Experts warn that shingles is often underestimated, despite its potential to cause severe complications.

The viral infection can leave millions with debilitating pain, increases the risk of stroke, and leads to long-term nerve damage. Yet only about 34% of Americans have received at least one dose of the vaccine — the most effective way to protect against it.

According to the Centers for Disease Control and Prevention, one in three people will develop shingles in their lifetime, with risk rising after age 50 and in those with weakened immune systems.

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After recovery, the virus remains dormant in nerve tissue and can reactivate years later. Aging, stress, and weakened immunity can trigger this reactivation.

Many people are unaware of how serious shingles can be. In the short term, it typically causes a painful rash with blisters and itching, along with symptoms such as fever, headache, and fatigue. The pain can be intense and disruptive.

In some cases, pain continues long after the rash fades — a condition called postherpetic neuralgia (PHN), one of the most common and debilitating complications.

Long-term effects can include chronic nerve pain lasting months or years, as well as complications such as vision loss if the eyes are affected or hearing problems. Shingles has also been linked to an increased risk of stroke, particularly in older adults.

Marian Nicholson, director of the Shingles Support Society in the U.K., says the pain can be extreme. “The older you are, the more grueling it is,” she says. “PHN can leave patients in unendurable misery in the final years of their lives.”

She notes that while antiviral treatments can help reduce symptoms and lower the risk of PHN, some patients still suffer severe, persistent pain. In rare cases, nerve damage can also lead to a condition called pseudohernia, in which weakened muscles cause tissue to bulge.

Health officials stress that prevention is key. The Centers for Disease Control and Prevention (CDC) recommends that adults age 50 and older receive the shingles vaccine, Shingrix, even if they don’t remember having chickenpox. The vaccine is given in two doses, two to six months apart.

Vaccination significantly lowers the risk of shingles and its complications, including long-term nerve pain. Individuals with weakened immune systems or certain health conditions should consult their doctor about timing and eligibility.