Recombinant Zoster Shingles Vaccine RZV

What is shingles?

Shingles (also called herpes zoster, or just zoster) is a painful skin rash, often with blisters. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body and can cause shingles later in life.

You can’t catch shingles from another person. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.

A shingles rash usually appears on one side of the face or body and heals within 2 to 4 weeks. Its main symptom is pain, which can be severe. Other symptoms can include fever, headache, chills, and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

For about 1 person in 5, severe pain can continue even long after the rash has cleared up. This long-lasting pain is called post-herpetic neuralgia (PHN).

Shingles is far more common in people 50 years of age and older than in younger people, and the risk increases with age. It is also more common in people whose immune system is weakened because of a disease such as cancer or by drugs such as steroids or chemotherapy.

At least 1 million people a year in the United States get shingles.

Shingles vaccine (recombinant)

Recombinant shingles vaccine was approved by FDA in 2017 for the prevention of shingles. In clinical trials, it was more than 90% effective in preventing shingles. It can also reduce the likelihood of PHN.

Two doses, 2 to 6 months apart, are recommended for adults 50 and older.

This vaccine is also recommended for people who have already gotten the live shingles vaccine (Zostavax). There is no live virus in this vaccine.

Some people should not get shingles vaccine (recombinant) or should wait.

Tell your vaccine provider if you:

  • Have any severe, life-threatening allergies.
    • A person who has ever had a life-threatening allergic reaction after a dose of recombinant shingles vaccine, or has a severe allergy to any component of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components.
  • Are pregnant or breastfeeding.
    • There is not much information about use of recombinant shingles vaccine in pregnant or nursing women. Your healthcare provider might recommend delaying vaccination.
  • Are not feeling well. If you have a mild illness, such as a cold, you can probably get the vaccine today. If you are moderately or severely ill, you should probably wait until you recover. Your doctor can advise you.

Risks of a vaccine reaction to shingles vaccine (recombinant)

With any medicine, including vaccines, there is a chance of reactions.

After recombinant shingles vaccination, a person might experience:

  • Pain, redness, soreness, or swelling at the site of the injection
  • Headache, muscle aches, fever, shivering, fatigue

In clinical trials:

  • most people got a sore arm with mild or moderate pain after vaccination
  • some also had redness and swelling where they got the shot
  • some people:
    • felt tired
    • had muscle pain
    • had a headache
    • had shivering
    • had fever
    • had stomach pain
    • had nausea
  • About 1 out of 6 people who got recombinant zoster vaccine experienced side effects that prevented them from doing regular activities.
  • Symptoms went away on their own in about 2 to 3 days.
  • Side effects were more common in younger people.

You should still get the second dose of recombinant zoster vaccine even if you had one of these reactions after the first dose.

Other things that could happen after this vaccine:

  • People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
  • Some people get shoulder pain that can be more severe and longer-lasting than routine soreness that can follow injections. This happens very rarely.
  • Any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

Like the safety for all vaccines, the shingles vaccine (live) is being closely monitored for unusual or severe problems.

What if there is a serious problem?

What should I look for?

  • Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior.
  • Signs of a severe allergic reaction can include:
    • hives
    • swelling of the face and throat
    • difficulty breathing
    • a fast heartbeat
    • dizziness
    • weakness

These would start a few minutes to a few hours after the vaccination.

What should I do?

  • If you think it is a severe allergic reaction or other emergency that can’t wait, call your local emergency service or get the person to the nearest hospital. Otherwise, call your doctor.

Sources

Adapted from Immunization Action Coalition, Vaccine Information Statements