What are the side effects of the Herpes Zoster (shingles) vaccine?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

The shingles vaccine, particularly Shingrix, commonly causes temporary side effects that typically last 2-3 days, including pain, redness, and swelling at the injection site, as well as systemic side effects such as muscle pain, fatigue, headache, shivering, fever, and upset stomach, as reported in the study by 1.

Common Side Effects

  • Pain, redness, and swelling at the injection site
  • Systemic side effects including muscle pain, fatigue, headache, shivering, fever, and upset stomach

Management of Side Effects

These reactions are generally more common and intense than with other adult vaccines, with the second dose often causing more pronounced effects than the first. While these side effects can be uncomfortable, they're a sign that your body is building protection against shingles. Taking over-the-counter pain medications like acetaminophen or ibuprofen after vaccination can help manage these symptoms.

Serious Side Effects

Serious allergic reactions are extremely rare, as noted in the study by 1. Despite the temporary discomfort, the vaccine's benefits in preventing shingles and its complications (particularly postherpetic neuralgia, which causes long-term nerve pain) significantly outweigh these short-term side effects for adults 50 and older. The study by 1 also highlights that the recombinant zoster vaccine, Shingrix, has a higher efficacy and persistence of protection compared to the live zoster vaccine, Zostavax.

From the FDA Drug Label

The reported frequencies of specific solicited local adverse reactions and general adverse reactions (overall per subject), by age group, from the 2 studies are presented in Table 1. Adverse Reactions Aged 50-59 Years Aged 60-69 Years Aged ≥70 Years SHINGRIX Placebo Local Adverse Reactions n = 1,315 % n = 1,312 % n = 1,311 % n = 1,305 % n = 2,258 % n = 2,263 % Pain 88 14 83 11 69 9 Pain, Grade 3d 10 1 7 1 4 0. 2 Redness 39 1 38 2 38 1 Redness, >100 mm 3 0 3 0 3 0 Swelling 31 1 27 1 23 1 Swelling, >100 mm 1 0 1 0 1 0 General Adverse Reactions n = 1,315 % n = 1,312 % n = 1,309 % n = 1,305 % n = 2,252 % n = 2,264 % Myalgia 57 15 49 11 35 10 Myalgia, Grade 3e 9 1 5 1 3 0.4 Fatigue 57 20 46 17 37 14 Fatigue, Grade 3e 9 2 5 1 4 1 Headache 51 22 40 16 29 12 Headache, Grade 3e 6 2 4 0.2 2 0. 4 Shivering 36 7 30 6 20 5 Shivering, Grade 3e 7 0.2 5 0.3 2 0.3 Fever 28 3 24 3 14 3 Fever, Grade 3f 0.4 0.2 1 0.2 0.1 0.1 GIg 24 11 17 9 14 8 GI, Grade 3e 2 1 1 1 1 0. 4

The side effects of the shingles vaccine include:

  • Local adverse reactions:
    • Pain (69-88% of subjects)
    • Redness (38-39% of subjects)
    • Swelling (23-31% of subjects)
  • General adverse reactions:
    • Myalgia (35-57% of subjects)
    • Fatigue (37-57% of subjects)
    • Headache (29-51% of subjects)
    • Shivering (20-36% of subjects)
    • Fever (14-28% of subjects)
    • Gastrointestinal symptoms (14-24% of subjects) 2

From the Research

Side Effects of Shingles Vaccine

  • The studies provided do not directly discuss the side effects of the shingles vaccine, but rather focus on its efficacy, safety, and recommendations for use in different populations 3, 4, 5, 6, 7.
  • However, it can be inferred that the shingles vaccine is generally safe, with some studies mentioning that it can be used in immunocompromised individuals and that its safety profile is not affected by previous vaccination with a live-attenuated herpes zoster vaccine 4, 7.
  • One study mentions that the recombinant zoster vaccine (RZV) is nonreplicating and thus safe in immunocompromised persons, suggesting that it may have a favorable safety profile compared to live-attenuated vaccines 4.
  • Another study discusses the importance of considering herpes zoster vaccination in eligible at-risk populations to protect against the disease and its associated complications, implying that the benefits of vaccination may outweigh the risks 3.

Vaccine Safety and Efficacy

  • The studies consistently show that the shingles vaccine is effective in preventing herpes zoster and its associated complications, with some studies demonstrating high efficacy rates in different populations 3, 4, 5, 7.
  • The recombinant zoster vaccine (RZV) is shown to be more effective than the live-attenuated varicella-zoster virus (VZV) vaccine in preventing herpes zoster 4.
  • The safety and efficacy of the shingles vaccine have been demonstrated in clinical trials and real-world effectiveness studies, with some studies highlighting the importance of vaccination in preventing the disease and its associated complications 3, 4, 6.

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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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