Is the Shingles Vaccine Safe for Cancer Patients?

Though about 1 out of every 3 people will develop shingles in their lifetime, people diagnosed with cancer are at a higher risk for developing the condition and related complications. The main reason for this is because cancer and its treatments can compromise your immune system, which makes it harder for your body to fight off infections.

Read on to learn more about the relationship between cancer and shingles, and the shingles vaccine's safety and effectiveness for people living with cancer.

Older person receiving vaccine injection from healthcare provider

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The Link Between Cancer and Shingles

Also called herpes zoster, shingles is a condition characterized by a painful rash on one side of the face or body. It's caused by the reactivation of the varicella-zoster virus in the body (the virus that causes chickenpox).

People diagnosed with lung cancer and other solid tumor cancers (such as breast, colon, and rectal cancers) are at a higher risk for developing shingles.

More specifically, the highest risk for shingles in people with solid tumor cancers includes those who:

The risk of developing shingles is also higher in people with blood-related cancers.

Both cancer and cancer treatments, including chemotherapy, impact your immune system and reduce your ability to fight off infections.

How Common Is Shingles in Cancer Patients?

In a 2019 study of 240,000 people, people diagnosed with cancer had a 40% higher risk of developing shingles than those who did not have a cancer diagnosis. When compared to the general population, people with cancer are two to four times more likely to develop shingles.

Types of Shingles Vaccines

Two types of shingles vaccines were previously available in the United States: Zostavax and Shingrix. Zostavax is no longer available for use.

Zostavax

Zostavax was made available in the United States in 2006. It was initially recommended for people age 60 and older.

This live-attenuated shingles vaccine (a vaccine that contains a live, but weakened virus) was administered in a single dose. It was found to reduce shingles cases by 51% and postherpetic neuralgia (PHN) by 67%. PHN is a common complication caused by shingles that results in long-term nerve pain.

Zostavax is no longer available and is not recommended for use.

Shingrix

This newer shingles vaccine, Shingrix, was made available in 2017.

Shingrix is a recombinant vaccine, containing a component of the virus that allows for a strong immune response. The vaccine is recommended for use in people age 50 and older.

Shingrix is administered in a two-dose series. The second dose is administered two to six months after the first.

Shingrix can reduce the risk of shingles and PHN by over 90%, with immunity lasting at least seven years following vaccination.

Because the vaccine does not contain a live, weakened virus, it's suitable and recommended for people who have compromised immune systems.

Recommended Shingles Vaccine

Shingrix, a recombinant vaccine, is the currently recommended shingles vaccine. The live-attenuated shingles vaccine, Zostavax, is no longer used or recommended. Shingrix is recommended even for people who are immunocompromised or previously had the Zostavax vaccine.

Shingles Vaccine Risks

There are a few risks associated with receiving the shingles vaccine. Pain, soreness, and swelling where you get the shot in your arm is possible.

Some additional side effects are possible after the first or second dose, which can include:

These typically go away on their own in two to three days. Younger people are more likely to experience side effects.

Fainting is possible after receiving the vaccine, as it is with any vaccine. The risk of developing Guillan-Barre syndrome is also increased after getting Shingrix.

Serious side effects are uncommon. Allergic reactions are possible and are also rare. Clinical trials found that no more than two people out of every 1 million had a severe allergic reaction to the vaccine.

Severe Side Effects From the Shingles Vaccine

Seek emergency medical attention if you or someone you know experiences severe side effects after receiving the shingles vaccine. Severe allergic reaction symptoms may include:

  • Hives
  • Facial or throat swelling
  • Trouble breathing
  • Fast heartbeat
  • Feeling weak or dizzy

Shingles Vaccine Contraindications

The vaccine is not recommended for people who have a history of severe allergic reactions to any component of the shingles vaccine.

You are advised to delay getting the shingles vaccine if you are currently:

  • Experiencing a shingles episode
  • Pregnant or breastfeeding

You don't have to be tested for the varicella-zoster virus before getting your shingles vaccine. However, if you've previously tested negative for it, getting the shingles vaccine isn't recommended. Following the recommendations for the chickenpox vaccine is advised in that case.

Why Is It Still Important for Cancer Patients to Receive the Shingles Vaccine?

People living with cancer and undergoing treatment for it are at a higher risk for developing shingles and complications. The recombinant shingles vaccine is both safe and effective for people with compromised immune systems, including cancer patients. Getting the vaccine will reduce the number of cases and reports of complications.

The timing of when you get the vaccine may be aligned with when your immune system is stronger.

For people with solid tumor cancers specifically, researchers have found that the vaccine produced an expected immune response, even in those who were undergoing chemotherapy. The immune response lasted even a year after getting the vaccine.

Summary

People living with and undergoing treatment for cancer are at an increased risk of developing shingles (herpes zoster) and related, serious complications. Getting the shingles vaccine is both safe and effective for people diagnosed with and being treated for cancer.

Shingrix is the currently recommended vaccine. It's a two-dose vaccine that does not contain a live, weakened virus, as the previously-approved Zostavax shingles vaccine did.

Shingrix is approved for people ages 50 and older, including people who are immunocompromised. It's over 90% effective at preventing shingles and related complications. Some short-term side effects include headache, pain or rash at injection site, fever, chills, and nausea. Severe side effects and allergic reactions are rare.

A Word From Verywell

Vaccines like Shingrix are powerful tools to reduce the risk of certain diseases. Better understanding a vaccine's safety and effectiveness is critical to informed decision-making. If you have a compromised immune system, some vaccines may not be recommended. Others are safe and effective for people with cancer or who are immunocompromised.

Discuss the benefits and risks of the Shingrix vaccine with your healthcare provider. Given your current health status and history, they can help you determine if a particular vaccine is right for you.

Frequently Asked Questions

  • Is Shingrix safe for cancer patients?

    The Shingrix vaccine is safe, effective, and recommended for immunocompromised people, including cancer patients. In clinical trials, the reported adverse events among immunocompromised people after receiving the shingles vaccine were no greater than those in the trials that received a placebo.

  • Are there any downsides to the shingles vaccine?

    Some short-term side effects have been reported, such as pain or rash at the injection site, headaches, fatigue, fever, chills, and nausea. These typically went away within two to three days. Some people may faint. Severe allergic reactions are rare. There is also a small risk of developing Guillain-Barre syndrome (a condition where the immune system attacks the body's nerve cells).

  • Is shingles life-threatening?

    Though the condition can be painful, it is rarely life-threatening itself. However, some of the complications of shingles can include blindness, hearing problems, brain inflammation, and death. People at risk for serious complications include those who are over the age of 50 or have compromised immune systems.

  • Can you still get shingles if you have had the shingles vaccine?

    It is still possible to get shingles even if you've been vaccinated. No vaccine will completely prevent disease or be 100% effective. The effectiveness of the Shingrix vaccine is higher than 90% at reducing the risk of shingles and the most common complication, postherpetic neuralgia (PHN).

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12 Sources
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