From the Guidelines
The shingles vaccine can potentially cause eye pain as a side effect, though it is not common, and individuals who experience severe or persistent eye pain after vaccination should contact their healthcare provider. The two available shingles vaccines, Shingrix and Zostavax, may cause temporary side effects including headache which could be perceived as eye pain in some individuals. Most commonly, people experience arm pain, redness, and swelling at the injection site, along with general symptoms like fatigue, muscle pain, headache, fever, and stomach discomfort. These side effects typically resolve within 2-3 days. The benefits of shingles vaccination generally outweigh the risks of side effects, as shingles itself can cause severe eye complications if the virus affects the ophthalmic nerve, as noted in studies such as 1 and 1. The vaccine works by boosting your immune system's response to the varicella-zoster virus, which may temporarily trigger inflammatory responses that could manifest as various forms of discomfort, including headaches that might affect the eye region. Key points to consider include:
- The shingles vaccine is recommended for immunocompetent adults 50 years or older, as stated in 1.
- The recombinant zoster vaccine (RZV) is preferred over the live zoster vaccine (ZVL) due to its higher efficacy and safety profile, as seen in 1 and 1.
- Herpes zoster vaccination is strongly recommended in patients 50 years or older and patients 19 years or older who are immunocompromised, as mentioned in 1. It is essential to follow the recommended vaccination schedule and to discuss any concerns or potential side effects with a healthcare provider, as they can provide personalized guidance and care. In the context of real-life clinical medicine, the benefits of shingles vaccination in preventing severe eye complications and other morbidity associated with herpes zoster infection outweigh the risks of temporary side effects, including eye pain.
From the Research
Shingles Vaccine and Eye Pain
- The shingles vaccine is recommended for adults aged 50 and over to prevent shingles, a painful rash caused by the varicella zoster virus 2.
- While the vaccine is generally well-tolerated, there have been reports of eye-related complications, including unilateral ptosis, proptosis, and orbital myositis, which resolved after treatment with steroids 3.
- Herpes zoster ophthalmicus, a condition that can cause eye pain, can be treated with oral antivirals, which have been shown to reduce the incidence and severity of complications, including eye pain 4, 5, 6.
- However, it is not clear if the shingles vaccine can directly cause eye pain, as the available evidence primarily focuses on the treatment and prevention of herpes zoster ophthalmicus and its complications, rather than the vaccine's potential side effects 2, 4, 5, 6.
- One study reported a case of orbital inflammation, including eye pain, after shingles vaccination, which may represent an autoimmune reaction to the vaccine 3.