four adults experience complications following infection, including postherpetic neuralgia (persistent pain in the area of the rash), bacterial skin infections, ophthalmic complications, cranial and peripheral neuropathies, encephalitis, pneumonitis, and hepatitis. Herpes zoster risk is increased in immunocompromised conditions including cancer, HIV, bone marrow or organ transplantation, and immunosuppressive therapies. Increasing age is also strongly associated with developing both herpes zoster infection and postherpetic neuralgia.

The herpes zoster vaccine effectively reduces the short-term risks for zoster and postherpetic neuralgia in adults ≥50 years. The Advisory Committee on Immunization Practices (ACIP) currently recommends routinely offering onetime vaccination for adults ≥60 years; the Federal Drug Administration has approved the vaccine for adults ≥50 years. Because the long-term efficacy of the herpes zoster vaccine is uncertain, the ACIP is re-evaluating the best age to administer the vaccine and the need for revaccination.

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