Shingles is one of those conditions that most Canadians have heard of but few think will happen to them. The reality is different: approximately 1 in 3 Canadians will develop shingles in their lifetime, and the risk increases meaningfully with age. For adults over 50, shingles is not a remote possibility — it is a genuine and preventable health risk that belongs in a conversation with your family physician.

Shingles Awareness Week (February 24 to March 2) is an opportunity to change that conversation. At Orleans Family Health Clinic, preventive care isn’t a once-a-year checkbox — it’s the foundation of everything we do for our patients and their families. And shingles vaccination is one of the most straightforward, high-impact preventive steps an adult over 50 can take.

What Is Shingles?

Shingles — medically known as herpes zoster — is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. After chickenpox resolves, the virus does not leave the body. It goes dormant in the nerve tissue and can remain there for decades. When the immune system is weakened — by aging, chronic illness, stress, or immunosuppressive medications — the virus can reactivate as shingles.

Canada sees approximately 130,000 new shingles cases every year. The condition can affect anyone who has had chickenpox, but two out of every three cases occur in adults aged 50 and older. Risk also increases in people living with chronic conditions such as diabetes, autoimmune disease, or any condition requiring immunosuppressive therapy.

What Does Shingles Look Like?

Shingles often begins with symptoms that can be mistaken for other conditions — which is one reason early diagnosis is sometimes delayed. The early warning signs include:

• Burning, tingling, or shooting pain on one side of the body or face
• Heightened skin sensitivity in a localized area
• Fatigue, fever, or headache

Within a few days, a red rash appears — typically a stripe across one side of the torso, though the face and eye area can also be affected. The rash progresses to fluid-filled blisters, which eventually crust over and heal over two to four weeks. Pain is the hallmark of shingles, and in many patients it is the most debilitating feature of the illness.

Antiviral medications can reduce the severity and duration of shingles when started within 72 hours of rash onset — making early recognition and timely primary care contact especially important.

The Complication That Changes the Equation: Postherpetic Neuralgia

The reason shingles demands serious preventive attention is not the rash itself — it is what can follow. The most common and serious complication of shingles is postherpetic neuralgia (PHN): persistent, often severe nerve pain that continues long after the visible rash has healed. PHN can last months or years and is frequently described as burning, electric, or stabbing pain that disrupts sleep, limits physical activity, and significantly reduces quality of life.

For older patients or those managing multiple chronic conditions, PHN compounds an already complex health picture. It is associated with depression, social withdrawal, and functional decline. There is no reliable cure for established PHN — which is precisely why prevention is the most effective strategy.

Additional complications of shingles include:

• Herpes zoster ophthalmicus — shingles affecting the eye, which can cause vision loss or blindness if untreated
• Ramsay Hunt Syndrome — a rare complication involving facial nerve paralysis and hearing loss
• Secondary bacterial skin infections
• Neurological complications in severe or immunocompromised cases

Shingles and Chronic Disease: A Relationship Worth Understanding

For patients with chronic conditions — diabetes, inflammatory bowel disease, rheumatoid arthritis, cancer, or conditions requiring long-term steroid or biologic therapy — shingles risk is elevated and complications tend to be more severe. Immunosuppressive medications directly increase the likelihood of viral reactivation, and the immune response to shingles may be more difficult to mount effectively.

This is why updated guidance from Canada’s National Advisory Committee on Immunization (NACI) now strongly recommends shingles vaccination for immunocompromised adults aged 18 and older — not just those over 50. If you or a family member is managing a condition that affects immune function, this is an important conversation to have with your physician.

Shingrix: The Vaccine That Works

Shingrix® (recombinant zoster vaccine, RZV) is the only shingles vaccine currently authorized in Canada. It is a non-live, two-dose vaccine — meaning it is safe for patients who are immunocompromised — with the two doses administered two to six months apart.

The evidence base for Shingrix is strong: clinical trials have demonstrated over 90% efficacy in preventing shingles in adults over 50, along with substantial reduction in PHN risk. Even in patients who go on to develop shingles despite vaccination, the illness tends to be less severe.

Shingrix is recommended for:

• All immunocompetent adults aged 50 and older
• All immunocompromised adults aged 18 and older (updated NACI recommendation, May 2025)

Side effects are common and reflect the vaccine’s strong immunogenic design: injection-site soreness, fatigue, muscle aches, and occasionally low-grade fever are typical and resolve within two to three days. Patients should be counselled to expect these reactions — they are a normal and temporary sign of an effective immune response.

If you have previously had shingles, vaccination is still recommended, generally about one year after the last episode. No booster doses are currently required beyond the initial two-dose series.

OHIP Coverage in Ontario

In Ontario, the Shingrix two-dose series is publicly funded under OHIP for adults aged 65 to 70 who have not previously received the publicly funded shingles vaccine.

For adults outside this age range:

• Those under 65 or over 70 are not currently covered under OHIP
• The vaccine is available privately, typically at approximately $150–$200 per dose
• Many private drug benefit plans provide partial or full coverage — patients are encouraged to check their plan before their appointment

Adults aged 50 to 64 are clinically recommended to be vaccinated, even though OHIP coverage does not begin until age 65. Your physician can help you understand your eligibility and navigate coverage options.

Your Family Physician as Your Prevention Partner

At Orleans Family Health Clinic, shingles vaccination is one component of a broader preventive care framework that we build with each of our rostered patients over time. Your family physician knows your health history, your medications, your chronic conditions, and your risk factors. That context matters when it comes to timing, eligibility, and ensuring that your vaccination fits safely within your overall care plan.

Preventive care — including adult immunization — is most effective when it’s embedded in an ongoing patient-physician relationship rather than handled in isolation. We encourage all patients aged 50 and older, and any patient with an immunocompromising condition, to raise shingles vaccination at their next appointment.

Health and happiness, hand in hand for families. That’s the commitment behind everything we do at Orleans Family Health Clinic. Shingles is preventable — and we’re here to help you stay ahead of it.

Visit orleansmedical.ca to learn more or to book an appointment.

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Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.