
Shingles came under the spotlight in Singapore when the government announced in February that subsidies will be extended for the vaccine. This came into force from 1 September 2025.
For those unaware, shingles is an infection that is most common among those aged over 50, and the likelihood of getting it increases with age.
When Kiki Law (not her real name) noticed a couple of blisters appearing above her lips in January this year, she chalked it up to pimples or allergies. She then found more blisters in her mouth but thought brushing her gum more thoroughly would solve the issue.
The next day, she felt a pain in her left ear and a frequent shooting pain from the left side of her neck to the top of her head. She never thought that this could be shingles.
I went to the polyclinic and was shocked when the doctor told me she could see blisters in my left ear and one sitting on my ear drum,
the 66-year-old recalls.
"She diagnosed me as having Ramsay Hunt syndrome, a form of shingles."
The shingles had affected the left side of Kiki’s head, on her ear and mouth. It took two weeks for the discomfort to subside and another two weeks “to feel myself again”, she reveals.
Advertisement
She didn’t know much about shingles before this, although she had heard stories from her mother and others from that generation about how shingles can be painful. However, she thought that shingles usually appears on the body or arms and never knew it could be present in the ears and mouth.
For Linda Giam, her experience with shingles began when she felt the nerves in her left leg tingling when she was out with friends. When she went home, she felt roughness on her buttocks while she was in the shower and later asked her husband to have a look. They concluded it was a rash.
She then went to the doctor the next morning, who confirmed it was shingles.
Although I developed a line of small blisters, I didn't feel any pain,
says the 78-year-old.
Linda was prescribed seven days of anti-virals and, by day four, the blisters had reduced in size. By week three, the blisters had healed and the scabs fell off soon after.
As the new skin grew in, she felt a burning sensation as well as a bit of an itch for two or three days. She applied a cream the doctor gave her to soothe the discomfort.
I didn't know about shingles before this and didn't know anyone who had it,
she says.
The link with chickenpox
Dr Zeng Shanyong from DTAP@Holland Village reveals that shingles is caused by the Varicella-Zoster Virus (VZV), the same virus that causes chickenpox.
After the initial primary infection, VZV goes into hibernation in the body. After many years, the latent virus can reactivate, leading to shingles,
he explains.
Symptoms include a burning pain, tingling feeling, or sensitivity in an area of skin a few days before the appearance of a rash, reveals Dr Choong Siew Li, family physician and associate consultant, National University Polyclinics.
Credit: National University Polyclinics
The rash develops into patches of blisters, usually appearing in a stripe or band on one side of the face, body, or limbs,
she adds.
“The rash usually starts to heal into a crusty surface within seven to 10 days and clears up within two to four weeks in most cases. Other accompanying symptoms can include fever, headache, or fatigue.”
A possible complication of shingles is persistent pain on areas of skin where the shingles rash occurred, lasting at least three months after the resolution of the rash, says Dr Choong. The risks for such persistent pain includes advanced age.
Sometimes the rash may affect and cause complications to the eyes or result in weakness on one side of the face,
she adds.
Credit: DTAP Clinic
Dr Zeng notes that shingles is normally a debilitating but not life-threatening condition.
However, if the patient is immunocompromised, disseminated zoster can happen, where the VZV can affect various organs, resulting in pneumonia, hepatitis, and even encephalitis. Consequences can be fatal.
Also read:
Debunking 6 Myths Of Ageing
Revealing the truths behind six myths of ageing, from sleep to sex.
Bipolar Disorder: Unmask The Complex Hidden Struggles That Go Beyond Mood Swings
Mental health experts expose the intricate layers of bipolar disorder, which affects 1 in 100 Singaporeans. Learn how to navigate relationships in the shadow of this invisible disability.
Risk of shingles increases with age
Shingles is more common among those above 50 years old because its activation is controlled by VZV-specific cell-mediated immunity, and studies have shown that cellular immunity to VZV decreases with age, says Dr Zeng.
Patients with a weakened immune system – for example, patients with HIV or transplant patients on immunosuppressant medications – also have reduced cell mediated immunity, accounting for the increased risk of shingles in this population,
he adds.
One myth surrounding shingles is that you will only get it if you’ve had chicken pox when you were younger.
Dr Zeng states that, even though this is true – as shingles is caused by a re-activation of dormant VZV infection in the body – you can still be at risk if you had a previous chickenpox vaccination.
This is because the varicella-zoster virus, whether from natural infection or vaccination, remains dormant in nerve tissues and can reactivate when the immune system weakens with age or due to certain medical conditions or medications,
says Dr Zeng.
Dr Choong points out that there is no cure for shingles, though early treatment with anti-viral medications can reduce its severity and duration. Therefore, it is beneficial to reduce the risk of shingles through proactive measures such as vaccination.
Shingles vaccination rebates
There is currently only one shingles vaccine, Shingrix, registered with the Health Sciences Authority in Singapore.
Credit: National University Polyclinics
Dr Franco Wong, family physician and senior consultant, National University Polyclinics, says this vaccine can help boost the body’s immunity against shingles activation.
It comes as a two-dose vaccination, scheduled two to six months apart,
Dr Wong elaborates.
"The vaccine has been shown to be highly effective in preventing shingles and the related nerve pain, which can be severe and long-lasting."
He adds that there may be injection site pain and fever, but they are self-limiting. This means that they will resolve on their own without any treatment.
Dr Zeng says shingles vaccination is indicated for anyone more than 50 years old and strongly recommended for patients aged over 60. Also, the vaccination is life-long, and there is no need for additional booster shots once the primary vaccination series is completed.
Even if you have had shingles, you should still consider vaccination as “an episode of shingles indicates the body’s immunity response is not as robust and the chances of subsequent shingles episodes is still present”, he adds.
If you’re aged 60 and over, expect to pay between $75 and $300 per course of Shingrix if you’re Singaporean, and around $450 per course if you’re a permanent resident. From 2026, MediSave can be used to pay for the cost of the vaccine after subsidies.
Find out more about the shingles subsidies here.