Can You Get Shingles If You’ve Never Had Chickenpox?

You might remember having the itchy rash from chickenpox when you were a young kid. However, chickenpox vaccination has made this infection much less common. 

The varicella-zoster virus, or VZV, causes chickenpox. After your body fights off the initial infection, the virus hides in the body’s nerves. It can later reactivate and cause a painful rash called herpes zoster or shingles.

So, can you get shingles if you’ve never had chickenpox? Let’s look at shingles versus chickenpox and what happens when you get these infections. 

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• Can you get shingles more than once? Yes, find out if you’re at risk for repeat shingles outbreaks.

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• What does shingles look like? Take a look at pictures of what shingles looks on different parts of the body.

Can people who’ve never had chickenpox get shingles?

Technically no — you can’t get shingles if you’ve never had chickenpox. 

Shingles is a reactivation of the varicella-zoster virus (VZV). So, if you’ve never been exposed to VZV, you can’t develop shingles later in life.

But there’s a way you can get exposed to VZV and not develop chickenpox — through a chickenpox vaccine. 

Chickenpox vaccination

The chickenpox vaccine, Varivax, is a live vaccine. It’s very effective and lowers the risk of developing chickenpox by 90%. But people who get the chickenpox vaccine can still develop shingles later in life, even if they never got chickenpox.

After you receive a chickenpox vaccine, the virus in the vaccine can replicate in the skin where you get the injection and travel to your nerves. Once the virus gets to your nerves, it can hide from the immune system and reactivate later on, causing shingles. This is how the “natural” VZV behaves, too. 

So, the vaccine virus can lead to shingles. However, experts note that this process isn’t common. That’s because the virus in the vaccine isn’t as strong as “natural” VZV. In fact, the virus in the vaccine is five times less likely to lead to shingles than the “natural” VZV.

Mild chickenpox illness

It’s also worth pointing out that some people who get exposed to the varicella-zoster virus for the first time develop very mild illness. 

These people have such mild symptoms that they don’t realize they are sick. They may be shocked when they develop shingles later in life because they didn’t realize they ever had chickenpox. But, in fact, they did have chickenpox and can develop shingles later on. Experts note that this situation isn’t common. 

What’s the difference between shingles and chickenpox?

VZV causes both shingles and chickenpox. 

Chickenpox is the illness that develops when you have an infection with VZV for the first time.  After your immune system fights off the infection, the virus can go into hiding in the nerves in your body. That’s a dormant virus — like a bear going into hibernation.

When VZV wakes up or reactivates, it causes shingles. 

How do you know if you have chickenpox or shingles?

While caused by the same virus, chickenpox and shingles are two illnesses that lead to different symptoms and look different. 

Chickenpox infection causes the following symptoms:

• First, people experience several days of fever.

• Then a rash starts as clusters of itchy blisters. 

• The blisters spread all over the body.

• The blisters pop and scab over in 5 to 10 days.

• The rash heals and fades as the immune system fights off the virus.

Here are some pictures of how chickenpox looks like in the skin.

Chickenpox blisters are filled with fluid.

Chickenpox bumps and blisters cover a person’s back.

Shingles infection causes different symptoms:

• First, people develop tingling or burning in one part of the body for a few days. Along with that, they may experience headaches, fever, and chills.

• Then a rash starts as clusters of bumps along the skin where people felt the tingling or burning.

• The bumps develop into blisters. Blisters are painful instead of itchy. 

• The blisters pop and scab over in 5 to 10 days

• The rash heals and fades as the immune system fights off the virus.

Here are some pictures of how shingles looks like. 

Grouped blisters caused by shingles is one of the symptoms of the infection.

A shingles outbreak only affects one part of the skin.

Get medical care if you think you have shingles. There are treatments that can help your body recover faster and ease symptoms. But these medications work best if started early. So it’s best to check with your primary care provider if you think you have early shingles symptoms or an early shingles rash.

What happens if you get exposed to chickenpox?

If you’re around someone with chickenpox, you may need to take action to prevent yourself from getting sick. Here’s what to do if:

You’ve never had chickenpox and aren’t vaccinated against chickenpox

You have up to a 90% chance of getting sick with VZV and developing chickenpox. This includes adults and children. You should get medical care if you’re in this category. You may need treatment so you don’t get sick. Young children, older adults, and people with weakened immune systems are at highest risk for severe illness. But even adults with no chronic medical conditions can get very sick from chickenpox.

You’ve never had chickenpox but you received a chickenpox vaccine

You’re in the clear if you received two doses of the chickenpox vaccine. You don’t need any treatment if you’re exposed to chickenpox. Studies show that 98% of vaccinated people will not get sick if they’re exposed to chickenpox. Get medical care if you only received one dose of the chickenpox vaccine. You may need treatment since you’re not completely immunized.

You’ve had chickenpox in the past

You’re in the clear if you’ve had chickenpox. You don’t need any special treatment. 

What happens if you get exposed to shingles?

You can’t get shingles from someone with shingles. But, you can get VZV.

If you’re around someone with shingles, you may need to take action to prevent yourself from getting sick. Here’s what to do if:

You’ve never had chickenpox and aren’t vaccinated against chickenpox

You can develop chickenpox if you’re around someone with shingles. People with shingles don’t spread VZV as easily as people with chickenpox. But experts still recommend that people who don’t have immunity to VZV receive treatment to protect them from VZV. Get medical care if you’re in this category.

You’ve never had chickenpox but you got a chickenpox vaccine 

You’re in the clear if you received two doses of a chickenpox vaccine. Your chances of getting sick are less than 2%. You don’t need any special treatment. Get medical care if you only received one dose of the chickenpox vaccine. You may need treatment to protect you against VZV since you’re not completely immunized.

You’ve already had chickenpox

You’re in the clear if you’ve had chickenpox. You don’t need any special treatment. 

Can you prevent chickenpox and shingles?

Yes, there are safe and effective vaccines that can keep you from getting sick with chickenpox and shingles.

Chickenpox (varicella) vaccine

Experts recommend that everyone receive two doses of the chickenpox vaccine. Children typically get their first dose between 12 and 15 months old and their second dose between 4 and 6 years old. 

Older children and adults should receive two doses of the chickenpox vaccine if they weren’t vaccinated as young children. You can get the doses 4 to 8 weeks apart. 

Shingles (herpes zoster) vaccine

Experts recommend two doses of the shingles vaccine for everyone over 50 years old. Experts also recommend the shingles vaccine for people over 19 years old who have a weakened immune system. 

You should get the shingles vaccine even if:

• You’ve never had chickenpox (or don’t remember having chickenpox).

• You got vaccinated against chickenpox. 

• You already had an episode of shingles.

You get the doses 2 to 6 months apart. Protection from the shingles vaccine lasts up to 10 years. 

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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