Persons With Chronic Diseases
Autoimmune disease
Although definitive data are lacking, individuals with autoimmune disease not being treated with immunosuppressive drugs are not considered significantly immunocompromised. Individuals 50 years of age without contraindications should receive RZV.
For more information, refer to Immunization of Immunocompromised Persons, and Immunization of Persons with Chronic Diseases in Part 3.
A New Shingles Vaccine
- U.S. News & World Report
If youre 50 or older, you’re advised to get immunized to protect yourself from shingles. If the new shingles vaccine made you feel worse than you expected, you’re not alone. Skin rash, joint pain, flu-like symptoms, headaches and fatigue are some complaints from patients who’ve had the recently approved Shingrix vaccine. Side effects can last two or three days, and the injection site in the upper arm can hurt. “Part of the problem is that health care providers may not have fully understood the instructions of administration,” said Talia Swartz, MD, PhD, assistant professor of medicine and infectious diseases at the Icahn School of Medicine at Mount Sinai. Providers can refer to the website of Shingrix manufacturer GSK for complete administration instructions for this relatively unfamiliar vaccine, Dr. Swartz suggested. “As providers are more comfortable with it, I believe the administration errors would be expected to be reduced,” she said.
– Talia Swartz, MD, PhD, Assistant Professor, Medicine, Infectious Diseases, Icahn School of Medicine at Mount Sinai
Rare Side Effects Of The Shingles Vaccine
In rare cases, a severe allergic reaction called anaphylaxis may occur. This can be a life-threatening emergency and requires immediate medical attention.
Symptoms of anaphylaxis after receiving the shingles vaccine include:
Typically, these side effects appear immediately or within a few minutes of vaccination your vaccination provider may be present. If you experience them after leaving the office, call 911.
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What Is The Shingles Vaccine
The shingles vaccine can protect you against shingles and postherpetic neuralgia , which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters.
Can The Shingles Shot Cause Guillain
Though rare, but Guillain-Barré syndrome can occur with both the shingles vaccine and the shingles virus itself.
Symptoms of this serious autoimmune disorder include a loss of sensation and muscle paralysis that tends to come on quickly, typically spreading up from your lower extremities.
It can be life-threatening, so contact a healthcare provider immediately if you think you may have symptoms.
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What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles.
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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Redness At Injection Site
Redness at and around the injection site is common and may appear immediately or some days after receiving Shingrix. This redness commonly develops due to a localized immune system response, which shouldnt cause further concern.
Arm redness should disappear within a few days after receiving the vaccine. However, if you experience redness with a rash or severe pain, let your doctor know as soon as possible.
Can Zostavax Cause Shingles
Yes. Shingles is a side effect of Zostavax that Merck & Co. added to the label at the request of the FDA in . The FDA also strengthened warnings about serious infections and infestations with the virus in the vaccine.
In Australia, safety officials have reported the death of sick patients who were given Zostavax and warned that it should not be given to patients with compromised immune systems due to the risk of death from serious infections with the vaccine virus.
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Why Is The Shingles Vaccine Important
Shingles causes a painful rash and blisters and it can lead to serious complications. The most common complication is post-herpetic neuralgia , a condition that causes burning pain that can last long after the shingles rash and blisters go away. The older you are when you get shingles, the more likely you are to develop PHN.
Getting vaccinated is the best way to prevent shingles and PHN.
Shingles is caused by the same virus that causes chickenpox. After you have chickenpox, the chickenpox virus stays dormant in your body. The virus can activate years later and cause shingles.
Symptoms of shingles include:
Shingles cant spread from person to person like chickenpox. But if you have shingles, you can spread the virus to someone who isnt immune to chickenpox meaning someone who hasnt had chickenpox and isnt vaccinated against it. If that happened, the person might get chickenpox but not shingles. Learn more about shingles.
- Adults age 50 and older
- Adults 19 years and older who have a weakened immune system because of disease or treatments
You need to get 2 doses of Shingrix. Youll need the second dose 2 to 6 months after the first dose. You need to get Shingrix even if you:
- Have already had shingles
- Have been vaccinated against shingles with Zostavax
- Are not sure if youve had chickenpox
Side Effects Of The Shingles Vaccines
What patients can expect after Shingrix or Zostavax injections.
Any medicine, including vaccines, carries a risk of adverse events or side effects. The CDC estimates that vaccine-related reactions occur once in a million doses, usually within a few minutes or hours of the injection. Generally they are minor and subside within a day or two.
The two available vaccines for shingles-Shingrix and Zostavax-each has its own associated side effects. Patients should be informed about what to expect prior to vaccination to help them manage their expectations.
Shingrix
GSK, the manufacturer of Shingrix, says its most common side effects include pain, redness, and swelling at the injection site muscle pain tiredness headache shivering fever and upset stomach. While severe allergic reactions are less common, they may range from hives, swelling of the face and throat, and difficulty breathing to a fast heartbeat, dizziness, and weakness.
In Shingrix clinical trials, the majority of people complained of mild to moderate pain in their arm, as well as redness and swelling at the injection site. About one in six people experienced side effects that prevented them from doing regular activities for two to three days. These side effects were reportedly more common in younger people.
Zostavax
Both Merck, which manufacturers Zostavax, and GSK acknowledge that their vaccines may not protect all individuals, so some people who get shingles vaccine may still develop shingles.
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Are There Other Vaccines Besides Zostavax That Help Prevent Shingles
Shingrix is another vaccine that is aimed to prevent a person from experiencing shingles.
The CDC states that Shingrix is the preferred drug over Zostavax. CDC recommends that healthy adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months, to best fight off the Shingles illness.28
According to CDC:
- two doses of Shingrix is more than 90% effective at preventing shingles, and
- protection stays above 85% for at least the first four years after a patient gets vaccinated.29
In one trial that involved more than 15,000 patients , Shingrixs efficacy for preventing Shingles was greater than 95% versus 51% efficacy for Zostavax.30 In a companion trial that included almost 14,000 patients , efficacy was about 90%.31
Side Effects Of The Shingles Vaccine
Shingles is a common disease, affecting about 1 out of 3 adults during their lifetime.
Shingles is most common among older adults. However, shingles can also occur in healthy younger adults and in children. Those with immune systems that have been weakened by HIV, AIDS, cancer or treatment with certain drugs are also at an increased risk of getting shingles. Shingles causes a painful rash and blisters and can lead to serious complications, including post-herpetic neuralgia.
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When They Start How Long They Last
The shingles vaccine is given in a two-shot series. You may experience side effects after the first, second, or both shots. Most of the time, these symptoms are mild and occur immediately following vaccination. They typically only last for two or three days.
Side effects of the shingles vaccine are more common in younger people, and might interrupt your normal daily activities for a few days.
This may seem like a downside of the shingles vaccine, but remember that these symptoms are a result of the creation of a strong shingles defense within your body.
It is OK to take Tylenol or Advil after a shingles vaccine to relieve symptoms. Rest and plenty of fluids may help, too.
Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
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Another Jab At Shingles
In October 2018, the FDA approved Shingrix, a two-shot shingles vaccine for patients 50 and older. To be the most effective, patients must get the second shot between two to six months after the first. Clinical trials demonstrated that it was 91% to 97% effective in preventing shingles, and that protection seems to stay strong, at least for the first four years in the patients who were tracked.
There has slowly been uptick, but still very large group of those aged 50 and older who have not received it, saysNatalie Baker, DNP, president of the gerontological advanced practice nursing association .
Given its improved efficacy and the fact that the efficacy of Zostavaxwanes over the course of a few years, regulators recommended getting the Shingrix shots even if you already received Zostavax, which was discontinued in 2020. A lot of our older adults have received Zostavax, but, unfortunately, it just does not continue to be effective, she says, explaining that even those patients should get the Shingrix vaccine.
What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
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Is The Vaccine Safe
The vaccine can be given to people with a previous history of shingles infection. It should not be given to anyone who currently has shingles. As stated above, the vaccine should not be given to people who are clinically immunosuppressed because the vaccine strain could replicate too much and cause a serious infection. For more information see the MHRA’s Drug Safety Update .
In clinical trials of the vaccine, there have been no reports of someone who was vaccinated passing the virus on to anyone else. However, because the shingles vaccine is a live vaccine, it is thought that this may be possible in rare cases.
There is thought to be a very small risk that someone who has been vaccinated could pass on the virus to someone who is not immune to chickenpox. This is only thought to be a risk if the person who has been vaccinated develops a shingles type rash at the injection site or elsewhere on the body.
The shingles vaccine is not recommended for pregnant women as a matter of caution. However, studies have been carried out on pregnant women who have accidentally received chickenpox or shingles vaccines. These have not shown any link between the weakened virus in the vaccine and any specific problems in babies born to these women. See this Public Health England statement for more information.
How Do We Know The Vaccine Is Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The shingles vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once theyâre in use, the safety of vaccines continues to be monitored by the MHRA.
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Who Should Get The Shingles Vaccine
The Centers for Disease Control and Prevention says you should get a shingles vaccine if you:
- Are an adult aged 50 and older
- Have never had shingles
- Have had shingles before
- Aren’t sure whether you’ve had chickenpox
- Have been previously vaccinated with the Zostavax shingles vaccine
- Are age 19 or older and are immunodeficient or immunosuppressed because of disease or therapy
Side Effects Of Herpes Zoster Vaccine
The most common side effects of the recombinant vaccine are pain, soreness, redness, and swelling at the injection site and headache, fatigue, muscle pain, shivering, fever, and digestive upset.
The most common side effects of the live-attenuated vaccine are soreness, redness, swelling, and itching at the injection site and headache.
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Who Shouldn’t Get A Shingles Vaccine
The CDC says some people shouldn’t get the shingles vaccine. That includes those who:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
- Tested negative for VZV immunity
- Currently have shingles
- Have a severe or moderate acute illness, such as a respiratory infection
Your healthcare provider can answer any questions you have about whether the vaccine is safe for you.
Itchy Skin Near The Injection Site
Itchy skin, also called pruritus, can potentially occur near the injection site after receiving Shingrix. Itching, swelling, and redness arent usually a huge cause for concern, as they often occur together as a localized reaction.
Applying Benadryl gel or hydrocortisone cream around the injection area can help reduce itchy, swollen, or red skin. If the itching worsens or spreads away from the injection site, get in touch with your doctor.
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