Shingles vs. Mpox: Symptoms, Differences, and How to Tell Them Apart
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Shingles and Mpox (or monkeypox) can both cause painful rashes and blisters, but they are caused by different viruses and spread in different ways. Confusion between the two conditions increased during the 2022 Mpox outbreak because both can cause rashes and blisters.
Shingles is caused by reactivation of the varicella-zoster virus, while Mpox is caused by the Mpox virus. Shingles usually causes a localized, painful rash on one side of the body, while Mpox can cause a more widespread rash along with symptoms such as fever and swollen lymph nodes.
Knowing the differences can help you understand what symptoms to watch for and when to contact a health care provider.
What is shingles?
Shingles (herpes zoster) is a viral infection caused by the varicella-zoster virus. That’s right—this is the same virus that causes chickenpox. If you had chickenpox as a child (most of us born before 1980 have), the varicella-zoster virus stays “asleep” deep within your nerve tissues. It can then reactivate years later due to age-related changes in your immune system or a health condition that makes your body less able to fight off infections. The result is an episode of shingles that lasts anywhere from three to five weeks.
What are the symptoms of shingles?
One common and notorious symptom of shingles is a painful, blistery rash that erupts on one side of the torso (or in some cases, the neck or face) and crusts over within a few weeks. Before the rash appears, early signs of shingles include a tingling, itching, or burning sensation in the affected area.
Other symptoms of shingles may include:
- Fever/chills
- Headache
- Fatigue
- Upset stomach
After a shingles rash clears, some people are left with long-lasting nerve pain in the same area. This is called postherpetic neuralgia (PHN), which is the most common complication after shingles. Pain from PHN can feel like burning, stabbing, throbbing, or heightened sensitivity—even from light touch or clothing.
Who is at high risk of getting shingles?
Shingles is more common in adults age 50 and older, since our immune system works less efficiently as we age. Other risk factors that can trigger an episode of shingles include chronic or extreme stress, certain medications, and medical conditions that compromise the immune system.
William Schaffner, MD is a Vanderbilt University professor and spokesperson for the Infectious Diseases Society of America. “With increasing age, you have an increasing occurrence of shingles,” he told Everyday Health. “If you’re lucky enough to reach 80 years of age, you have somewhere between a one-third to one-half chance of having had shingles by that time if you haven’t been vaccinated.”
Laarni San Juan was 53 when she developed what she thought was a pimple on her face. It turned out to be the early signs of a shingles rash. She thought she'd be back to normal within a few days or weeks—but nine months later, her face was still irritated and red.
More than a year after her shingles outbreak, San Juan has scarring and a left eye that droops slightly. "To think this all could have been prevented by the shingles vaccine—which is recommended by the CDC for people 50 and over—infuriates me," she told Healthy Women. "I never thought I’d be an advocate for a vaccine, but now I find myself spreading awareness about shingles at every opportunity I get, and am also part of a study on shingles."
Is shingles contagious?
Shingles itself is not contagious. But, the varicella-zoster virus can spread to someone who has never had chickenpox, causing them to develop chickenpox rather than shingles. The main way the shingles virus is spread is through direct contact with the fluid from the rash blisters. It can also be transmitted when someone breathes in virus particles from the blisters of a person with an active case of shingles.
How do you avoid getting shingles?
Getting the shingles vaccine (Shingrix) is the best, most effective way to reduce your risk of developing shingles and its complications. For healthy adults age 50 and older (even those who have already had shingles), the Centers for Disease Control and Prevention (CDC) recommends two doses of Shingrix separated by two to six months. According to CDC research, Shingrix was 97% effective in preventing shingles in adults age 50 to 69 with healthy immune systems. In people age 70 and older, the vaccine was 91% effective.1
“As an infectious disease physician, nothing excites me more than to have a vaccine that could prevent something I know could have some consequences and could be very painful,” Sabrina Assoumou, MD, MPH, an infectious disease doctor at Boston Medical Center, told SELF.
Scientists have discovered another compelling reason to get your shingles shot—it may have cognitive benefits. A 2026 study added to the growing body of evidence linking shingles vaccination with a reduced dementia risk. Older adults who received the shingles vaccine after entering a nursing home were 24% less likely to be diagnosed with dementia over the next four years than unvaccinated peers.2 Dementia is an umbrella term for a set of debilitating cognitive symptoms affecting more than 57 million people around the world. This discovery suggests the shingles vaccine components could potentially hold the key to more effective dementia treatments and prevention.
What’s more, getting vaccinated against shingles may be good for your heart. Recent research revealed that adults with heart disease who received the shingles vaccine had almost half the risk of serious heart-related events over the next year compared with those who remained unvaccinated.3
Study findings published this year also showed evidence the shingles vaccine may slow the biological aging process.4
What is Mpox (monkeypox)? And is it similar to smallpox?
Monkeypox (Mpox) is a rare disease commonly found in Central and West Africa, where it’s endemic (occurs regularly). This disease is caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Monkeypox has symptoms similar to smallpox, but those symptoms are less severe—and the fatality rate for monkeypox is much lower.
While monkeypox was initially discovered in monkeys, recent outbreaks of the disease have shown us it can be spread from animals to humans. There are two types of Mpox: Clade I, which has historically caused higher rates of severe disease, and Clade II. Clade II is a highly survivable (99.9%) type of monkeypox that was responsible for the 2022 global outbreak.
What are the symptoms of monkeypox (Mpox)?
People with monkeypox often start off having flu-like symptoms that include:
- Fever and chills
- Fatigue
- Headache
- Muscle aches
- Swollen lymph nodes
- Respiratory symptoms
Symptoms may then progress to a skin rash that appears as flat red spots on the face, hands, feet, or genitals. These spots evolve into fluid-filled blisters, which eventually scab over, similar to shingles rash blisters.
How is monkeypox (Mpox) spread?
Monkeypox (both types) can be spread from the time symptoms begin until the rash is fully healed. It spreads mainly through:
- Close contact with an infected person’s rash, scabs, or bodily fluids (including through sexual contact)
- Touching contaminated objects, such as clothing or bed linens
- Direct contact with infected animals (in rare cases)
How can Mpox be prevented?
The primary vaccine used to prevent Mpox is the same one used to prevent smallpox. It’s called JYNNEOS, an FDA-approved, two-dose series administered 4 weeks apart. While JYNNEOS is not advised for the general public, it’s recommended for people at higher risk for monkeypox, such as health care/emergency response professionals or people exposed to confirmed cases. JYNNEOS can be given before potential exposure or after known exposure to the disease.
Other steps to prevent monkeypox include avoiding close contact with infected people, practicing safe sex, and good hygiene habits.
Shingles vs Mpox: What's the difference?
Shingles and Mpox are different viral infections, even though both can cause a rash or blisters. Here's how they compare.
| Differences | Shingles | Mpox |
| What causes it? | Reactivation of the varicella-zoster virus, which remains dormant in people who’ve had chickenpox | Caused by the monkeypox virus, unrelated to chickenpox or shingles |
| What does the rash look like? | Usually a painful, localized rash on one side of the body | Rash or lesions that can appear on the face, hands, feet, mouth, or genitals |
| Other symptoms | Pain, burning, tingling, itching, fever, headache, fatigue, or upset stomach | Fever, chills, fatigue, headache, muscle aches, swollen lymph nodes, and respiratory symptoms |
| How does it spread? | Not directly contagious, but the varicella-zoster virus can spread to someone who has never had chickenpox, causing them to develop chickenpox instead shingles | Spread through close contact with an infected person or a contaminated object or surface |
| Who is at most risk? | Primarily affects older adults (age 50+) or people with compromised immune systems | Can affect anyone of any age, but outbreaks often involve settings where people are in close contact |
| How can you prevent it? | Shingrix vaccination and avoiding contact with an active shingles rash | JYNNEOS vaccination for people at higher risk and avoiding close contact with infected people |
| What should you do if you have symptoms? |
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Can you tell the difference between a shingles rash and an Mpox rash?
Sometimes, but you shouldn't try to diagnose either condition based on the rash alone. Shingles typically causes a painful, localized rash on one side of the body, while Mpox can cause lesions in multiple areas and is often accompanied by symptoms such as fever and swollen lymph nodes. Because symptoms can overlap, contact a health care provider if you're concerned about a new or unexplained rash.
Preventing shingles should be a priority for older adults
“It’s not always easy to tell shingles and monkeypox apart,” said Dorothea Vafiadis, NCOA Senior Strategist for Healthy Aging. “A red, bumpy, and often painful skin rash can happen with both conditions, as well as flu-like symptoms. But the fact is these are two very distinct illnesses that are prevented and treated in different ways.”
If you’re 50 or older, preventing shingles should be at the top of your priority list—since the benefits of the vaccine far outweigh the minimal risks. Plus, unlike an annual flu or COVID vaccine, a two-dose Shingrix shot offers solid protection that can last ten or more years.
Shingrix is widely available in doctor's offices and pharmacies and covered by Medicare Part D and Medicaid as well as most private health insurance plans. To find a shingles vaccine provider near you and schedule an appointment today, use this shingles vaccine locator tool.
Sources
1. Centers for Disease Control and Prevention (CDC). Shingles Vaccination. Found on the internet at https://www.cdc.gov/shingles/vaccines/index.html
2. Kaleen N. Hayes, PharmD, PhD, et. al. Dementia Risk After Recombinant Herpes Zoster Vaccination in Older Adults With a Recent Skilled-Nursing Facility Stay. Annals of Internal Medicine. June 16, 2026. Found on the internet at https://www.acpjournals.org/doi/10.7326/ANNALS-25-04689
3. American College of Cardiology. Shingles Vaccine Drastically Cuts Risk of Serious Cardiac Events. March 17, 2026. Found on the internet at https://www.acc.org/about-acc/press-releases/2026/03/16/19/33/shingles-vaccine-drastically-cuts-risk-of-serious-cardiac-events
4. Jung Ki Kim, PhD, et. al. Association between shingles vaccination and slower biological aging: evidence from a US population-based cohort study. The Journals of Gerontology Series A. January 20, 2026. Found on the internet at https://academic.oup.com/biomedgerontology/article/81/3/glag008/8430804?login=false#google_vignette
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