Can I get the shingles vaccine if I have ocular shingles with persistent symptoms but no open lesions?

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Shingles Vaccination in Patients with Ocular Shingles

Yes, you can receive the shingles vaccine if you have ocular shingles with persistent symptoms but no open lesions. The vaccine can help prevent future episodes of shingles, which is particularly important since you've already experienced ocular involvement.

Rationale for Vaccination

  • The shingles vaccine is a live attenuated vaccine that boosts specific T-cell production against the varicella zoster virus (VZV), which can help prevent viral reactivation and development of future herpes zoster episodes 1.
  • Having had shingles once does not prevent future recurrences, and vaccination can reduce the risk of subsequent episodes.
  • This is especially important for patients with ocular involvement, as ocular complications can lead to serious consequences including vision loss.

Timing Considerations

When deciding when to get vaccinated after having ocular shingles:

  1. Wait until acute phase has resolved:

    • No open lesions should be present (which you've indicated is the case)
    • The most active inflammatory phase should have passed
  2. Persistent symptoms without active lesions do not contraindicate vaccination:

    • Post-herpetic neuralgia or residual ocular symptoms without active viral replication are not contraindications
    • The vaccine will not worsen existing symptoms and may help prevent future episodes

Special Considerations for Ocular Shingles

  • Ophthalmologist consultation: Before vaccination, consult with your ophthalmologist to ensure your ocular condition is stable enough for vaccination
  • Monitor for changes: After vaccination, be vigilant for any changes in ocular symptoms and report them to your ophthalmologist
  • Continue current treatment: Maintain any prescribed treatments for your ocular symptoms during and after vaccination

Vaccine Safety in Your Situation

  • The shingles vaccine has been shown to be safe and effective in individuals who have previously experienced herpes zoster 2
  • While there is a rare case report of orbital inflammation following shingles vaccination 3, the benefits of preventing recurrent shingles (especially ocular involvement) outweigh this very rare risk
  • Common side effects include injection site reactions (pain/swelling) and headache 1

Contraindications

Do NOT get the shingles vaccine if you:

  • Are immunocompromised
  • Are allergic to neomycin or any component of the vaccine
  • Are pregnant
  • Currently have active, open shingles lesions (which you do not)

Follow-up Care

  • Continue regular follow-up with your ophthalmologist to monitor for any late-onset complications of ocular shingles
  • Report any new symptoms that develop after vaccination
  • Remember that while the vaccine significantly reduces the risk of recurrence (by approximately 50-70%), it does not guarantee complete protection 1

By getting vaccinated, you're taking an important step to protect yourself from future episodes of shingles, which could potentially involve the eye again and lead to more serious complications.

References

Research

Herpes zoster vaccination.

The Korean journal of pain, 2013

Research

Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP).

MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2008

Research

Unilateral Ptosis, Proptosis, and Orbital Myositis After Shingles Vaccination.

Ophthalmic plastic and reconstructive surgery, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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