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shingles awareness: how aging and chronic conditions increase risk of infection
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nearly one in three canadians develops shingles in their lifetime. the incidence and severity increases sharply after age 50.
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anyone with a chronic disease or compromised immune system is at higher risk for shingles—although there’s an alarming lack of awareness about it. a new survey of canadians 50-plus living with a chronic condition found that 77 per cent fear disruption to daily life from shingles, yet nearly half (46 per cent) say they have never discussed shingles with their health-care professional.
is it dangerous? it can be, yes.
what is shingles?
shingles is a viral infection that causes a painful rash that looks like a strip of blisters on your face or body. it comes from the varicella-zoster virus, the same virus that causes chickenpox. and if you’ve had chickenpox, the virus stays dormant in your body and can resurface many years later as shingles. a compromised immune system that occurs with aging or a chronic condition like diabetes, arthritis or hypertension, for example, increases the risk and severity of shingles.
dr. jeremy gilbert, an endocrinologist at toronto’s sunnybrook health sciences centre specializing in chronic diabetes management, shingles incidence and risks, says that people need to be aware of the risk and protect themselves.
“shingles presents usually as a rash in one area, often on the face or abdomen or chest or back, and it can be a very painful rash, so like a burning sensation,” he says. “but it can lead to a complication of shingles. so if it affects the eye, that’s a complication. the most common complication is something called phn or postherpetic neuralgia, which is basically that area, even when the rash clears, is still extremely painful and that can go for weeks, months to years. and it’s very debilitating, like rip-roaring pain, can’t work, can’t function, nasty stuff.”
singer justin bieber, for example, had a complication of shingles linked to infection of some of the nerves on his face—so there are a lot of things that can happen, none of them pleasant to live with.
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there’s also mounting evidence linking heart disease and stroke, leading causes of death, to shingles. a large harvard-led study published in 2022 by the journal of the american heart association revealed that people who’ve had shingles have a higher long-term risk of developing a major cardiovascular problem compared to study participants who didn’t have shingles. the elevated risk for stroke persisted for 12 years or longer after the shingles episode.
so no, no one wants to get shingles.
how many people get shingles?
nearly one in three canadians develops shingles in their lifetime. the incidence and severity increase sharply after age 50.
further to the health impact, an ontario retrospective study revealed that having heart disease increased a person’s chances of getting shingles by 15 per cent. among those who had two or more chronic conditions, including cardiovascular disease, asthma, diabetes or chronic obstructive pulmonary disease, the risk of shingles increased by up to 27 per cent. the data showed the elevated rate of shingles among cardiovascular disease patients was most pronounced in people aged 65 and older, which is consistent with immunosenescence, the natural weakening of the immune system over time that compromises the ability of older adults to fight off infections. the study findings were presented at the october 2025 canadian cardiovascular congress in quebec city.
dr. gilbert’s messaging is also for health-care providers, including specialists, to be informed and talk about shingles with their patients.
“the reason why specialists need to know about this is it’s not just diabetes, but it’s any chronic disease state, so lung doctors with the emphysema patients and the kidney doctors with chronic kidney disease and the cardiologists with heart failure,” he explains. if these patients get shingles, their course of shingles can be far worse: they’re more likely to be hospitalized, they’re more likely to get the complications of shingles and it makes their chronic condition worse.
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shingles comes with significant morbidity and mortality, he notes, “which you don’t think about. it’s a rash. you don’t equate that. but we know diabetes is a risk factor for heart disease. kidney disease is a risk factor for heart disease. getting shingles now becomes a risk factor for heart disease.”
while specialists have a long list of concerns to monitor for patients, he says addressing shingles is important. half the patients in his practice who get shingles end up with the dreaded postherpetic neuralgia.
“this pain syndrome is really debilitating. these are people who are often on multiple types of treatments, like neurological pain medications, tylenols, advils, gabapentins and maybe even opioids as well.”
shingles vaccine is ‘extremely effective’
the critical piece here is that shingles is a preventable condition with a vaccine that is “extremely effective, very well tolerated, two doses and done,” he says. shingles can happen to healthy adults as well, so get vaccinated.
the vaccination is recommended for people aged 50 and older, but those who are younger with chronic conditions should also discuss vaccination with a health-care provider. there is no recommendation for booster doses.
as dr. gilbert points out, taking action to get vaccinated is “something you can actually do as opposed to just saying too bad” after getting shingles and living with the outcome.
while some private insurance covers the cost of the two-dose vaccination, public health coverage differs across the country. the vaccine is available free of charge for seniors aged 65 to 70 in ontario. to find out more about vaccination coverage, check with your local health authority or insurance provider.
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