The Senate Social Affairs Committee (CAS) confirmed, on Wednesday (11), the approval of a bill that provides for the inclusion of the vaccine against herpes zoster, a disease popularly known as shingles, in the national vaccination calendar of the Unified Health System (SUS).
The proposal establishes the free offer of the vaccine to people aged 50 and over and adults with a compromised immune system.
The text now goes to the Chamber of Deputies for analysis, if an appeal is not presented for a vote in the Senate plenary. To become law, the proposal still needs to pass through the Chamber and receive presidential approval.
Bill 4,426/2025, presented by senator Eudócia Caldas (PSDB-AL) and reported by Damares Alves (Republicanos-DF), had already been approved by the commission in September. This Wednesday, senators confirmed the definitive version of the text.
The measure seeks to expand access to vaccination against a disease that becomes more frequent with aging and can cause complications, such as persistent pain for months or even years.
Currently, the vaccine is only available on the private network, with prices that can reach R$2,400 for the complete two-dose regimen.
Vaccine is not yet offered by SUS
In January this year, the Ministry of Health decided not to incorporate the herpes zoster vaccine into the public network after an assessment by the National Commission for the Incorporation of Technologies into the Unified Health System (Conitec).
At the time, the vaccine was analyzed for elderly people aged 80 and over and immunocompromised people aged 18 and over.
According to the ministry, although the clinical importance of the vaccine has been recognized, the incorporation was not considered cost-effective under the conditions evaluated.
The estimate was for a budgetary impact of more than R$5.2 billion over five years.
In an interview with g1, Renato Kfouri, infectious disease specialist and vice-president of the Brazilian Society of Immunizations (SBIm), explained that the decision was mainly related to cost.
"The discussion is not whether the vaccine works — it works very well. The central point is cost-effectiveness, budgetary impact and how to prioritize priorities within the National Immunization Program," he stated.
According to the expert, the recombinant vaccine currently available in Brazil is around 90% effective in preventing herpes zoster, including among the elderly.
The Ministry of Health informed, at the time, that it intended to continue negotiating with the manufacturer to seek a price compatible with the SUS budget.
What is shingles?
Herpes zoster is a disease caused by the varicella-zoster virus, the same virus responsible for chickenpox.
After the initial infection, usually in childhood, the virus remains dormant in the body and can be reactivated decades later, especially with aging or when the immune system is compromised.
The disease causes painful lesions and blisters on the skin, usually concentrated in one region of the body. Before the lesions appear, the patient may experience burning, tingling, itching and intense pain.
One of the main complications is post-herpetic neuralgia, characterized by chronic pain that can persist for months or even years after the lesions disappear.
In addition to preventing the disease and its complications, the vaccine has also been investigated for possible cardiovascular benefits.
A meta-analysis presented at the 2025 European Congress of Cardiology, which brought together 19 studies, identified an association between vaccination against herpes zoster and a reduction of up to 18% in the risk of cardiovascular events, such as heart attack and stroke.
The researchers emphasize, however, that the evidence is predominantly observational. Therefore, it is not yet possible to state that the vaccine is directly responsible for reducing the risk.
Who can get the vaccine?
The Brazilian Society of Immunizations recommends routine vaccination against herpes zoster for people aged 60 and over and considers vaccination from 50 onwards.
For immunocompromised people, the indication may begin at age 18, depending on the clinical condition.
The vaccine currently available in Brazil is the adjuvanted recombinant type, applied in two doses.
Despite being approved by the National Health Surveillance Agency (Anvisa), it is not yet part of the National Immunization Program (PNI).
If the project approved by the Senate becomes law, the public authorities will still need to organize the acquisition and distribution of doses to make it possible to offer them free of charge to the population.
