On the NHS, the shingles vaccine is offered to everyone turning 65, everyone aged 70 to 79, and adults aged 18 and over with a severely weakened immune system, which can include people on certain medicines that strongly suppress the immune system. It is given as 2 doses. The NHS says the non-live shingles vaccine is safe to have while you take prednisolone. Ask your GP surgery or rheumatology team whether you are eligible, and get vaccinated even if you have had shingles before.
Shingles is more likely, and more likely to cause serious problems, as you get older or if your immune system is weakened. Many arthritis treatments work by calming the immune system, so this is a vaccine worth asking about. This guide covers who is eligible, how arthritis medicines fit in and what to do if you think you have shingles. For the full winter picture, see our vaccines on DMARDs and biologics guide.
Who can get the shingles vaccine on the NHS
The NHS in England offers the shingles vaccine to:
- people turning 65 on or after 1 September 2023 (if you turned 65 before that date, you become eligible at 70)
- everyone aged 70 to 79 who has not had it yet
- adults aged 18 and over with a severely weakened immune system, which the NHS says includes people taking certain medicines that severely weaken the immune system
The age-based offer lasts until your 80th birthday (you can have the second dose until your 81st). Only people with a severely weakened immune system can start the vaccine after 80. Scotland, Wales and Northern Ireland run similar programmes, so check with your GP surgery about the details where you live.
Do my arthritis medicines make me eligible?
Possibly. Whether your treatment counts as "severely weakened" depends on the medicine, the dose and how long you have taken it, and only your GP or rheumatology team can confirm it. Ask them directly if you take:
- steroid tablets such as prednisolone, especially at higher doses or for a long time
- DMARDs such as methotrexate, leflunomide or azathioprine
- biologics or JAK inhibitors
- a combination of these
If you are about to start a medicine that suppresses the immune system, ask whether it would be better to have the vaccine first. If you were vaccinated in the past but now have a severely weakened immune system, the NHS says you may need it again.
Is it safe with my medicines?
- The NHS shingles vaccine is a non-live vaccine. The NHS says non-live vaccines, including the shingles vaccine, are safe to have while you take prednisolone
- Always tell the nurse or pharmacist which arthritis medicines you take before any vaccine
- Do not stop or pause your arthritis medicines to have a vaccine unless your own team tells you to
- You can usually have the shingles vaccine at the same time as the flu, COVID-19 and pneumococcal vaccines. See our flu jab guide
How the vaccine is given
- 2 doses. For age-based eligibility, they are given 6 to 12 months apart
- For a severely weakened immune system, they are given 8 weeks to 6 months apart
- Your GP surgery will usually contact you by letter, text, phone or email. If you think you are eligible and have not heard, contact them
- If you have a high temperature or feel too unwell for normal activities on the day, wait until you feel better
The NHS says most side effects are mild and settle within 2 or 3 days: a sore, swollen or bruised arm, headache, aching, tiredness, a temperature or shivers. Paracetamol and resting the arm usually help. If your joints ache for a day or two, keep gently moving them as you normally would.
If you think you have shingles
The first signs can be a tingling or painful patch of skin, a headache or feeling generally unwell. A rash of blotches usually appears a few days later, on one side of the body. It turns into itchy blisters that scab.
- See a pharmacist as soon as possible, ideally within 3 days of the rash appearing. Antiviral medicine works best when started early
- Ask for an urgent GP appointment or contact NHS 111 if the rash is on your eye or nose, your vision changes, or you have a severely weakened immune system, which can include strong arthritis medicines
- Tell whoever treats you which arthritis medicines you take, and do not stop them yourself
- Keep the rash clean, dry and loosely covered, and use a cool compress. While the rash is weeping, avoid pregnant people who have not had chickenpox, people with a weakened immune system and newborn babies
Pain can last for weeks after the rash heals, and sometimes for months (post-herpetic neuralgia). If that happens, ask your GP about nerve pain treatment rather than adding more painkillers yourself. Our painkillers guide explains the options.
Frequently asked questions
I have already had shingles. Do I still need the vaccine?
Yes. The NHS says you can get shingles more than once, so it is important to be vaccinated even if you have had it before.
Will the vaccine cause a flare of my arthritis?
Some people feel achy for a couple of days after any vaccine. That is different from a flare. If joint swelling or stiffness lasts longer than a few days, contact your GP or rheumatology advice line. Our flare-up guide helps you tell the difference.
I am over 80. Can I still have it?
Only if you have a severely weakened immune system. Ask your GP or rheumatology team whether that applies to you.
When to get urgent help
Call 999 or go to A&E if someone becomes suddenly confused, struggles to breathe or has signs of sepsis such as blotchy or blue skin or a rash that does not fade when pressed. If you take steroids, our steroids and infection guide lists the signs to act on. For a cough that will not settle, see our chest infection guide.
Sources and further reading
- NHS: Shingles vaccine
- NHS: Shingles
- NHS: Common questions about prednisolone (vaccines)
- NHS: Taking methotrexate with other medicines
- NHS: Rheumatoid arthritis treatment
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Vaccines on DMARDs and biologics — live and non-live vaccines
- Flu jab and arthritis — free NHS eligibility
- Winter viruses and arthritis medicines — a sick-day plan
- Steroids and infection — what to watch for
- Rheumatoid arthritis — condition hub
- Painkillers and NSAIDs — safer pain relief
- Chest infections and arthritis — self-care and warning signs
- Flare-up guide — flare or something more serious