Dear Dr. Roach: I received the first dose of Shingrix (which help prevent getting shingles) this week and had pretty severe side effects, though in the range of what can be expected: high fever (101.5), intense shivering, a severe headache and 12 hours of extreme fatigue. The entire reaction began 11 hours after the shot and ended 18 hours after that. I am 61 and in excellent health, taking only 25 mcg of levothyroxine daily. Show
I have a few questions that I hope you can answer. I’ve tried looking at the clinical trial results for Shingrix, but I am not qualified to understand the information as presented. 1. Is it likely that I’ll have a similar (or worse?) reaction to the second shot? The package insert says one can react to the first, second, neither or both. 2. Are both injections identical? 3. When I had chickenpox as a child, I was way sicker than the average kid. Related? 4. If I get shingles, do I have a higher risk for a severe case? J.G. Dear J.G.: Compared with the previous one-time vaccine Zostavax, the new two-dose Shingrix vaccine is much more effective. However, it does have a higher risk of side effects. You have had the most common side effect, though only 10 percent of people will have symptoms as bad as yours. These symptoms are caused by your body mounting an inflammatory response to the glycoprotein in the vaccine (the new vaccine does not contain a live virus). You clearly have a robust system to fight off infection. To answer your questions in order: You are at higher risk for a similar reaction for the second shot. I would plan your day accordingly, and premedicate with Tylenol (even though it may make the vaccine slightly less effective). The second vaccine is identical to the first. I have read recent reports that there are widespread shortages of the vaccine. Chickenpox and shingles can affect you both by the virus attacking you and by an exuberant inflammatory and immune reaction. I would guess that you are at lower risk for viral complications (such as infection of the eye, brain or lungs) but at higher risk for symptoms due to your own system, such as high fever. In many cases, the body’s response to infection can be as damaging as the infection itself. Dear Dr. Roach: Please discuss the problem of the thirst mechanism as it relates to the elderly. I’m 70 years old and in almost perfect physical health. I bicycle every day — 75 miles each week. Even with this enormous physical exercise, I am never thirsty all day and night. Also, I do not perspire. I need to force myself to drink water. Why don’t I feel thirsty? M.U. Dear M.U.: Thirst is a powerful motivation. In people with an intact thirst mechanism, the desire for water can be overpowering; it’s one of the body’s main ways of regulating salt and volume in the body. You are exactly right that as people age, the thirst mechanism becomes less powerful, and that tends to leave older people with a slightly higher amount of salt in the body compared with younger people. Remembering to drink water, especially on hot summer days, reduces the risk of dehydration. However, people who drink continually may never trigger the thirst response. There are many social cues to drink, and people who are not losing fluid through exertion and sweat may never trigger a strong thirst response. Drinking too much is as dangerous as not drinking enough: If thirst is really impaired, you need to use other mechanisms to monitor fluid status. For example, needing to urinate every several hours (at least) is one way of staying in the right zone. The shingles vaccine can prevent you from getting shingles and postherpetic neuralgia (PHN), a common complication from shingles. Healthy adults ages 50 years and older should get the vaccine, which is given in two doses. Side effects are usually mild and can include pain, redness and swelling at the injection site. Serious reactions are rare.
OverviewWhat is the shingles vaccine?The shingles vaccine can protect you against shingles and postherpetic neuralgia (PHN), which is the most common complication of shingles. Shingles is a painful rash caused by the varicella-zoster virus, the same virus that causes chickenpox. The rash usually develops on one side of your body or face. It starts with red bumps and then the bumps turn into fluid-filled blisters. What does the shingles vaccine do?The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone who’s had chickenpox can get shingles. That’s because the varicella-zoster virus lives silently in your nervous system after you've had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime. What is the name of the shingles vaccine?In the United States, there is currently one shingles vaccine authorized for use. The shingles vaccine is called Shingrix™ (recombinant zoster vaccine). As of November 18, 2020, another shingles vaccine called Zostavax® is no longer available for use in the United States. Who should get the shingles vaccine?The CDC recommends all healthy adults ages 50 years and older get two doses of the shingles vaccine to prevent shingles and problems that can develop after you’ve had the disease. The two doses should be separated by two to six months. You should get the shingles vaccine even if you:
Who should not get the shingles vaccine?Some people shouldn’t get the shingles vaccine. These people include those:
Procedure DetailsHow is the shingles vaccine given?Your healthcare provider will give you the shingles vaccine as an injection (shot) in your upper arm. You will get two doses of the vaccine separated by two to six months. Risks / BenefitsWhat are the advantages of getting the shingles vaccine?The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month. Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach. For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia (PHN), and it is the most common complication of shingles. What side effects can the shingles vaccine cause?The shingles vaccine helps your body’s immune system build up a solid defense against shingles, so you may experience temporary side effects after getting the shots. These side effects may include:
Severe reactions to the shingles vaccine are extremely rare. If you develop any of the following signs of an allergic reaction, call 911 or go to your nearest ER:
Recovery and OutlookHow effective is the shingles vaccine in preventing shingles?The shingles vaccine can provide strong protection against shingles and postherpetic neuralgia (PHN), the most commonly occurring shingles complication. The shingles vaccine is 97% effective in preventing shingles in people ages 50 to 69 years old. It’s 91% effective in people ages 70 years and older. In addition, the shingles vaccine is 91% effective in preventing PHN in people ages 50 to 69 years old. It’s 89% effective in people ages 70 years and older. How long does the shingles vaccine last?More than 85% of people ages 70 years and older remained protected from shingles for at least four years after they were vaccinated. Since your risk of shingles and PHN increases as you get older, it’s important to have strong protection against shingles in your older years. Can you get shingles after you’ve been vaccinated?While the shingles vaccine is highly effective, some people can still get shingles. However, people who do get shingles after getting the shingles vaccine usually have milder symptoms and a shorter illness. You’ll also be less likely to have complications from shingles, including postherpetic neuralgia. Can you get shingles if you had the chickenpox vaccine?Some people get shingles years after they received the chickenpox vaccine. However, it is much less common to get shingles after receiving the chickenpox vaccine than after having chickenpox. When to Call the DoctorWhat questions should I ask my healthcare provider?It’s normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
Frequently Asked QuestionsHow long after I’ve received the shingles vaccine am I contagious?With the currently authorized shingles vaccine, Shingrix, you won’t be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them. Shingrix doesn’t use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone. A note from Cleveland Clinic No one likes to get shots, especially for something you’ve already been vaccinated for. But the newer version of the shingles vaccine is one you’ll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles. Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 05/13/2022. References
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Is second Shingrix shot worse than first?Shingrix is administered in two doses, usually two to six months apart. Shingrix is safe and effective for most people. Side effects from the second dose of Shingrix are somewhat more common than the first dose, although that's not always the case. Most side effects of Shingrix are mild and resolve on their own.
How long will I be sick after second shingles shot?Other reactions that may occur after getting Shingrix® include fever, muscle soreness, fatigue, shivering, nausea, vomiting and diarrhea. According to the Canadian Immunization Guide, these reactions have been temporary, lasting 2-3 days in studies (clinical trials).
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