Nov. 12, 2025 – Two years ago, Lisa Junker left a holiday party early with an intense earache. She was diagnosed with swimmer's ear and sent home with antibiotic drops. But when she awoke days later with disabling vertigo – vomiting every time she tried to stand – she knew something else was wrong.
"The ENT [ear, nose, and throat doctor] came in and took one look and said, 'This is shingles. Every medication you're taking is not correct,'" said Junker, now 52, a medical journal editor in Centerville, Virginia.
She began antivirals and nerve pain medication, but the virus had already done damage: She lost hearing in one ear and could no longer safely walk without help.
The CDC recommends all adults get the shingles vaccine at age 50, and Junker had been just months away from her 50th birthday when she planned to get it at her checkup. New research now shows that getting the vaccine – either before or after a shingles episode – not only reduces the risk of a devastating case like Junker's but also lowers the risk of vascular dementia and heart problems.
The shingles vaccine "is the one I recommend the strongest to my patients who are adults over 50," said Harvard Medical School professor Paul E. Sax, MD. "People may not understand how debilitating a case of shingles can be," including blindness, brain swelling, and nerve damage that can turn an otherwise healthy person into a chronic pain patient, he said.
Staying Protected: Doses, Risks, and Tips
Junker got the shingles vaccine after her infection. Her ENT warned that if shingles returns, it will likely strike the same spot.
About 1 in 3 people will get shingles in their lifetime. Around age 50, "your immune system starts to weaken. That's just the normal process of aging. And it makes you more susceptible to getting shingles," said Ankush Bansal, MD, an internal medicine hospitalist in Miami.
Other things that raise risk include anything that stresses or weakens the immune system – chronic conditions, a major illness or injury, or severe emotional stress such as the death of a loved one. With head trauma, for instance, "it's not that you bumped your head specifically, but it's everything that followed after that," Bansal said. "And for stress, it doesn't mean, 'I'm stressed because I'm late for work.' This is chronic stress – people close to you have died, you've been really sick, lost your job, or you have a substance use dependency." Conditions like type 2 diabetes also raise your risk.
The shingles vaccine is a two-shot series, given two months apart. If you've had one dose but missed the second, you don't need to start over, said Bansal. Yet fewer than 1 in 5 adults over 50 have completed both doses. A single shot is only about 50% effective after three years, but the second boosts protection to as much as 90% and lasts longer.
"It seems that you need the two doses to prime your immune system enough to be able to recognize it and to remember it," Bansal said. "The way vaccines work is they create certain kinds of cells in your immune system called memory cells. If they ever see the shingles protein floating around in your blood, they remember and they know to go attack it."
You can get the shots at your doctor's office or a pharmacy. And if you're worried about side effects like muscle aches or fatigue, it's fine to proactively take acetaminophen or ibuprofen, said Sax, who is also the clinical director of the Division of Infectious Diseases at Brigham and Women's Hospital in Boston.
"Given how common shingles is, I don't think there's any doubt that the risk of the shingles vaccine" – a day or two of fever, body aches, or fatigue at worst – "is worth taking to prevent a case of shingles," said Sax.
The Lasting Impact – and Why the Vaccine Matters
Junker lost hearing in her "shingles ear" and kept losing her balance even after the vertigo and nausea passed. She went on short-term disability for vestibular nerve damage, which affects the inner ear and balance, and spent five months in physical therapy relearning how to walk.
"I couldn't walk normally anymore. I staggered. The only thing I can compare it to is that it looked like I was drunk walking around. It was nerve-wracking going up and down the stairs because I would suddenly lose my balance," she said, noting that balance depends on equal input from vision, sensation in the feet, and the vestibular nerves.
Now, Junker keeps track of how many people she's told her story to who then got vaccinated. They often compare notes on whether the first or second shot hit harder – though Sax said there's no evidence of a consistent pattern in studies.
If you do get strong side effects after the second shot, "it's telling you that your body is protected and it's ready," Bansal said.
"Even if you've skipped other vaccines, this one seems to protect you from lifelong pain," said Ali Dehghani, DO, a resident doctor at Case Western Reserve University School of Medicine in Cleveland. His recent study, presented at an infectious disease conference, found that shingles vaccination reduced the risk of vascular dementia by 50% and of heart or blood vessel problems – like clots, strokes, or heart attacks – by 25%.
He called the benefits "a tangible payoff for the short side effects of a vaccine."
A particularly fascinating finding, Dehghani said, was that vaccinated people who did have a breakthrough rash still saw benefits. The study also suggested that those vaccinated within six months after an outbreak had similar reductions in risks of dementia and problems with their heart and blood vessels.
Thankfully, Junker's hearing returned after six months, and her balance has improved.
"I thought shingles basically meant you got a painful rash," she said. "If I could go back and have had the vaccine beforehand, I would do it in a heartbeat. It's worth it."
