Shingles (Herpes Zoster) Vaccine Safety
Shingles Disease and How to Protect Against It
Shingles, or herpes zoster, is a painful skin rash that develops on one side of the face or body. It is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. Anyone who has had chickenpox in the past can get shingles because VZV remains in the body after a person recovers from chickenpox. VZV can reactivate many years later, causing shingles.
Shingles is more common in older adults, people who have medical conditions that weaken the immune system, and people who take medications that suppress their immune systems. Getting vaccinated is the best way to prevent shingles.
There are currently two shingles vaccines licensed and available for use in the United States — Shingrix® (recombinant zoster vaccine) and Zostavax® (zoster vaccine live). While both shingles vaccines are safe and effective, they are different in their composition, effectiveness, and potential side effects.
CDC recommends Shingrix as the preferred vaccine, over Zostavax, to prevent shingles and the complications from the disease. Shingrix provides stronger protection against shingles compared to Zostavax.
- Shingrix [PDF – 1 MB] The Food and Drug Administration (FDA) licensed Shingrix in 2017 to prevent shingles. CDC recommends that adults age 50 years and older receive two doses of Shingrix. Shingrix is the preferred vaccine to prevent shingles. See the Recommendations of the Advisory Committee on Immunization Practices (ACIP) for Shingrix (2018).
- Zostavax [PDF – 169 KB]: The FDA licensed Zostavax in 2006 to prevent shingles. CDC recommends one dose of Zostavax for adults age 60 years and older. This vaccine may be used in certain cases, such as when a person prefers Zostavax or is allergic to Shingrix. See the Recommendations of the ACIP for Zostavax (2008).
Vaccines, like any medicine, can have side effects. Because the two herpes zoster vaccines are different in composition, their potential side effects may differ.
Common side effects:
- Pain, redness, and swelling at the injection site
- Muscle pain
- Upset stomach
Most side effects are mild to moderate – lasting 2-3 days – and may affect normal daily activities. Side effects are more common in younger people.
Who Should Not Get Shingrix
People with a history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine or after a previous dose of Shingrix.
People who currently have shingles, and women who are pregnant or breastfeeding, should wait to get Shingrix.
Common side effects:
- Redness, pain, swelling, warmth or itching at the injection site
Most side effects are mild to moderate, and last 1-3 days.
Who Should Not Get Zostavax
Pregnant women, some people who have medical conditions or are taking medications that could weaken the immune system (ask your doctor if you have concerns), and people with a history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine.
CDC and FDA continuously monitor the safety of vaccines after they are approved. If a problem is found with a vaccine, CDC and FDA will inform health officials, health care providers, and the public.
CDC uses three systems to monitor vaccine safety:
- The Vaccine Adverse Event Reporting System (VAERS): an early warning system that helps CDC and FDA monitor problems following vaccination. Anyone can report possible vaccine side effects to VAERS.
- The Vaccine Safety Datalink (VSD): a collaboration between CDC and eight integrated health care organizations which allows ongoing monitoring and research.
- The Clinical Immunization Safety Assessment (CISA) Project: a partnership between CDC and seven medical research centers that conducts clinical research on vaccine-associated health risks.
Both Shingrix and Zostovax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.
In 8 clinical trials of more than 10,000 participants:
- Grade 3 reactions (vaccination-related reactions severe enough to prevent normal activities) were common (17%) after patients received Shingrix.
- About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling.
- About 1 out of 10 reported grade 3 systemic reactions such as myalgia (muscle pain), fatigue (feeling tired), headache, shivering, fever, and gastrointestinal illness.
- Most people (78%) who got Shingrix reported at least some pain at the injection site.
- A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. See Safety of zoster vaccine in elderly adults following documented herpes zoster.
- A 2012 study found a small risk for allergic reactions 1 to 7 days after Zostavax. See Safety of zoster vaccine in adults from a large managed-care cohort: a Vaccine Safety Datalink study.
- In rare cases, people who got vaccinated with Zostavax experienced a blister-like rash; some were found to have been caused by the vaccine.
- Zostavax Vaccine Information Statement
- What Everyone Should Know about Shingles Vaccine (Shingrix)
- What Everyone Should Know About Shingles Vaccine (Zostavax)
- CDC’s Shingles Disease Website
- Shingles: Clinical Overview
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- Page last reviewed: October 27, 2015
- Page last updated: January 26, 2018
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