What Are The Possible Side Effects Of Shingles Immunisation
All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.
For most people, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.
Talk to your doctor about possible side effects of shingles vaccines, or if you have possible side effects that worry you.
Common side effects of shingles vaccines include:
- pain, redness, swelling or itching where the needle went in
Serious reactions to immunisation are rare. With Zostavax® vaccination, very rarely a generalised chickenpox-like rash may occur around 24 weeks after vaccination. This may be associated with fever and feeling unwell. This rash may be a sign of a serious reaction to the virus in the vaccine. Seek medical attention and inform of recent Zostavax vaccination if you experience this reaction.
The Consumer Medicine Information links in How do you get immunised against shingles? list the side effects of each vaccine.
When To See A Healthcare Provider
For most people, the effects of Shingrix are mild and short-term. In very rare cases, Shingrix can cause more serious side effects.
Seek urgent medical care if you experience signs of a severe allergic reaction a few minutes or hours after your second dose of Shingrix, such as:
- Rapid heartbeat
- Facial swelling
- Swelling in the throat or mouth
You should also let your healthcare provider know if your Shingrix side effects are severe or arent going away on their own.
What If I Wait Too Long To Take The Second Shingrix Dose
The Centers for Disease Control and Prevention state that if more than 6 months have passed since you received your first dose, you should get the second dose as soon as possible. You dont have to start the doses all over again.
Also, if you get the second dose within 4 weeks after the first dose, it should not be counted. You should get your follow-up dose at least 1 to 2 months after the first dose, per your doctors recommendation.
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How Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
Who Can Give The Vaccine
There is not much you need to do to prepare to get a shingles vaccine. You dont even necessarily need an appointment.
A doctor can schedule a time to give you the vaccine, but licensed pharmacists are also allowed to administer it. Some pharmacies offer shingles vaccines on a walk-in basis. Check with your healthcare professional or pharmacy to be sure.
Whether youve made an appointment or walked into a pharmacy for vaccination, the next steps are simple.
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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.
Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
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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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Know Your Shingles Risk
You can get shingles at any age if youve had chickenpox.
But older adults and those who are immunocompromised get it most often. Two-thirds of shingles cases in Canada happen to people over 50 years old. The severity of shingles and its complications also increase with age.
Age is the most important risk factor.
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A Nasty Persistent Condition
Dr. Navjot Jain, an internal medicine specialist at The Ohio State University Wexner Medical Center, says shingles is an offshoot of the chicken pox virus.
While many people have experienced chicken pox and therefore have the dormant virus, those who experienced chicken pox before they were 18-months old are considered to be at a higher risk .
Basically, shingles is the activation of the varicella zoster virus, which causes chicken pox, Jain told Healthline. Herpes zoster, which causes the vesicular rash associated with shingles, is a reactivation of the varicella zoster virus.
Even after the initial painful rash caused by shingles dies down, the aftereffects can be even worse.
The most common thing that we see after shingles is something called postherpetic neuralgia, which is nerve pain that can last for months, typically 90 days or more, and sometimes for several years, said Jain. Its excruciating pain at the site of where the patient would have previously had the shingles rash.
The agony of postherpetic neuralgia is often enough to convince patients to get vaccinated against shingles, says Jain.
Theres also the fact that a subtype of shingles, herpes zoster ophthalmicus, occurs in about 15 percent of shingles cases. In rare cases, says Jain, this can lead to vision loss.
How Does The Shingles Vaccine Work
The vaccine recommended for most people is a live vaccine called Zostavax. It contains a weakened chickenpox virus . It’s similar, but not identical, to the chickenpox vaccine.
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
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How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
When To See A Doctor For The Possible Side Effects Of A Shingle Vaccine
Most side effects of the shingles vaccine will resolve on their own within a few days of vaccination or can be treated with over-the-counter medications like acetaminophen or ibuprofen.
In the rare case that you develop a more serious reaction after vaccination, you should call a doctor or go to a health clinic.
Medical emergency
Its rare but possible to have a serious allergic reaction to a shingles vaccine. Call emergency services or go to the nearest emergency room if you experience the following symptoms after a vaccination:
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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
What Are The Possible Reactions After The Vaccine
The shingles vaccines are very safe. Common reactions to the vaccines include headache as well as soreness, redness and swelling where the vaccine was given. Itching and a rash may also occur after getting Zostavax® II. Other reactions that may occur after getting Shingrix® include fever, muscle soreness, fatigue, shivering, nausea, vomiting and diarrhea.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
It is important to always report serious or unexpected reactions to your health care provider.
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Reasons To Get The Shingles Vaccine
Once a person develops chickenpox after contracting the varicella-zoster virus, the virus never leaves the body. It remains dormant in the nerve roots and can reappear as shingles later in life.
The primary symptom of shingles is a painful rash on one side of the body, most often on the torso or face. People initially have pain or a burning sensation on the skin without a rash, and then painful blisters develop. The rash lasts approximately seven to 10 days and fully clears within two to four weeks.
The likelihood of developing shingles increases dramatically after age 50. Therefore, the Centers for Disease Control and Prevention recommends that all adults age 50 and over receive two doses of Shingrix to prevent shingles. The vaccine is recommended even if a person is unsure if they have ever had chickenpox.
People with weakened immune systems are at higher risk for shingles. Therefore, the Food and Drug Administration also recently approved Shingrix vaccination for adults age 18 and older who are at risk for shingles due to immunodeficiency or immunosuppression caused by an underlying disease or medication.
Who Should Get The Shingrix Vaccine
The CDC states that anyone over 50 is a candidate for the shingles vaccine. They also recommend that you get it if you have a weakened or compromised immune system and are at least 19 years old. Certain diseases and treatments for other conditions can weaken your immune system.
You should get it whether or not you remember having chickenpox in the past, which is caused by the same virus. Your doctor doesnt need to test for any previous infections with that virus before administering Shingrix. Its safe to assume that 99% of people born before 1980 have been exposed to the shingles virus in the form of chickenpox.
Theres one exceptional instance where your doctor will need to decide if you need Shingrix. The vaccine is recommended only if you have a weakened immune system and are certain that youve never had chickenpox or gotten the chickenpox vaccine.
Research is currently ongoing to determine whether or not its safe to get Shingrix at the same time as your Covid-19 vaccine. But you shouldnt get Shingrix if you have Covid-19 or have recently been exposed. This will protect your health care provider from any unnecessary exposure.
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Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report AEFIs through local public health officials and to follow AEFI reporting requirements that are specific to their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For LZV the following AEFIs are also of particular interest and should be reported:
- Suspected transmission of vaccine-strain virus to a close household or occupational contact. This phenomenon has been documented following varicella vaccine but it is rare, and transmission has not been documented with LZV.
- Recurrent HZ following immunization of individuals with a history of HZ prior to immunization, noting the area of recurrence.
- Recurrent HZO following immunization of a person who has had a previous episode of HZO. If available, a vitreous fluid specimen should be sent to a laboratory with a request to determine whether the virus is the vaccine strain or wild type virus.
For definitions of serious and unexpected adverse events, refer to Adverse Events Following Immunization in Part 2.
For more information refer to Reporting Adverse Events Following Immunization in Canada.
Who Should Not Get The Shingles Vaccine
If you are getting Shingrix®, speak with your health care provider if you have had a life-threatening reaction to a previous dose of the vaccine or to any part of the vaccine.
If you are getting Zostavax® II, speak with a health care provider if you:
- Have had a life-threatening reaction to any part of the vaccine including gelatin or neomycin
- Have an immune system weakened by disease or medical treatment
- Have active, untreated tuberculosis
- Are pregnant or planning to become pregnant. Women should avoid becoming pregnant for 3 months after getting Zostavax® II
There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns, speak with your health care provider.
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What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
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Administration With Other Vaccines
CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines, including COVID-19 vaccines. Concomitant administration of Shingrix with Fluarix Quadrivalent , 23-valent pneumococcal polysaccharide vaccine and Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed , and 13-valent pneumococcal conjugate vaccine has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns. Coadministration of Shingrix with adjuvanted influenza vaccine and COVID-19 vaccines is being studied.
Shingrix and pneumococcal vaccine can be administered at the same visit if the person is eligible for both. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and can be administered concomitantly with Shingrix.
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Shingles Vaccine And Insurance
Private health insurance plans often cover vaccination costs. Still, a patient might have a charge depending on the specific insurance plan.
Medicaid may or may not cover the vaccine cost.Medicare Part D plans cover the shingles vaccine, but there may be a cost to the patient depending on the plan. Usually, the fees are less than $50 per dose.
Medicare Part B does not cover the shingles vaccine.
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.
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Available Vaccines And Vaccination Campaigns
Since 2008, the U.S. Advisory Committee on Immunization Practices has recommended most Americans aged 60 and older get the shingles vaccine. A newer recommendation was issued in 2018 with the licensure of a new vaccine: .
In adults 50-69 years old, Shingrix reduces the risk of shingles by more than 96%. For those 70 and older, the vaccine is 91.3% effective at preventing shingles. It similarly reduces the risk of post-herpetic neuralgia. Modeling studies project that protection will wane to 0 by 19 years after immunization. Study of the expected duration of protection is ongoing.
The antigen in Shingrix is a surface protein of the varicella zoster virus produced by culturing genetically engineered Chinese hamster ovary cells. Vaccination consists of two doses of vaccine, given at months 0 and 2-6.
The older shingles vaccine is a live, attenuated vaccine. It was licensed in 2006. The generic name of the vaccine is Zoster Vaccine, Live . It is still available, although Shingrix is recommended over Zostavax because of its superior effectiveness and duration of protection.
People who have previously been vaccinated with Zostavax are recommended to vaccinate with Shingrix.
Most Medicare drug plans cover the cost of the shingle vaccine and its administration, minus any copayments, for people 65 and older. Most private insurance plans provide coverage for the vaccination for people 50 and older.
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