Vaccine

Shingles after Shingrix: Transient risk or cause for concern?

December 5, 2025

A self-controlled case-series analysis of two Australian datasets found an 11-fold increase in shingles presentations within 21 days after the first dose of recombinant zoster vaccine (RZV, Shingrix) among adults ≥65 years. No increase was observed in younger adults. After the second dose, shingles risk decreased across all age groups, and recipients had a 73% reduction in shingles overall. Postherpetic neuralgia risk wasn't elevated. Researchers conclude the transient increase after dose one is likely mild and outweighed by strong protection after completing the two-dose series.

Clinical takeaway: Counsel older patients about possible mild shingles shortly after dose one, but emphasize completing both doses for sustained protection.

Source:

Shetty AN, et al. (2025, September 9). Clin Infect Dis. Transient increased risk of shingles post Shingrix vaccination: Self-controlled case series analysis. https://pubmed.ncbi.nlm.nih.gov/40924159/