To the Editor: Kudos to Drs. Singh and Englund for their excellent article concerning the shingles vaccine in the January 2009 issue. However, I would like to know the authors’ thoughts about the purpose and cost-effectiveness of vaccinating patients who definitely have had shingles. I have heard that the recurrence rate is 3% to 5%, and the efficacy of the vaccine is only 50% to 65%. Though every article I have read states we can give the vaccine to these patients, should we?