Provaxxer asked
Your answer on Shingrix says it is recommended by the Center For Disease Control (CDC) that you receive Shingrix (the shingles vaccine) whether or not you remember having chickenpox in the past. And further down you say it is recommended you get vaccinated even if in the past you had shingles, received Zostavax (older version of shingles vaccine), or are not sure if you had chickenpox. But then you say: The Shingrix vaccine is not recommended in patients who..... test negative for immunity to varicella zoster virus (evidence they never had chickenpox). Which is it?
Answer
Sorry for the confusion on this! The answer we wrote regarding recommendations for the shingles vaccine with reference to your chickenpox history can be found here: Getting The Shingles Vaccine Shingrix If You Never Had Chickenpox.
We hope our answer below clears up your question.
Chickenpox History And Shingles Vaccine (Shingrix Recommendations)
The CDC says that individuals do not need to be tested to see if they have a history of varicella (chickenpox) because:
- More than 99% of people have been exposed to the virus (even if they don't remember having it).
- False negatives for the test are common, meaning that you may get a negative reading when in actuality you have been exposed to the virus.
In other words, the assumption is that you have had, or have been exposed to, the varicella (chickenpox), even if you don't know.
Per the CDC:
...even if a person does not recall having chickenpox, serologic testing for varicella immunity is not recommended. It is often a barrier to herpes zoster vaccination, and false negatives are common."
Now, if a person happens to have been tested and knows with certaintly they have not been exposed to the varicella virus, then the shingles vaccine is not recommended. They are instead recommended to get the chickenpox (varicella) vaccination. Again, per the CDC:
"...if serologic evidence of varicella susceptibility becomes available to the healthcare provider, providers should follow ACIP guidelines for varicella vaccination. Shingrix has not been evaluated in persons who are seronegative to varicella, and it is not indicated for the prevention of varicella."
Summary
- Since most people have been exposed to the chickenpox virus, screening for it is not recommended to determine whether or not you should get the shingles vaccine. It is just recommended to get the shingles vaccine.
- If, on the small chance, you have been tested and you know with certainty you have not been exposed to the chickenpox virus, you should not get the shingles vaccine. You should instead get the chickenpox vaccine.
