Therapeutics Letter 114 looks at Shingrix, a new vaccine for shingles. Conclusions: Compared to placebo the Shingrix vaccine reduced the incidence of herpes zoster by 3.26 % (NNV = 31) over 3.5 years in all age groups and reduced the incidence of post-herpetic neuralgia by 0.28% (NNV ≈ 350). Compared to placebo Shingrix increased grade 3 systemic reactions (which prevented normal daily activities for about 1-3 days) by 4 to 9% (NNH 11 to 25). The effectiveness (i.e. maintained protection) and safety of Shingrix are still unknown beyond about four years. Discuss the balance of baseline herpes zoster risk, harms, benefits and costs when considering this vaccine.