A large U.S. study suggests the shingles vaccine may do more than prevent a painful rash. In adults with heart disease, vaccination was linked to sharply lower rates of heart attacks, strokes and death.
A routine shot to prevent a painful rash may also offer powerful protection for the heart.
Adults with atherosclerotic heart disease who received a shingles vaccine had nearly half the rate of serious cardiac events in the following year compared with similar patients who were not vaccinated, according to new research being presented at the American College of Cardiology’s Annual Scientific Session (ACC.26).
The study analyzed health records from more than 246,000 U.S. adults age 50 and older with atherosclerotic cardiovascular disease, a condition caused by plaque buildup in the arteries that can lead to heart attacks and strokes. Researchers compared 123,411 people who had received at least one dose of a shingles vaccine with an equal number who had not been vaccinated, matching the groups so they were similar in age, demographics and other health conditions.
Lead author Robert Nguyen, a resident physician at the University of California, Riverside, noted the findings reinforce a growing body of evidence that a vaccine designed to prevent shingles may also help protect the heart.
“This vaccine has been found over and over again to have cardioprotective effects for reducing heart attack, stroke and death,” Nguyen said in a news release. “Looking at the highest risk population, those with existing cardiovascular disease, these protective effects might be even greater than among the general public.”
Shingles, or herpes zoster, occurs when the virus that causes chickenpox reactivates years later, triggering a blistering, often excruciating rash. The Centers for Disease Control and Prevention recommends the shingles vaccine for all adults 50 and older, as well as some younger adults with weakened immune systems, to prevent the infection and its potential for long-term nerve pain.
But shingles can have consequences beyond the skin. Previous studies suggest that a shingles infection can spur inflammation and blood clot formation around the brain and heart, raising the risk of heart attacks, strokes and venous thromboembolism, a dangerous clot in the veins. By preventing shingles in the first place, the vaccine is thought to reduce those downstream risks.
To test that idea in a high-risk group, Nguyen and colleagues used TriNetX, a large database of electronic health records from millions of Americans. They identified adults 50 and older with documented atherosclerotic cardiovascular disease between 2018 and 2025, then divided them into two groups: those who had received at least one dose of the Shingrix or Zostavax shingles vaccine, and those who had never received a shingles shot.
The team then tracked major cardiac outcomes that occurred between one month and one year after vaccination for the first group, and over the same time frame for matched individuals in the unvaccinated group.
Across the board, vaccinated patients fared better.
Those who received a shingles vaccine were 46% less likely to experience any major adverse cardiac event in that period and 66% less likely to die from any cause. They were also 32% less likely to have a heart attack, 25% less likely to have a stroke and 25% less likely to develop heart failure.
Nguyen noted the level of risk reduction is substantial and comparable to what might be expected from a major lifestyle change, such as quitting smoking. The results, he added, support existing recommendations that all adults over 50 get vaccinated against shingles, especially those already living with heart disease.
For clinicians and public health officials, the findings add a new dimension to conversations about vaccines, which are often framed narrowly around infection control.
“Vaccines are one of the most important medicines we have to prevent disease,” Nguyen added. “Sometimes patients are unsure about whether they should get a vaccine or not, particularly in an age of disinformation. These results provide another reason for them to elect to get the vaccine.”
The study does have limitations. It looked only at outcomes during the first year after vaccination, so it cannot say how long any heart-protective effects might last over a lifetime. Earlier research in a healthier general population suggested that shingles vaccination was associated with a 23% lower risk of cardiovascular events and that benefits could extend for up to eight years, but the new analysis focused specifically on people who already had cardiovascular disease.
Another challenge is teasing apart the effect of the vaccine itself from the characteristics of people who choose to get vaccinated. Individuals who keep up with recommended shots may also be more likely to exercise, eat well, take medications as prescribed and have better access to health care. The researchers adjusted for some health behaviors and socioeconomic factors, including housing and economic stability, social environment, employment, education and literacy, but they acknowledge that the study may still overestimate the benefits that are independently due to preventing shingles infections.
Even so, the large sample size and statistical methods used give the team confidence that shingles vaccination is associated with a meaningful reduction in cardiovascular risk for people with atherosclerotic disease.
Nguyen will present the study, titled “Herpes Zoster Vaccination and Risk of Cardiovascular Events in Patients with Atherosclerotic Cardiovascular Disease,” on March 30 in New Orleans, where ACC.26 is bringing together cardiologists and cardiovascular specialists from around the world.
For patients and families, the message is straightforward: a recommended vaccine that already guards against a painful viral illness may also help protect one of the body’s most vital organs.
As researchers continue to explore how infections and immunity intersect with heart health, shingles vaccination is emerging not just as a way to avoid a rash, but as a potential tool in the broader effort to prevent heart attacks, strokes and premature death in older adults.
Source: American College of Cardiology