Shingles is a viral infection that causes a painful rash. It develops when the varicella zoster virus (the virus that causes chickenpox) becomes reactivated later in life. The risk of shingles and its complications increases with age and is high in people who are immunosuppressed. In people with Crohn’s or Colitis, this risk is higher in people taking a janus kinase (JAK) inhibitor compared with biologics.
The best way to reduce your risk of complications from shingles is to get vaccinated.
Who can have the shingles vaccine?
From 1 September 2025, anyone aged 18 years or older who is immunosuppressed will be eligible for the shingles vaccine. This includes people with Crohn’s or Colitis who are taking:
- Targeted therapy, such as a JAK inhibitor or biologic (or have taken one in the last 3 months).
- JAK inhibitors include filgotinib, tofacitinib and upadicitinib
- Biologics include anti-TNF medicines (such as adalimumab, infliximab and golimumab), guselkumab, mirikizumab, risankizumab and ustekinumab
- Other targeted medicines include etrasimod and ozanimod
- Moderate to high-dose steroids. That is equal to 20mg or more of prednisolone each day for more than 10 days in the previous month.
- Long-term medium-dose steroids. That is equal to 10mg or more of prednisolone each day for more than 4 weeks in the previous 3 months.
- Higher doses of non-biologics such as: methotrexate (more than 20mg per week), azathioprine (more than 3mg per kg per day) or mercaptopurine (more than 1.5mg per kg per day). These doses are higher than those usually used in Crohn's and Colitis.
- Certain combinations of medicines at doses lower than those above.
If you are taking vedolizumab your risk from shingles is low. If you have other risk factors, such as you have previously taken an anti-TNF medicine or you are also taking a steroid your risk may be higher. Check with your IBD team if you think you should get the shingles vaccine.
People who are about to start treatment with one of these immunosuppressants might also be eligible for the vaccine. If so, they should have the vaccine as soon as possible, and at least 14 days before starting the immunosuppressant.
How, when, and where is the vaccine given?
Shingrix is a non-live vaccine. This means it is safe to have if you are taking an immunosuppressant.
Adults should receive two doses of the Shingrix vaccine. The second dose is given 8 weeks to 6 months after the first dose in people who are immunosuppressed.
The Shingrix vaccine is given by injection into a muscle, usually in the upper arm.
Shingles is not seasonal (like the flu) and the vaccine can be given at any time of the year. It can also be given at the same time as the flu vaccine.
If you are eligible, the shingles vaccine should be available free of charge through your GP surgery or vaccination clinic. The NHS or your GP should contact you to offer you the shingles vaccine. How you get your vaccine may vary across the four nations.
