Alarming News for Shingle Vaccine Recipients

This article originally appeared on The Epoch Times and was republished with permission.

Guest post by Marina Zhang

Getting the recombinant zoster (shingles) vaccine (RZV), or Shingrix, if you have had an ocular shingles event, may increase your risk of experiencing a second event, a recent study shows.

Ocular shingles refers to all shingles that manifest in the eye area. Milder cases of ocular shingles typically occur near the eyelids, while more severe cases may cause inflammation inside the eyes and potentially lead to blindness.

Researchers at the University of California (UC)–San Francisco found that, compared to unvaccinated people with a history of ocular shingles, those who receive the RZV have 1.64 times the risk of developing ocular shingles again.

“It’s not a huge increased risk,” lead author Dr. Nisha Acharya, director of the Uveitis and Ocular Inflammatory Disease Service at UC–San Francisco, told The Epoch Times.

“To my knowledge, it’s the first data that we have on risks of reactivation following zoster vaccination for this patient population who already have the disease. I think it raises some questions.”

Reactivation of Ocular Shingles May Not Be Viral Reactivation

Shingles is caused by the chickenpox (varicella) virus. After a person gets chickenpox, the virus retreats into the nerves in the body and becomes dormant. If the virus lies dormant in the nerves going into the eye, it can later cause ocular shingles during viral reactivation.

Roughly 10 percent to 20 percent of people who contract shingles will develop ocular shingles, according to the American Academy of Neurology.

While shingles recurrence on the skin is common and usually a sign of the latent virus acting up, there may be another mechanism to explain some ocular recurrences: “your immune system reacting against some remnant of the prior infection,” Dr. Acharya said.

Because the vaccine activates the immune system, it may cause the body to react and target viral-related remnants in the eye, leading to a recurrence of ocular shingles, she said.

“There may not be active, replicating virus anymore, but you can sometimes have inflammation because your immune system is reacting against what we call viral antigens, or parts of the virus or segments related to that prior infection,” Dr. Acharya said.

What This Means for Vaccine Recommendations

Dr. Acharya said it is still too early to conclude whether current vaccine recommendations should be changed.

Since 2020, the RZV has been the only shingles vaccine available in the United States.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all people older than 50 and immunocompromised people older than 19 should get vaccinated, even if they have a history of shingles.

“There hasn’t really been any compelling evidence that having an episode of zoster will prevent you from getting a subsequent episode,” Dr. Rafael Harpaz, a retired infectious disease epidemiologist from the CDC, who specialized in herpes zoster and varicella virus, told The Epoch Times.

“In that respect, since the vaccine definitely does prevent zoster, it is more effective than actually getting zoster itself.”

However, because no data exist on RZV safety in patients with a history of ocular shingles, some ophthalmologists have been reluctant to recommend vaccinations to patients with ocular shingles, the authors discussed in their study.

Dr. Acharya’s team evaluated more than 16,400 patients with ocular shingles in their database. Those who went on to get RZV vaccines were tracked for up to 90 days and compared against those with a history of ocular shingles but who did not get vaccinated.

Only those prescribed medication because of a recurring ocular shingles diagnosis were considered to be recurring cases. The authors reported that recurrence of ocular shingles eight weeks after vaccination “was 37.7 per 1000 person-years compared with 26.2 per 1000 person-years in the [unvaccinated] group.”

Read the full story at The Epoch Times.