How soon do side effects start after receiving the Shingrix vaccine? – Side effects can start as soon as you receive your dose. While they won’t happen to everyone, pain, discoloration, and swelling at the injection site can appear right away. But these are short-term side effects that usually last 2 or 3 days.
chills injection site itchiness malaise (a general feeling of discomfort) joint pain nauseadizziness
If you’re concerned about how soon side effects can start with Shingrix, talk with your doctor. They can help you prepare for immediate side effects and manage any that happen later.
- 0.1 How soon after shingles vaccine do you feel bad?
- 0.2 Why do I feel so bad after my second shingles shot?
- 0.3 Does the first or second shingles shot have more side effects?
- 1 Can you drink alcohol after shingles vaccine?
- 2 Is Shingrix a live virus vaccine?
- 3 Can Shingrix cause Guillain Barre Syndrome?
- 4 Can you get a COVID shot and shingles shot at the same time?
- 5 What should you not do before getting the shingles vaccine?
- 6 Which is better Shingrix or Zostavax?
- 7 Should I take it easy after shingles vaccine?
- 8 Is it OK to take ibuprofen after shingles vaccine?
How soon after shingles vaccine do you feel bad?
Who Should Get Shingrix? – Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix.
Had shingles Received Zostavax* Received varicella (chickenpox) vaccine
There is no maximum age for getting Shingrix. If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
- Chickenpox and shingles are related because they are caused by the same virus (varicella-zoster virus).
- After a person recovers from chickenpox, the virus stays dormant (inactive) in the body.
- It can reactivate years later and cause shingles.
- Shingrix is available in doctor’s offices and pharmacies.
- If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live (Zostavax) is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix. Currently have shingles. Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine. Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia (PHN), the most common complication of shingles.
In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles; in adults 70 years and older, Shingrix was 91% effective. In adults 50 years and older, Shingrix was 91% effective in preventing PHN; in adults 70 years and older, Shingrix was 89% effective. In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination. Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots.
The side effects might affect your ability to do normal daily activities for 2 to 3 days. Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea.
Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people. You might have a reaction to the first or second dose of Shingrix, or both doses.
If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Guillain-Barré syndrome (GBS), a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the, or by calling 1-800-822-7967. If you have any questions about side effects from Shingrix, talk with your doctor.
- Shingrix causes a strong response in your immune system, so it may produce,
- These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days.
- You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
- Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction.
Why do I feel so bad after my second shingles shot?
Common side effects of the second dose of the Shingrix vaccine include pain, swelling, and fever. Some side effects are more likely to occur after the second dose than after the first dose. Shingrix is a Food and Drug Administration (FDA)-approved vaccine that helps prevent shingles, an infection caused by the reactivation of the varicella-zoster virus, in adults ages 50 and older.
In this article, we review all the potential side effects of Shingrix. We also explore how to ease symptoms and when to seek medical help. Pain at the injection site is a common side effect of many vaccines, including Shingrix. This pain is generally mild but can feel like anything from slight discomfort to deep bruising.
In some cases, injection site pain can be severe enough to limit arm movement. To ease this discomfort, you can apply cold packs to the affected area for 20 minutes at a time. If these aren’t effective, over-the-counter (OTC) pain remedies may help. However, if you have injection site pain that is severe or lasts longer than 2 to 3 days, follow up with your doctor.
Redness at and around the injection site is common and may appear immediately or some days after receiving Shingrix. This redness commonly develops due to a localized immune system response, which shouldn’t cause further concern. Arm redness should disappear within a few days after receiving the vaccine.
However, if you experience redness with a rash or severe pain, let your doctor know as soon as possible. Swelling around the injection site is another common side effect of Shingrix. Like pain and redness, minor swelling can usually result from a localized immune system response, which isn’t necessarily dangerous.
You can apply hydrocortisone cream on or around the injection site to reduce redness and swelling. However, if you experience severe swelling that doesn’t go away, or the swelling accompanies other symptoms of an allergic reaction, seek medical attention right away.
- Itchy skin, also called pruritus, can potentially occur near the injection site after receiving Shingrix.
- Itching, swelling, and redness aren’t usually a huge cause for concern, as they often occur together as a localized reaction.
- Applying Benadryl gel (or spray) or hydrocortisone cream around the injection area can help reduce itchy, swollen, or red skin.
If the itching worsens or spreads away from the injection site, get in touch with your doctor. Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches.
A fever indicates that the body’s immune system is doing its job of responding to the vaccine. Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F (39.4°C) or higher, reach out to your doctor immediately.
Muscle pain, also known as myalgia, is another common side effect of most vaccines, including Shingrix. The symptom is more common after receiving the second dose, as the body continues to build stronger immunity to the virus. You can take OTC remedies to help ease muscle pain.
This symptom generally peaks within the first few days after the vaccine and disappears as the immune system settles back down. Joint pain, also called arthralgia, is a potential side effect of Shingrix that commonly occurs with muscle pain. This type of pain after a vaccine is generally due to a temporary increase in inflammation, which can affect the fluid around the joints.
Like muscle pain, taking an OTC pain reliever can help reduce joint pain from the vaccine. However, ask a doctor to look at any joint or muscle pain that doesn’t go away within a few days. Chills and muscle pain can occur together as a side effect of the Shingrix vaccine.
- Like muscle pain, body chills are more common after the second dose due to an increased immune system response to the vaccine.
- Wrapping up in warm clothes and blankets, increasing the room temperature, and even taking a warm bath or shower can help ease body chills and aches.
- This symptom should disappear within 2 to 3 days after receiving the vaccine.
Fatigue is a common side effect of the second dose of Shingrix that can range from mild to severe. This symptom often occurs after vaccination when the body exerts extra energy to keep the immune system working. Resting throughout the day, getting extra sleep, and making sure not to overexert yourself can help reduce fatigue levels.
- Energy levels should usually return to normal within a few days of adequate rest, hydration, and nutrition.
- Headaches are another common side effect from the second dose of Shingrix and often occur in conjunction with fever.
- People who frequently get headaches or migraine attacks when sick may be more susceptible to developing a headache after vaccination.
OTC pain medications and adequate water and sleep can help relieve headache symptoms. However, if you have been experiencing headaches or head pain that worsens or persists without medication, reach out to your doctor. Dizziness is a potential side effect of the Shingrix vaccine that often accompanies other symptoms, like fever and headache.
- Inflammation within the sensory system is a common cause of dizziness after receiving a vaccine.
- Lying down and resting when you start to feel dizzy can help ease this symptom.
- Speak with your doctor right away if you’re unable to move around without feeling dizzy or you’ve been experiencing frequent dizzy spells.
Nausea, vomiting, diarrhea, and abdominal pain are all side effects of the Shingrix vaccine. It’s common for gastrointestinal side effects — especially nausea or upset stomach — to accompany other side effects like fever, headache, and dizziness. Eating a bland diet and staying hydrated are two of the most important steps for easing gastrointestinal discomfort,
hivesface swellingthroat swellingdifficulty breathingfast heart ratedizzinessweakness
If you experience any of the above symptoms after receiving the Shingrix vaccine, seek medical attention immediately. Older adults are often more susceptible to shingles and the long-term complications it can cause, so Shingrix is intended for adults ages 50 and older. According to the Centers for Disease Control and Prevention (CDC), you should receive Shingrix if you:
are healthyhad a previous shingles vaccine called Zostavax aren’t sure if you previously had chickenpox
Healthcare professionals can administer Shingrix to anyone who has had shingles or chickenpox in the past, including those who aren’t sure if they’ve already had chickenpox. Shingrix is a two-dose vaccine that helps prevent shingles in adults ages 50 years and older.
Why do I feel so bad after Shingrix?
What side effects can I expect from the first dose of Shingrix? – The Shingrix vaccine is a two-dose series, which means that you’ll receive one dose of the vaccine, and then a second dose between 1 and 6 months later. Mild side effects after getting your first dose of Shingrix are common. Examples of mild side effects that were commonly reported in clinical trials of Shingrix include:
fatigue dizziness fainting gastrointestinal side effects*reaction at the injection site*muscle pain*
Though these side effects can occur after your Shingrix dose, not everyone receiving the vaccine will experience them. In addition, most side effects from Shingrix only lasted between 2 and 3 days before easing. So if you do experience side effects, they are typically short term.
Does the first or second shingles shot have more side effects?
Summary – The FDA approved the shingles vaccine Shingrix to prevent shingles and possible health complications. The CDC recommends adults ages 50 and older and immunocompromised adults ages 19 and over get two doses of Shingrix. 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.
- The most common side effects from the shingles vaccine include redness/pain/swelling at the site of injection, headache, itchiness, muscle pain, joint pain, chills, fatigue, headache, dizziness, and upset stomach.
Very rarely, serious side effects, such as a severe allergic reaction, may occur.
Can you drink alcohol after shingles vaccine?
Shingrix and alcohol There aren’t any specific warnings or guidelines about alcohol and Shingrix. If you have concerns about drinking alcohol and getting the Shingrix vaccine, talk with your doctor.
What medications to avoid after shingles vaccine?
Some products that may interact with this vaccine include: drugs that weaken the immune system (including cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone), certain antiviral drugs (such as acyclovir, famciclovir, valacyclovir).
Is second Shingrix shot worse than first?
The lowdown – When receiving the Shingrix vaccine, a person should expect to start experiencing symptoms immediately afterward. Most people experience side effects after the second dose as opposed to the first one, but side effects may appear following either dose. A person should seek medical assistance if symptoms become severe.
Is Shingrix a live virus vaccine?
A: Yes, Shingrix is an inactive vaccine so you can administer it with other inactive or live vaccines.
Is there a downside to the shingles vaccine?
Should I get the shingles vaccine? If I’ve already had shingles, should I get the vaccine so that I don’t get shingles again? – Answer From Pritish K. Tosh, M.D. People who are eligible to get it should get the Shingrix vaccine in the U.S. Shingrix is recommended by the Centers for Disease Control and Prevention (CDC) for adults age 50 and older for the prevention of shingles and related complications, whether they’ve already had shingles or not.
You may get the Shingrix vaccine even if you’ve already had shingles. Also, consider getting the Shingrix vaccine if you’ve had the Zostavax vaccine in the past, or if you don’t know whether you’ve had chickenpox. Shingrix is a nonliving vaccine made of a virus component. It’s given in two doses, with 2-6 months between doses.
The most common side effects of a shingles vaccine are redness, pain, tenderness, swelling and itching at the injection site, and headaches. The shingles vaccine Zostavax is no longer sold in the U.S. but may be available in other countries. Although some people will develop shingles despite vaccination, the vaccine may reduce the severity and duration of it.
- Have ever had an allergic reaction to any component of the shingles vaccine
- Have a weakened immune system due to a condition or medication
- Have had a stem cell transplant
- Are pregnant or trying to become pregnant
The cost of the shingles vaccine may not be covered by Medicare, Medicaid or insurance. Check your plan. With Pritish K. Tosh, M.D.
Can Shingrix cause Guillain Barre Syndrome?
Recurrence of a Rare Subtype of Guillain-Barré Syndrome Following a Second Dose of the Shingles Vaccine Monitoring Editor: Alexander Muacevic and John R Adler 1 Medical Education, Wayne State University School of Medicine, Detroit, USA Find articles by 2 Family Medicine, Western Michigan University Homer Stryker M.D.
School of Medicine, Kalamazoo, USA Find articles by © 2022, Chohan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy. The exact cause of GBS remains unknown, however, it commonly develops post-infection. Since the 1950s, various vaccines have been attributed to causing the syndrome, yet no definitive relationship has ever been determined.
- In 2021, the Food and Drug Administration (FDA) placed a black-box warning for Shingrix, a non-live recombinant vaccine against the varicella-zoster virus, regarding a possible risk of acquiring GBS post-vaccination in adults aged 65 and older.
- We report the recurrence of a rare subtype of GBS in a 61-year-old patient following the second dose of Shingrix.
This case highlights the difficulty of diagnosing and treating recurrent GBS. It also raises awareness that Shingrix may be related to the development of GBS in younger patients. This case also emphasizes the importance of differentiating GBS from other polyneuropathies.
- Eywords: gbs variant, neuromuscular disease, vzv, zoster vaccine, shingrix, guillain-barré syndrome Guillain-Barré Syndrome (GBS) is an immune-mediated polyneuropathy.
- It is thought to be the most common form of acute, flaccid neuromuscular paralysis in the United States.
- Every year, there are one to two cases per 100,000 individuals, with the highest incidence in males,
The pathogenesis of GBS is the formation of immunoglobulin G (IgG) autoantibodies against gangliosides in myelinated axons of the peripheral nervous system. This demyelination, in turn, leads to the delayed transmission of impulses between neurons. About 70% of patients develop the syndrome after an infection,
Campylobacter jejuni (C. jejuni) is thought to be the most common preceding agent, However, nonspecific viral pathogens that cause diarrheal illnesses may also be implicated. In turn, molecular mimicry, where antibodies against recently acquired infectious agents may react with gangliosides on neurons, may be involved in GBS,
GBS can present as differing variants. The most common variant in the United States, acute inflammatory demyelinating polyradiculopathy (AIDP), is characterized by lymphocytic infiltration of myelin, Acute motor axonal neuropathy (AMAN) and acute motor and sensory axonal neuropathy (AMSAN) are rare variants that may occur due to molecular mimicry of axonal components.
The former is characterized by motor impairment only, while the latter is characterized by motor and sensory weakness. Most variants of GBS only affect the peripheral nervous system. Symptoms are characterized by progressive, bilateral weakness of the extremities. This leads to diminished deep tendon reflexes and ataxia.
Sensory disturbances are nonspecific but include paresthesia, numbness, and impaired proprioception and vibration. There are four required criteria for the diagnosis of GBS: 1. progressive symmetric weakness of more than a single limb; 2. hyporeflexia or areflexia; 3.
Progression of symptoms in less than four weeks; 4. symmetric weakness, An initial diagnosis of GBS is often made clinically. After admitting the patient, the next step is performing a lumbar puncture. Cerebrospinal fluid analysis commonly shows albuminocytological dissociation – an increase in protein count but normal lymphocyte count.
The prevalence of this finding has an 80% sensitivity for the disorder, A nerve conduction study can be performed. Electrodes are placed on the skin overlying a nerve and measure the speed of electrical impulses moving through neurons. Delayed F-waves, motor responses to nerve stimulations, and lower conduction velocities are characteristic of GBS.
While this is the main diagnostic test done, electromyography (EMG) may also be performed. This measures the strength of impulses traveling to muscles. Diminished speed points to GBS and which specific variant the patient may have. The most lethal complication of GBS is diaphragmatic weakness and subsequent respiratory failure.
As such, frequent monitoring of vital capacities and inspiratory force is done, If needed, the patient may be intubated and placed on mechanical ventilation. Plasma exchange (PLEX) or intravenous immunoglobulin G therapy (IVIG) is often done for patients experiencing debilitating weakness.
- PLEX directly removes antibodies and immune complexes in the plasma that may be causing GBS.
- IVIG’s role is less understood but is thought to impair antigen presentation, modulation of antibodies, and disruption of complement,
- Shingles, known as Herpes Zoster, is an infection that occurs after varicella-zoster virus (VZV) reactivation.
VZV is often acquired in childhood and can remain latent in the dorsal root ganglion. Immunosuppression (from other illnesses) or age-related immune system decline can lead to decreased protection against the virus, and subsequent reactivation, The diagnosis of VZV is clinical, with the appearance of a painful, pustular rash in a dermatomal pattern.
In October 2017, the Federal Drug Administration (FDA) approved Shingrix, a non-live recombinant vaccine aimed to prevent shingles in adults 50 years and older. Administered in two doses, two to six months apart, the most common side effects are pain at the site of injection, muscle aches, and fever.
In March 2021, the FDA placed a black box warning on Shingrix regarding the possible risk of acquiring GBS. A self-controlled case series found an increased risk of GBS during a 42-day period after vaccination with Shingrix, The study also found an estimated three cases of GBS per million vaccinations administered in adults aged 65 and older,
- This report illustrates the case of an elderly male who developed the rare acute motor sensory axonal neuropathy (AMSAN) variant of GBS.
- He recovered fully.
- Almost a year after his initial episode, the patient experienced a recurrence of the AMSAN variant of GBS following the administration of the Shingrix vaccine.
The patient had no other illnesses or infectious exposures prior to his recurrence episode. Recurrent GBS is a rare phenomenon and difficult to diagnose. Limited literature exists on how the disorder presents and the risk factors associated with it. We hope to increase awareness of recurrent GBS and the possible link to vaccination with this case report.
- Initial episode The patient was a 61-year-old with a past medical history of hypothyroidism, bipolar disorder, obstructive sleep apnea, hyperlipidemia, lumbar spine surgery, and right total knee replacement.
- Over the course of two weeks, the patient developed weakness in his body.
- He had recurrent, five-minute-long episodes of bilateral shaking of hands, which progressed to his entire body.
His leg weakness and gait instability lead to three falls. The patient endorsed feeling particularly weak when standing and needing to support himself with a wall to remain upright. The patient denied experiencing vertigo, visual impairment, hearing loss, sensory impairment, headaches, or loss of consciousness.
- After visiting his psychiatrist, who noticed his weakness, he was encouraged to visit the emergency department (ED).
- Upon arrival at the ED, the patient was admitted to neurology and underwent further workup.
- The patient denied recent illnesses, gastrointestinal issues, or travel outside his home state.
Physical examination showed globally reduced pinprick sensation, reduced sensation to vibration bilaterally below the ankles, and impaired proprioception bilaterally below the ankles. The patient had absent deep tendon reflexes in the bilateral upper and lower extremities.
Romberg sign was also present at the time of examination. The patient had no abnormalities on an initial complete blood count, comprehensive metabolic panel, and urinalysis. All hormones and inflammatory mediators were within normal limits. ENA, ANA, anti-DSDNA, anti-GQ-1B, and anti-GQ-1C were negative.
A paraneoplastic panel revealed no abnormalities.C. jejuni antibodies were negative. A lumbar puncture revealed albuminocytological dissociation-elevated protein with normal leukocyte count (Table ). Nerve conduction and EMG were also done and pointed to a diagnosis of the AMSAN variant of GBS.
|CSF Parameters||Patient’s Values||Reference|
|Leukocyte Count||4||0-5 mm 3|
|Lactic acid||17||10-25 mg/dL|
|Oligoclonal bands||Negative||Negative in GBS|
The patient received five sessions of plasma exchange (PLEX) every other day over the course of one week. He received four total sessions. He gradually experienced an improvement in motor and sensory parameters. He was discharged after eight days with referrals to outpatient physical/occupational therapy and neurology.
- Recurrence episode Approximately 10 months later, the patient presented to his neurologist due to one week of difficulty walking.
- The patient endorsed feeling “wobbly” and unable to feel sensations in his fingers and toes.
- He also endorsed shortness of breath.
- Due to possible respiratory distress, his neurologist advised him to go to the emergency department.
Upon arrival, the patient was again admitted. The patient denied recent illnesses, gastrointestinal issues, or travel outside his home state. The patient said he received a second dose of Shingrix two weeks before symptoms started. Since his symptoms presented nearly identically to the first episode, the patient was diagnosed with acute recurrent exacerbation of the AMSAN variant of GBS.
He was monitored for respiratory distress with pulmonary function testing every eight hours. Physical examination showed globally reduced pinprick sensation, reduced sensation to vibration bilaterally below the ankles, and impaired proprioception bilaterally below the ankles. The patient had absent deep tendon reflexes in the bilateral upper and lower extremities.
Romberg’s sign was unable to be assessed. The patient again received PLEX therapy daily for a total of four sessions. The patient experienced a complete improvement in motor strength. Sensation and reflexes continued to improve but had not yet returned to baseline.
- After five days of admission, the patient was discharged with recommendations to follow up with his neurologist.
- Over time, the introduction of several new vaccines has subsequently led to an increase in reported GBS cases.
- However, to date, little concrete evidence exists proving vaccines can cause the syndrome.
The 1976 influenza vaccine originated this association, with an estimated eight-fold increase in developing GBS, Subsequent seasonal influenza vaccinations have not been associated with a risk of developing GBS, After the introduction of the polysaccharide diphtheria toxoid conjugate vaccine (MCV4) in 2004, frequent reports of GBS occurring in children surfaced.
- Further studies have found no concrete association between the two,
- The introduction of the measles/mumps/rubella, human papillomavirus, and rabies virus has also led to numerous case reports of post-vaccination GBS.
- No causal relationship has ever been found,
- In addition to the primary trial that showed a modestly increased risk of developing GBS following Shingrix administration, there have been several case reports of this phenomenon.
In 2019, one report described a 76-year-old female who developed the syndrome 10 days following her first dose of Shingrix, Initial treatment with IVIG resulted in marked improvement; however, upon discharge, the patient re-experienced symptoms of GBS.
- Further treatment with PLEX resulted in a return to baseline.
- Another report from 2020 describes a 79-year-old male who developed GBS 10-days following Shingrix administration,
- He was treated successfully with IVIG.
- Both reports are consistent with the primary trial, which found an increased risk in adults aged 65 and older who received the first dose,
Recurrence of GBS is defined as a second episode occurring at least two months after complete recovery from the first episode (or at least four months after partial recovery of the first episode), The recurrence rate is around 5%, Patients with recurrent GBS are generally younger and usually present with the Miller-Fisher subtype,
Our patient had the AMSAN variant in both episodes. Treatment of recurrent GBS is similar to initial treatment, focusing on protecting airways and administrating PLEX or IVIG. Treatment of GBS following vaccination remains identical as well. Limited research exists on how similar or severe recurrent GBS is to the initial episode.
Studies from the 1990s generally found that recurrent episodes can be severe with possible respiratory impairment, However, a study from 2020 found most patients to have a mild second episode, Our patient had similar symptoms in each episode. His second episode presented with some respiratory distress in addition to previous symptoms similar to the previous episode.
- This case also highlights the importance of distinguishing recurrent GBS from GBS with treatment-related fluctuation (GBS-TRF) and chronic inflammatory demyelinating polyneuropathy (CIDP), as each is treated differently.
- GBS-TRF, which can occur in up to 15% of patients, there is post-treatment improvement in symptoms and then redevelopment of symptoms within two months,
It may occur due to lasting immune system activation and too early initiation of therapy, Patients with these cases are usually given specific, tailor-made treatments. Similar to GBS, CIDP is a demyelinating autoimmune disease where symptoms slowly worsen and persist longer than eight weeks,
- It is treated with steroids.
- Future studies should focus on determining whether there are links between the triggers for the initial and recurrent GBS episodes.
- This relationship may provide valuable insight into what causes the syndrome to develop.
- Insight into the clinical presentation of recurrent GBS must also be further studied.
Determining how similar it presents to the initial episode, which treatments are appropriate, and if there are any potential triggers will provide insight into how to treat the syndrome. Determining whether Shingrix is associated with GBS in younger patients is of utmost importance.
- Our patient was younger than the demographic the FDA released a black box warning for.
- As we learn more about GBS and its causes, we will better understand any link to vaccines and can provide adequate care to patients suffering from it.
- The limitations of this report include potential exposures to risk factors of GBS that the patient may have been exposed to in the time period between his first and second episodes.
Additionally, recurrent GBS is still poorly understood and its relationship to Shingrix is actively being researched. To our knowledge, this is the first case of GBS recurrence following vaccination with Shingrix. Relatively little data exist regarding GBS recurrence risk after vaccination.
Officially, the CDC recommends precautions for patients with a history of GBS receiving certain vaccinations. In general, providers are recommended to educate the patient on the efficacy and benefit of vaccines and monitor for any potential GBS-like symptoms following vaccination. Clinicians should be specifically cautious for patients of any age, with a past history of GBS, who are receiving the Shingrix vaccine.
In terms of treatment, clinicians should also be aware that the regimen remains identical to the initial episode. When presented with a recurrence of GBS, clinicians must also definitively rule out GBS-TRF or CIDP before administering treatment. The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations.
- Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein.
- All content published within Cureus is intended only for educational, research and reference purposes.
- Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional.
Do not disregard or avoid professional medical advice due to content published within Cureus. The authors have declared that no competing interests exist. Consent was obtained or waived by all participants in this study 1. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis.
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How can I reduce the side effects of Shingrix?
The rest of your body: –
muscle aches tiredness headache shivering
fever stomach pain nausea
These side effects may affect your ability to do daily activities, but they should go away on their own in a few days.
Get the second dose of Shingrix even if you have a reaction after the first dose. Taking an over-the-counter pain medicine such as ibuprofen or acetaminophen after getting Shingrix can help ease discomfort from side effects. Contact your doctor if you have serious side effects.
Can you get a COVID shot and shingles shot at the same time?
Can I get a COVID-19 vaccine at the same time as another vaccine? Wait at least 14 days before getting any other vaccine, including a flu or shingles vaccine, if you get your COVID-19 vaccine first. And if you get another vaccine first, wait at least 14 days before getting your COVID-19 vaccine.
Can I get shingles vaccine and COVID booster at the same time?
Can I get a flu vaccination at the same time as my COVID-19 vaccine? – Yes. You can get a COVID-19 vaccine and other vaccinations like a flu or shingles vaccine at the same time or close together, according to the CDC,
Is red wine good for shingles?
Does moderate alcohol use interfere with shingles treatment? – Answer From Pritish K. Tosh, M.D. Generally, it’s best to avoid alcohol during shingles treatment. Shingles (herpes zoster) is a viral infection that causes a painful rash. An episode of shingles usually heals on its own within a few weeks.
However, immediate shingles treatment — often including an antiviral drug, such as acyclovir (Zovirax), famciclovir or valacyclovir (Valtrex) — can reduce pain, speed healing and reduce the risk of complications. Although alcohol warnings aren’t specifically listed in the product labels for the antiviral drugs most often used to treat shingles, it’s usually best to avoid mixing alcohol and medication.
Alcohol can reduce the effectiveness of certain medications, as well as increase the risk of side effects, such as dizziness, especially in older adults. With Pritish K. Tosh, M.D.
Can Shingrix cause eye problems?
Can Zostavax Cause Vision Problems? – In February 2016, FDA required Merck to add eye disorders, including necrotizing retinitis, to the list of potential side effects for Zostavax. Necrotizing retinitis is an inflammation of the eye that is associated with chickenpox and shingles.
It is commonly found in patients who are immunocompromised. Necrotizing retinitis can cause pain, floaters, flashes, blurred vision, and redness of the eye. If not treated, keratitis can cause permanent vision loss. Researchers at the University of Missouri have also linked the shingles vaccine to keratitis, an inflammation of the cornea.
They found 20 cases of keratitis within one month of patients receiving the chickenpox and shingles vaccinations. Keratitis can cause pain, redness, excess tears, blurred or decreased vision, and difficulty opening eyes. If not treated, it can cause permanent vision loss.
What should you not do before getting the shingles vaccine?
Have Pain Meds HandyJust in Case – There is no need to do anything before your vaccine, Dr. Patel says. “Most people have very mild symptoms such as soreness of the arm at the site of the injection, so be sure to choose the non-dominant arm,” she says.
- However, if after getting the vaccine you have a fever or feel achy, she suggests taking an over-the-counter pain medicine such as ibuprofen or acetaminophen.
- Symptoms should resolve in a day or two,” she says.
- In rare cases, a patient may have an anaphylactic reaction.
- Signs of this serious side effect include swelling of the face, dizziness, and trouble breathing.
If these are symptoms you experience, seek medical assistance immediately,” Dr. Patel says. Unfortunately, shingles can strike more than once, which is why the vaccine is still recommended for people who’ve already had shingles to help prevent any future occurrences (one-third of unvaccinated Americans will get shingles, and about 5% of those will get it more than once).
- There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated,” Dr.
- Friedland says.
- And while the shingles vaccine affords superhero-like levels of protection against the virus (protection that lasts about five years, according to the Centers for Disease Control), no vaccine is 100-percent effective.
“It’s possible to still get shingles after being vaccinated, but the vaccine can significantly reduce the intensity of shingles if you become infected,” Dr. Patel says. And as of now, a booster isn’t recommended. Notes: This article was originally published July 29, 2021 and most recently updated August 10, 2021,
Which is better Shingrix or Zostavax?
Your risk of shingles and postherpetic neuralgia (PHN) increases as you get older. CDC recommends that people 60 years old and older get shingles vaccine (Zostavax®) to prevent shingles and PHN. Shingrix (recombinant zoster vaccine) is the preferred vaccine, over Zostavax® (zoster vaccine live), a shingles vaccine in use since 2006.
- Zostavax may still be used to prevent shingles in healthy adults 60 years and older.
- For example, you could use Zostavax if a person is allergic to Shingrix, prefers Zostavax, or requests immediate vaccination and Shingrix is unavailable.
- Zostavax (zoster vaccine live) was licensed by the FDA in 2006.
This vaccine reduces the risk of developing shingles by 51% and PHN by 67%. It is given in one dose as a shot, and can be given in a doctor’s office or pharmacy.
Should I take it easy after shingles vaccine?
The shingles vaccine (Shingrix) can help prevent shingles and the long-lasting pain that it can cause. Shingrix is generally well tolerated. Still, you may have arm pain, headache, or fever for a couple of days after the vaccine. Take it easy and avoid heavy physical activity after your shot.
Can I shower after shingles shot?
Older children and adults –
If allowed, they can have paracetamol or ibuprofen if their arm is sore. Follow the directions on the packaging. If the injection site is red and warm to touch, you can put a cool wet cloth (not an ice pack) on their arm. It really helps to keep moving the arm after an immunisation so they can still play sport that day. It is ok to have a shower after an immunisation. They should keep drinking plenty of oral fluids, preferably water.
How long are you off work with shingles?
Managing an employee with shingles Croner-i is a comprehensive knowledge and resource platform that enables professionals to stay ahead of change in their industry, with legislation, trends and best practice. Call to learn more. Last reviewed 6 September 2021 Nicola Jagielski from Health Assured describes what shingles is, and advises on whether employees who have the infection should be working. Shingles, also known as herpes zoster, is a non-life threatening viral infection. The main symptoms of shingles are a skin rash with blistering. Usually, this clears up within a couple of weeks, although in some extreme cases it can linger for years. Other symptoms include:
pain, numbness and tingling in affected areas sensitivity to contact itching bursting blisters that crust over fatigue sensitivity to light headaches and fever.
For some people, especially the elderly or those with a weakened immune system, shingles can be a serious condition. Shingles is caused by the varicella-zoster virus. This is the same virus that causes chickenpox — in fact, after you’ve recovered from a bout of chickenpox, the virus remains in your body.
- You cannot catch shingles from someone with shingles or chickenpox, but you can catch chickenpox from someone with shingles if you have not had chickenpox before.
- It generally stays dormant in nerve tissue near your spinal cord but it can come back as shingles, even after a period of years has passed, usually when your immune system is lowered.
Ideally, anyone suffering an actual illness should stay at home. Can an employee work with shingles? Technically, yes. The symptoms and signs generally aren’t serious enough to stop the average office worker, if they grit their teeth and ignore the rash.
However, shingles can transmit chickenpox. Since chickenpox in adults and vulnerable people is deadly serious, especially for certain vulnerable people, you should ask the employee to work from home for a period if that’s possible, or otherwise insist that they take medical leave. People such as care workers, nurses, teachers, etc should definitely not be going into work with shingles.
If someone is taking shingles sick leave, they shouldn’t need a lot of time off. They can come back once they feel better in the event of a fever — but if they have a rash on exposed skin, they should really stay off work until this has crusted over. This can take around seven days, although it can take up to four weeks for the rash to heal completely.
antiviral medications antibiotics topical creams oral pain medications steroid injections in severe cases.
Mostly, these won’t have an effect on an ability to work a desk job. The major symptoms of shingles — the rash, itching, fever, etc — usually clear up in a couple of weeks. But in severe cases, with complications like eye infections or severe post herpetic neuralgia (pain that continues after the virus has cleared up), the employee might need longer.
Is it OK to take ibuprofen after shingles vaccine?
Important reminders –
You may choose to take an over-the-counter pain medicine such as ibuprofen or acetaminophen after getting Shingrix to ease discomfort from side effects. If you get side effects after the first dose of Shingrix, you should still get the second dose to get the full protection from the vaccine. Just because you have a reaction to the first dose does not mean that you will have a reaction to the second.
About 1 out of every 3 people in the United States will develop shingles during their lifetime. The pain from shingles has been compared to childbirth or passing a kidney stone. It can last for months or years after the rash goes away. Shingles vaccine can help prevent shingles and the complications from the disease. Photo Courtesy M.Oxman : Get the Shingrix Vaccine If You Are 50 or Older