The annualized incidence of herpes zoster, due to the endogenous reactivation of varicella zoster virus (VZV), varies between 2 and 5 cases per 1,000 persons with a clear increase over 60 years of age. Mass vaccination against varicella in infants could decrease natural boosters with an increase in zoster incidence. Efficacy of a high titre VZV vaccine in preventing zoster and its sequelae was demonstrated in a multicentric study on over 38.000 older adults. The availability of a specific anti zoster vaccine, recently approved by FDA, could offer an important tool to reduce health problems and improve quality of life in the elderly.