Who’s at Risk of Shingles?
While anyone who’s had chickenpox can develop shingles, some groups of people are considered at higher risk due to other factors. Here’s who may be more likely to develop this condition.
Older Adults
Although young people are increasingly getting diagnosed with shingles, the highest-risk group is adults ages 50 and older, particularly those 60 and above, says Dr. Hoffman.
“The older you are, the higher the chance of shingles and of complications like long-lasting nerve pain,” she says. “Risk is even greater in older adults who also have weakened immune systems.”
Age is a top factor because the chickenpox vaccine wasn’t approved for use in the United States until 1995. Before that, chickenpox used to be very common, with more than four million cases annually.
That means that those born before routine vaccination are much more likely to have gotten chickenpox at some point and have it living dormant in their system as a result. In fact, more than 99 percent of Americans born before 1980 have had chickenpox, even if they don’t remember it.
Immunocompromised People
When the immune system is weakened in some way, that makes it more difficult to keep the dormant virus under control, says David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. Because of that, any illness or condition that affects the immune system could put you at higher risk of shingles if you’ve had chickenpox in the past.
“HIV patients, cancer patients, organ transplant recipients, and those receiving immunosuppressive therapy are at highest risk of developing shingles,” he says. Other diseases associated with an increased risk of shingles are autoimmune diseases, such as rheumatoid arthritis and lupus, plus chronic conditions like diabetes, chronic obstructive pulmonary disease, asthma, chronic kidney disease, and cardiovascular conditions, Dr. Cutler says.
Immunosuppressant medications are currently used for a range of conditions, and include corticosteroids (steroids), biologics, janus kinase (JAK) inhibitors, and others, he says. Even if you’re only on one for a short time, it could cause the once-dormant virus to reactivate.
People Under a Lot of Stress
Experiencing a high degree of physical or emotional stress can have a negative effect on the immune system, enough that it can become compromised, says Saira Shahab, MD, an infectious disease specialist at Episcopal Health Services in Far Rockaway, New York.
“Chronic illness or constantly being in high-stress situations can temporarily weaken immune defenses,” she says.
Although these individuals may not be as at risk of shingles as those with autoimmune diseases or on immunosuppressant medications, experiencing ongoing or traumatic stress can still be a risk factor for developing shingles, she says.
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