Shingles simulated.

What this shows

Risks can be hard to make sense of when they’re just numbers. This simulation makes the risk of shingles tangible by following 1,000 adults through life after 50, showing how many get shingles and how many have lasting nerve pain. It then re-rolls the dice as if all had been vaccinated. The Shingrix vaccine prevents most of both.

How it works

This is a Monte Carlo simulation: for each adult, we roll dice weighted by likelihood.

Getting shingles. An unvaccinated adult faces about a 33% lifetime risk, roughly one in three, per the CDC. The virus is the same one that causes chickenpox, reactivating decades later.

Nerve pain. About 15% of shingles cases progress to postherpetic neuralgia, nerve pain that can last months or years after the rash clears. It’s the complication most worth avoiding.

Two doses of Shingrix are about 90% effective at preventing shingles, blending the ZOE-50 and ZOE-70 trials, and they prevent the nerve pain along with the cases they stop.

Caveats. The model holds that 90% flat across the whole horizon, but protection is only proven to about ten years; how much longer it lasts isn’t known.