The number of older adults with chronic illnesses who develop shingles is increasing, highlighting the need for vaccination against shingles.
India is at a major epidemiological transition. Chronic diseases are rapidly increasing due to a combination of genetic, physiological, environmental, and behavioral factors. From middle age onwards, non-communicable diseases emerge as major health challenges. Currently, almost 75% of older adults have at least one chronic disease and approximately 23% have multiple comorbidities.
People living with chronic illnesses often have weakened immune systems. Persistent inflammation, metabolic stress, long-term treatment for diseases such as cancer, and the use of immunosuppressive drugs such as corticosteroids can weaken immune defenses, making it harder for the body to fight infections that are easily overcome in healthy people. This vulnerability is further exacerbated in older adults, as the risk, frequency, and severity of infections increase with age.
What is shingles?
Among the infectious diseases that elderly people with chronic illnesses need to be especially careful of is herpes zoster. Because shingles can be painful, confusing, and debilitating, and can seriously impact your quality of life. In recent years, the incidence of this disease has been increasing worldwide as the population ages. It is caused by the shingles virus, the same virus that causes chickenpox. After you recover from chickenpox, the virus remains latent in your body and is suppressed by your immune system. When your immune system weakens due to aging or chronic illness, the virus can reactivate and cause shingles.
What is bilateral shingles?
There is a bidirectional relationship between shingles and chronic disease. People with chronic illnesses are more susceptible to shingles and its complications. One of the most serious complications of shingles is postherpetic neuralgia (PHN). This persistent nerve pain can last for months or even years, making daily life difficult and affecting sleep, mobility, and mental health.
On the other hand, shingles can worsen existing chronic conditions, leading to complications and disease progression. A study published in the Journal of the American Heart Association shows that shingles is associated with an increased risk of stroke and serious cardiac events. This is because it releases chemicals that cause intense inflammation in the body and irritate blood vessels. This stimulation weakens fatty plaques in the arteries, which can lead to artery rupture. When this happens, blood clots can form, which can lead to serious problems such as heart attack or stroke.
How many people get shingles in India?
More than 75 million elderly people in India have at least one chronic disease, which puts them at higher risk of getting shingles, according to the India Center for Vaccination. Despite the risks, awareness of this condition, its impact, and conversations about prevention remain low. This gap was recently highlighted by the 2026 India Shingles Behavior Survey.
The survey found that nearly one in three adults over age 50 with a chronic illness could not explain why their symptoms increased their risk of getting shingles, and 24% reported knowing little or nothing about the disease. 48% have never talked to a doctor about shingles. Awareness is particularly low among people living with diabetes (24%) and cardiovascular disease (18%), who are the least likely groups to have discussed shingles with their doctor.
Is there no cure for shingles?
There is no fundamental cure for shingles, but it can be prevented. Vaccination serves as an effective preventive measure against shingles. Vaccinations can help the body fight infections such as shingles by strengthening a weakened immune system. Shingles can cause complications that extend far beyond a skin rash in people with chronic illnesses, which makes prevention extremely important.
Given the increasing burden of chronic disease and the clear risks, prevention of shingles should become part of routine care. Older adults and people with chronic health conditions are encouraged to consult their doctors about their personal risks and available precautions.
