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Does the COVID-19 vaccine cause shingles?

Uncertainty and Misinformation Vaccines

A: Nope! The COVID-19 vaccine does not give anyone shingles.

Shingles is caused by the virus that causes chickenpox, called varicella zoster. It can hide out in the body long after chickenpox has gone away and reactivate later to cause the rash known as shingles.

What is shingles?

Shingles, also called zoster or herpes zoster, is a painful rash with blisters that most often pops up on one side of the face or body. Burning pain, itching, or tingling might start a few days before the rash appears. The blisters usually scab over in about 1 week and typically goes away in 2-4 weeks. Some unlucky folks have pain even after the rash gets better, called post-herpetic neuralgia.
Shingles is caused by the same virus that causes chickenpox, varicella zoster. If someone had chickenpox, the virus can hang out in the nerves of the body and “reactivate” later. Shingles is SUPER common: about 1 out of every 3 people in the US will develop shingles in their lifetime. Because we started vaccinating kids for chickenpox in 1995, we expect to see the rates of shingles go way down in the future.

So why the concern about the COVID-19 vaccine and shingles?

A small study was published in the journal Rheumatology by researchers in Israel. They reported 6 cases of shingles after vaccination in a group of 491 people with autoimmune inflammatory rheumatologic disease (think things like rheumatoid arthritis or Sjogren’s). They also looked at 99 people in a “control” group, people who do not have an autoimmune inflammatory rheumatologic disease and those people did not have any shingles outbreaks. There are some critical things to think about when looking at this study. It was not designed to determine if there was any causal relationship between vaccination and shingles outbreaks. The “control” group wasn’t a very good control. A better comparison would be people with similar conditions who did not get the vaccine. And, importantly, people with rheumatologic diseases are already at a much higher risk of developing shingles. People who have weakened immune systems or take medications that suppress the immune system (like these folks) are much more likely to develop shingles. Lastly, the rates of developing shingles did not appear to be higher than the expected baseline rates for people with rheumatologic conditions (what happens out in the world even without the vaccine).

Shingles outbreaks can also occur in times of stress (like say a pandemic or having to get a vaccine). Severe illness, diabetes, increasing age, and sleep disturbance have also been linked to shingles outbreaks. There is NOTHING in the COVID-19 vaccines that can give someone the virus that causes shingles.

How can I prevent shingles?

Shingles sucks. But we have good news! There are vaccines to prevent shingles and Shingrix (a commonly used vaccine) is about 90% effective at preventing shingles. In the US, vaccination against shingles is recommended for adults age 50 years and older. Ask your primary care clinician about the shingles vaccine (seriously, PCPs love talking vaccines)!

If you do have the bad luck of developing shingles, there are treatments available. These include antiviral medications (like acyclovir) and medications for pain. Sometimes the disease can be severe and require hospitalization or specialist treatment, but most of the time the rash gets better over a few weeks.

Lots of love,
Those Nerdy Girls

Links:

More information about Shingles from the CDC

The study published in Rheumatology

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