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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.

Learn more about shingles.

Available Shingles Vaccines

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.

Shingles Vaccine Side Effects

Vaccines, like any medicine, can have side effects. Because the two herpes zoster vaccines are different in composition, their potential side effects may differ.

Shingrix

Common side effects:

  • Pain, redness, and swelling at the injection site
  • Muscle pain
  • Tiredness
  • Headache
  • Shivering
  • Fever
  • 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.

Zostavax

Common side effects:

  • Redness, pain, swelling, warmth or itching at the injection site
  • Headache

 

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.

How CDC Monitors Shingles Vaccine Safety

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:

A Closer Look at the Safety Data

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.

Shingrix

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.

Zostovax

More Resources

Related Scientific Articles

English D. Willis, Meredith Woodward, Elizabeth Brown, Zoran Popmihajlov, Patricia Saddier, Paula W. Annunziato, Neal A. Halsey, Anne A. Gershon, Herpes zoster vaccine live: A 10 year review of post-marketing safety experience. Vaccine. 2017 Dec 19:35(52):7231-7239.

Cunningham AL, Lal H, Kovac M, Chlibek R, Hwang SJ, Diez-Domingo J, et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. NEJM. 2016:375(11), 1019-32.

Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang SJ, Levin MJ, McElhaney JE, Poder A, Puig-Barberà J, Vesikari T. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. NEJM. 2015:372(22):2087-96.

Cohen J. A New Vaccine to Prevent Herpes Zoster, NEJM. 2015:372:2149-2150 [Link: ]

Baxter R, Tran TN, Hansen J, Emery M, Fireman B, et al. Safety of Zostavax™-A cohort study in a managed care organization. Vaccine. 2012 Oct 19;30(47):6636-41.

Gagliardi AM, Gomes Silva BN, Torloni MR, Soares BG. Vaccines for preventing herpes zoster in older adults. Cochrane Database Syst Rev. 2012 Oct 17;10:CD008858.

Hales CM, Harpaz R, Ortega-Sanchez I, Bialek SR. Update on Recommendation for Use of Herpes Zoster Vaccine . MMWR. 2014 Aug 22; 63(33):729-731.

Harpaz R, Ortega-Sanchez IR, Seward JF. Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008 Jun 6;57(RR-5):1-30.

Mills R, Tyring SK, Levin MJ, Parrino J, Li X, et al. Safety, tolerability, and immunogenicity of zoster vaccine in subjects with a history of herpes zoster. Vaccine. 2010 Jun 7;28(25):4204-9.

Morrison VA, Oxman MN, Levin MJ, Schmader KE, Betts RF, et al. Safety of Zoster Vaccine in Elderly Adults Following Documented Herpes Zoster. J Infect Dis. 2013;208(4):559-563.

Murray AV, Reisinger KS, Kerzner B, Stek JE, Sausser TA, et al. Safety and tolerability of zoster vaccine in adults ≥60 years old. Hum Vaccin. 2011 Nov;7(11):1130-6.

Schmader KE, Levin MJ, Gnann JW Jr, McNeil SA, Vesikari T, et al. Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years. Clin Infect Dis. 2012 Apr;54(7):922-8.

Simberkoff MS, Arbeit RD, Johnson GR, Oxman MN, Boardman KD, et al. Safety of herpes zoster vaccine in the shingles prevention study: A randomized trial. Ann Intern Med. 2010 May 4;152(9):545-54.

Tseng HF, Liu A, Sy L, Marcy SM, Fireman B, et al. Safety of zoster vaccine in adults from a large managed-care cohort: A Vaccine Safety Datalink study. J Intern Med. 2012 May;271(5):510-20.

Vermeulen JN, Lange JM, Tyring SK, Peters PH, Nunez M, et al. Safety, tolerability, and immunogenicity after 1 and 2 doses of zoster vaccine in healthy adults ≥60 years of age. Vaccine. 2012 Jan 20;30(5):904-10.

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