Here are answers to some frequently asked questions about Shingrix. Show
Can I get the Shingrix vaccine if I have an egg allergy?Yes. It’s safe for you to get the Shingrix vaccine if you’re allergic to eggs. Shingrix doesn’t contain any egg protein. But certain flu vaccines may contain egg protein. If you have an egg allergy, be sure to tell your doctor before getting any vaccines. I’m living with HIV. Is it safe for me to get Shingrix?The Centers for Disease Control and Prevention (CDC) hasn’t made a recommendation about the use of Shingrix in people living with HIV. However, one study looked at healthy adults ages 18 and older who were living with HIV and had an HIV dosing schedule that was customized to their needs. These people received the Shingrix vaccine, and the study results did not report any safety issues. If you’re living with HIV, talk with your doctor about the risks and benefits of getting Shingrix. What’s the age range for getting the Shingrix vaccine?Shingrix is approved for use people:
There’s no upper age limit for getting Shingrix, so there isn’t a set age range. How safe is Shingrix?The FDA has approved Shingrix for preventing shingles (herpes zoster) in adults. The results of several studies showed that Shingrix was safe and effective. There have been concerns about ingredients, such as thimerosal, that may be added to vaccines. Thimerosal is a kind of preservative that contains mercury. It’s added then taken out of some vaccines to keep other germs and bacteria from growing. The concern arose when early research connected thimerosal to autism. This link has since been found to be false. Shingrix doesn’t contain thimerosal. Can I receive Shingrix if I have shingles or if I had shingles in the past?The CDC doesn’t recommend the Shingrix vaccine for people who currently have shingles. It’s best to wait until your shingle rashes have gone away before you receive Shingrix. If you’ve have had shingles in the past, you can take Shingrix. It may help prevent future shingles infections. Can I get Shingrix if I’ve never had chickenpox?If you’ve never had chickenpox (varicella), the CDC recommends that you get the chickenpox vaccine instead of Shingrix. Researchers haven’t studied Shingrix in people who have never had chickenpox. And Shingrix is not approved for preventing chickenpox. If you can’t recall whether you’ve had chickenpox, you may need to be screened for it. But this will depend on your age. It’s assumed that people born in the United States and elsewhere before 1980 have been exposed to chickenpox. Therefore, you may be able to receive Shingrix. You should check with your doctor first to make sure. Can Shingrix cause a rash?It’s unlikely that a Shingrix injection will cause a rash. But note that an injection site reaction is different from a shingles rash. (See “Injection site reactions” in the “Shingrix side effects” section above.) A shingles rash, which is caused by shingles itself, is often painful. It commonly appears as blisters around the torso, neck, or face. People who received Shingrix in clinical studies didn’t report shingles-like rashes. However, studies did find that some people had shingles-like rashes after receiving the Zostavax shingles vaccine. (Zostavax was an alternative shingles vaccine. But it’s no longer available in the United States. See the “Shingrix vs. Zostavax” section above to learn more.) I had my first shingles vaccine three days ago. Today my arm still aches, has a red rash and itches a bit below the injection site. Is this normal? If so, how long should I anticipate it lasting?
Answer We've written a number of articles about Shingrix, the recommended vaccine for the prevention of shingles (i.e. herpes zoster), including one going over all of the documented side effects:
The side effects you are experiencing (e.g. muscle aches, a red rash, and itching), are fairly common. The rash and itching specifically would be classified as an 'injection-site' reaction, which simply refers to side effects occurring locally, at the site where you received the shot (most likely the deltoid region of your arm). The prescribing information for Shingrix lists the following incidence rates (i.e. how often they occur as a percentage of total people receiving the vaccine) for muscle aches and injection-site reactions:
You can clearly see you aren't alone in what you are experiencing. It should be noted that some individuals experience the side effects of Shingrix more severely than others. In fact, clinical trials for the drug 'graded' the side effects experienced based on their severity:
Looking at injection-site reactions for those aged 50-59, 30.5% of individuals receiving the vaccine experienced them. However, 9% are these injection site reactions were classified as 'grade 3'. Overall, studies show that the side effects of Shingrix last around 2 to 3 days, regardless of how severe they are. In the next section, I discuss this in greater detail. The prescribing information for Shingrix states, based on the clinical trials for the vaccine, the median duration of side effects experienced is only 2 to 3 days:
It is important to point out, that regardless of the severity of the side effects you experienced from Shingrix (even if you had a 'grade 3' reaction), the average duration is still around 2 to 3 days. One of the largest studies completed that evaluated the safety of efficacy of Shingrix was published in the New England Journal of Medicine and states this regarding the duration of side effects: The reactions were transient, with median durations of 2 to 3 days for injection-site reactions, 1 to 2 days for systemic reactions, and 1 to 2 days for grade 3 reactions.N Engl J Med. 2016 Sep 15;375(11):1019-3 The same study published a detailed survey of side effect duration, which I have adapted into the below chart:
*Adapted from Table S3. N Engl J Med. 2016 Sep 15;375(11):1019-3 There doesn't appear to be much of a difference between the rate of side effects between the first and second dose of Shingrix, and just because you experienced a side effect from the first dose, doesn't necessarily mean you will have one to the second dose. The 'Ask The Experts' section of the Immunization Action Coalition (Immunize.org) discusses this: Reactions to the first dose do not strongly predict reactions to the second dose. RZV [Shingrix] recipients should be encouraged to complete the series even if they experienced a grade 3 reaction to the first dose.Immunization Action Coalition: Ask The Experts As a final note on this subject, remember that the duration of time that side effects last, as stated in studies and the prescribing information for Shingrix, is the median number of days. The median is simply the value at the midpoint of the frequency distribution. It doesn't necessarily constitute the average. Therefore, you could expect side effects to last slightly longer or (hopefully in your case!) shorter than 2 to 3 days. Nevertheless, it would be unusual for them to continue much past one week (7 days) . If you continue to experience side effects for a significant length of time, or they are hampering your ability to normally function, it is important to see your doctor to be properly evaluated. References
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How long do Shingrix side effects last
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