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Is the Shingles Vaccine Safe?

Is the Shingles Vaccine Safe?

Last Reviewed : 12/18/2020
Is the Shingles Vaccine Safe?

There is ample evidence showing the effectiveness and safety of the shingles vaccine. It is now being used in the United States since 2017 when it was approved by The Food and Drug Administration (FDA). No safety concerns have been raised,andit has very few side effects.

Shingles are causedby the varicella zoster virus, the same virus that causes chickenpox. When a person develops chickenpox, the virus remains dormant in the nerves of the individual, even after the rash has subsided. These dormant viruses get activated whenever the host's immunity gets hampered due to any disease or with progressing age. These reactivated viruses then spread along the distribution of the nerve and cause shingles in that dermatome (area of skin supplied by that nerve). It causes a burning sensation and painful fluid-filled blisters that turn into sores before healing. Shingles may even have complications like severe neurologic pain in the region of that nerve which is called post-herpetic neuralgia (PHN). Sometimes PHN may develop even in the absence of shingles rash.

One cannot get the shingles infection from another person. As it happens, due to the reactivation of dormant viruses, only someone who has had chickenpox in the past can develop shingles. However, contact with a person with shingles may cause infection in a previously unexposed individual, leading to chicken pox. So, individuals with shingles should cover their arms with full sleeves and avoid touching others as it is contagious– approximately 20% of people who have had chickenpox go on to develop shingles, especially elderly people.The incidenceof shingles is quite high in the elderly, averaging at the age of 60-70 years. On average, about one in every three people develop shingles in their lifetime.

There are two types of vaccines available for shingles, the Zostavax vaccine, andthe Shingrix vaccine. Zostavax is a live zoster vaccine. It contains a weakened form of the zoster virus. It stimulates an immune response against the virus in humans, thereby effectively preventing reactivation of the viruses which lead to the development of shingles. Once vaccinated, it boosts immunity from shingles for five years after vaccination. Zostavax has a reduced incidence of shingles by 51% and using PHN by 67%. Zostavax is recommended by the CDC in people ages 50-59 years of age. Because it is effective only for fiveyears, early vaccination may lead to no vaccine when their immunity is lower and when the risk of reactivation is highest in their sixties. 99% of Americans have already developed shingles by the age of 40. So, they might have already gotten thechicken pox even if they do not remember so. Anyone with a history of shingles must receive the vaccine as it decreases their risk of a future reoccurrence. But they cannot take Zostavax if they presently have an episode of shingles, and must wait until the disappearance of the rash to get the vaccine.

Shingrix is a recombinant vaccine, where the DNA of the virus is used by bio technological methods to produce an antigen, which incites the immune reaction in humans. The immunityprovided by this vaccine lasts longer. It is recommendedfor the age group of 60-69 or above. Studies have shown Shingrix to have been90% effective against preventing shingles, hence it is now the recommended vaccine. But it also has a higher incidence of adverse effects like pain, redness, and swelling at the site of injection, muscle pain, gastric trouble, tiredness, and headache.

The vaccine is recommended for:

  • Anyone aged 50-60 years or above
  • Anyone who has had chicken pox earlier in life
  • Anyone who has had shingles earlier in life
  • Anyone who doesn’t remember whether or not they have had chicken pox earlier
  • Also, for people with chronic medical conditions such as chronic kidney disease, diabetes mellitus, and rheumatoid arthritis unless contraindicated or the person is using drugs causing immunosuppression.

 

People who should not receive the vaccine:

  • Anyone with an allergy to gelatin, the antibioticneomycin, and other components of the vaccine
  • Anyone with an allergic reaction to a previous shot of the vaccine
  • Anyone taking drugs that block or suppress the immune system like drugs taken for Irritable Bowel Disease and Rheumatoid Arthritis
  • Anyone who has a myelosuppressive disorder like Lymphoma or Leukemia.
  • Anyone who has received immuno-suppressants or are under treatment for graft versus host disease
  • Anyone with an immune suppressive disease like HIV-AIDS
  • Anyone undergoing treatment for cancer involving radiation or chemotherapy

 

Anyone who is pregnant or breast feeding or planning pregnancy may have to wait to receive the vaccine.

Safety of the vaccine is ensured by continuous monitoring for adverse reactions or health risks. Various methods by which CDC monitors vaccines include:

  • Vaccine adverse event reporting system (VAERS)
  • Vaccine safety datalink (VSD)
  • Clinical immunization safety assessment (CISA)

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