Get the shingles vaccine after 50

Moderate value
Evidence A
Buys life
For: Elderly relative at home, Age 35+
Costs a lot
Takes minutes
No willpower

In plain words

In a phase 3 trial, this vaccine blocked 97% of shingles, about the same across age groups. The drawback is 3000 to 4000 CNY for 2 doses, entirely out of pocket. What that money buys is a 97% reduction in cases.

Cost: The recombinant shingles vaccine takes 2 doses, about 3000 to 4000 CNY in all. You pay all of it yourself.
What you get: A phase 3 trial across 18 countries enrolled 15,400 (1.54万) people. People were randomized into two groups, one getting the vaccine and one a control shot, and followed for 3.2 years on average. The result was 6 cases of shingles in the vaccine group and 210 in the placebo group. That works out to 0.3 versus 9.1 per 1000 person-years, where a person-year means 1000 people observed for a year. The paper states: “overall vaccine efficacy against herpes zoster was 97.2% (95% CI 93.7–99.0, P<0.001).” Efficacy in the individual age groups ranged from 96.6% to 97.9%.
Notes: It ranks low on value because it is expensive. Shingles itself rarely kills; the trouble is postherpetic neuralgia, which can hurt for months to years. After the shot, the shares with pain at the injection site and fever are not low. For the most severe level (grade 3 symptoms) it was 17.0% versus 3.2%.
Evidence grade: A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources: Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. https://doi.org/10.1056/NEJMoa1501184

Mentioned in

Don't spend big on supplements, herbal tonic pastes (膏方) or tonic products to “balance the body”

Translated from the Chinese original. Original book, section 1, tip 21. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer