Table of ContentsView AllTable of ContentsShingles Risk With RAShingrix Vaccine and RAMedication ComplicationsFDA and CDC StancesVaccine HesitancyShingles and the Immune SystemAlternatives
Table of ContentsView All
View All
Table of Contents
Shingles Risk With RA
Shingrix Vaccine and RA
Medication Complications
FDA and CDC Stances
Vaccine Hesitancy
Shingles and the Immune System
Alternatives
The Centers for Disease Control and Prevention (CDC) recommends that older and immunocompromised adults get two doses of Shingrix (the recombinant zoster vaccine, or RZV) to prevent shingles and related complications.Some people with rheumatoid arthritis (RA) may worry that theshingles vaccine Shingrixwill make their symptoms worse.
Rheumatoid arthritis (RA) is a chronic medical condition that causes swelling, inflammation, loss of mobility, stiffness, and pain in the joints.It is anautoimmune disorder, which means that it causes the body’s immune system to “overreact” and attack its own healthy cells.
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Risk of Shingles in RA Patients
Rheumatoid arthritissignificantly increases the risk of shingles and related complications.Studies suggest that people with RA have a 1.5 to 2 times higher risk of developing shingles than the general population.
When people with RA do get shingles, they are also more likely to develop serious medical complications. For example, a 2017 study found that people with RA who contracted shingles were twice as likely to have astrokein the following months.
Additionally, people over age 50 and immunocompromised individuals (such as many with RA) are especially at risk of developing long-term complications from shingles, such as postherpetic neuralgia (PHN).
PHN causes severe, long-term nerve pain in the area of the shingles rash. In rare cases, shingles can lead to pneumonia, hearing loss, vision problems, encephalitis (brain inflammation), and even death.
There are several reasons why people with RA are more likely to get shingles and experience complications.
Additionally, several common rheumatoid arthritis medications have been found to increase the risk of shingles, including:
Can You Get the Shingrix Vaccine With RA?
The CDC currently recommends that most people with RA and other autoimmune conditions get Shingrix, especially because they are at significantly higher risk ofshingles.
According to the American College of Rheumatology (ACR), the benefits of vaccination for people with rheumatoid arthritis usually far outweigh the relatively minor risks.
Data suggests that Shingrix is safe and effective in preventing shingles in people with RA. A 2021 study found that Shingrix was over 90% effective among people with RA and other autoimmune and inflammatory conditions.
Meanwhile, a 2020 study indicated that reports of flare-ups from patients with RA were rare after two doses of the shingles vaccine.
Exclusion From Clinical Trials
People with RA and other autoimmune disorders were excluded from the initial clinical trials for Shingrix.
Additionally, a handful of case reports have indicated that the shingles vaccine may increase the risk of overactive inflammatory responses.This has led some people with RA to worry about the risk of side effects from the shingles vaccine.
However, larger studies indicate that Shingrix is safe and effective for most people with autoimmune disorders. One 2021 study found that Shingrix was effective in preventing both shingles and PHN, even among immunocompromised people and people over 80 years old.
Shingrix Ingredients
Shingrix is a non-liverecombinant vaccine.This means that its active ingredient is a small part of the germ that causes the herpes zoster virus.It also contains anadjuvant—an ingredient that boosts the long-term effectiveness of a vaccine.
Shingrix replacedZostavax(zoster vaccine live), which hasn’t been in use in the United States since 2020.
Unlike Shingrix, Zostavax is a live vaccine.Live vaccinescontain a weakened version of a virus—in this case, herpes zoster.Live vaccines are generally not recommended for people who are taking immunosuppressive drugs.
Shingrix Side EffectsMost people experience at least some side effects from the shingles vaccine. Some of the most common Shingrix side effects include:Redness, pain, and/or swelling at the injection siteMuscle painFeverHeadacheNauseaStomach painFatigueChillsMost of the side effects from Shingrix are relatively mild and go away on their own within about two to three days.If you experience symptoms of a severe allergic reaction after getting Shingrix—such as difficulty breathing, hives, a rapid heartbeat, or swelling in the face or tongue—you should seek emergency medical assistance.
Shingrix Side Effects
Most people experience at least some side effects from the shingles vaccine. Some of the most common Shingrix side effects include:Redness, pain, and/or swelling at the injection siteMuscle painFeverHeadacheNauseaStomach painFatigueChillsMost of the side effects from Shingrix are relatively mild and go away on their own within about two to three days.If you experience symptoms of a severe allergic reaction after getting Shingrix—such as difficulty breathing, hives, a rapid heartbeat, or swelling in the face or tongue—you should seek emergency medical assistance.
Most people experience at least some side effects from the shingles vaccine. Some of the most common Shingrix side effects include:
Most of the side effects from Shingrix are relatively mild and go away on their own within about two to three days.
If you experience symptoms of a severe allergic reaction after getting Shingrix—such as difficulty breathing, hives, a rapid heartbeat, or swelling in the face or tongue—you should seek emergency medical assistance.
RA Medications and Shingles Vaccine Schedule
If you take immunosuppressive drugs to treat rheumatoid arthritis, here’s what you should know about getting Shingrix:
FDA and CDC Recommendations
According to the CDC, people ages 50 and up andimmunocompromisedadults ages 19 and older should get two doses of Shingrix to prevent shingles, PHN, and other possible complications.Shingrix is effective and safe for most people, including people with autoimmune disorders.
The CDC currently recommends that people with chronic medical conditions, such as RA, get the shingles vaccine.Additional CDC guidelines for people with autoimmune conditions are as follows:
The Food and Drug Administration (FDA) approved the use of Shingrix in 2017 for people ages 50 and older. In 2019, the FDA approved Shingrix for immunocompromised adults ages 18 and older.
Some individuals are hesitant to receive vaccines. A common concern regarding Shingrix and RA is that it may trigger RA pain.
A few isolated reports suggest that people experienced rheumatoid arthritis flare-ups after getting Shingrix.However, larger studies suggest that post-Shingrix RA flare-ups are rare and that the shingles vaccine is effective for people with RA.
Because people with RA and other autoimmune disorders are especially at risk of developing shingles and related complications, the CDC recommends that they get two doses of Shingrix.
Stress, infections, aging, and even minor illnesses can lower your immune function and increase your risk of shingles.
Some individuals are concerned that shingles can increase your risk of developing an autoimmune condition.
While it’s unclear whether shingles can increase your risk of getting an autoimmune disorder, research suggests that the opposite is often true—having an autoimmune condition such as RA increases your risk of getting shingles.
Shingles Vaccine Alternatives
Shingrix is currently the best way to protect yourself against shingles and serious potential complications.However, if you have RA and don’t plan to get the shingles vaccine, here are a few ways to lower your shingles risk:
Summary
Shingrix is a non-live, recombinant vaccine that helps to prevent shingles and shingles-related complications, such aspostherpetic neuralgia(PHN). People aged 50 and older and immunocompromised people aged 19 and older should get two doses of Shingrix.
While people with RA were not included in the initial clinical trials for Shingrix, the vaccine has demonstrated safety in people with other autoimmune conditions. People with RA should usually get Shingrix, even if they are taking a low-dose immunosuppressive medication to treat their symptoms.
29 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Shingrix shingles vaccination: what everyone should know.Stevens E, Weinblatt ME, Massarotti E, Griffin F, Emani S, Desai S.Safety of the zoster vaccine recombinant adjuvanted in rheumatoid arthritis and other systemic rheumatic disease patients: a single center’s experience with 400 patients.ACR Open Rheumatol. 2020;2(6):357-361. doi:10.1002/acr2.11150MedlinePlus.Rheumatoid arthritis.Centers for Disease Control and Prevention.Rheumatoid arthritis.Redeker I, Albrecht K, Kekow J, et al.Risk of herpes zoster (shingles) in patients with rheumatoid arthritis under biologic, targeted synthetic and conventional synthetic DMARD treatment: data from the German RABBIT register.Ann Rheum Dis. 2022;81(1):41-47. doi:10.1136/annrheumdis-2021-220651MedlinePlus.Shingles (herpes zoster).Centers for Disease Control and Prevention.Signs and symptoms of shingles (herpes zoster).Calabrese LH, Abud-Mendoza C, Lindsey SM, et al.Live zoster vaccine in patients with rheumatoid arthritis treated with tofacitinib with or without methotrexate, or adalimumab with methotrexate: a post hoc analysis of data from a phase IIIb/IV randomized study.Arthritis Care Res (Hoboken). 2020;72(3):353-359. doi:10.1002/acr.24010Calabrese LH, Xie F, Yun H, et al.Herpes zoster and the risk of stroke in patients with autoimmune diseases.Arthritis Rheumatol. 2017;69(2):439-446. doi:10.1002/art.39855Yun H, Yang S, Chen L, et al.Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.Arthritis Rheumatol. 2016;68(9):2328-2337. doi:10.1002/art.39670Maltz F, Fidler B.Shingrix: a new herpes zoster vaccine.P T. 2019;44(7):406-433.NHS.Rheumatoid arthritis - treatment.Segan J, Staples MP, March L, Lassere M, Chakravarty EF, Buchbinder R.Risk factors for herpes zoster in rheumatoid arthritis patients: the role of tumour necrosis factor-α inhibitors.Intern Med J. 2015;45(3):310-318. doi:10.1111/imj.12679Sunzini F, McInnes I, Siebert S.JAK inhibitors and infections risk: focus on herpes zoster.Ther Adv Musculoskelet Dis. 2020;12:1759720X20936059. doi:10.1177/1759720X20936059Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 2019;23(1):50-74. doi:10.1177/1203475418811335American College of Rheumatology.ACR vaccine information for members to share with patients.Dagnew AF, Rausch D, Hervé C, et al.Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials.Rheumatology (Oxford). 2021;60(3):1226-1233. doi:10.1093/rheumatology/keaa424Heydari-Kamjani M, Vante I, Uppal P, Demory Beckler M, Kesselman MM.Uveitis sarcoidosis presumably initiated after administration of Shingrix vaccine.Cureus. 2019;11(6):e4920. doi:10.7759/cureus.4920Izurieta HS, Wu X, Forshee R, et al.Recombinant zoster vaccine (Shingrix): real-world effectiveness in the first 2 years post-licensure.Clin Infect Dis. 2021;73(6):941-948. doi:10.1093/cid/ciab125Department of Health and Human Services.Vaccine types.Centers for Disease Control and Prevention.Adjuvants and vaccines.Centers for Disease Control and Prevention.What everyone should know about Zostavax.Cao Y, Zhao D, Xu AT, Shen J, Ran ZH.Effects of immunosuppressants on immune response to vaccine in inflammatory bowel disease.Chin Med J (Engl). 2015;128(6):835-838. doi:10.4103/0366-6999.152683Centers for Disease Control and Prevention.Clinical considerations for use of recombinant zoster vaccine (RZV, Shingrix) in immunocompromised adults aged >19 years.Centers for Disease Control and Prevention.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.Food and Drug Administration.Shingrix.Food and Drug Administration.Clinical review, October 20, 2017 - Shingrix.Centers for Disease Control and Prevention.Shingles vaccine recommendation.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rheumatoid arthritis: diagnosis, treatment, and steps to take.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Shingrix shingles vaccination: what everyone should know.Stevens E, Weinblatt ME, Massarotti E, Griffin F, Emani S, Desai S.Safety of the zoster vaccine recombinant adjuvanted in rheumatoid arthritis and other systemic rheumatic disease patients: a single center’s experience with 400 patients.ACR Open Rheumatol. 2020;2(6):357-361. doi:10.1002/acr2.11150MedlinePlus.Rheumatoid arthritis.Centers for Disease Control and Prevention.Rheumatoid arthritis.Redeker I, Albrecht K, Kekow J, et al.Risk of herpes zoster (shingles) in patients with rheumatoid arthritis under biologic, targeted synthetic and conventional synthetic DMARD treatment: data from the German RABBIT register.Ann Rheum Dis. 2022;81(1):41-47. doi:10.1136/annrheumdis-2021-220651MedlinePlus.Shingles (herpes zoster).Centers for Disease Control and Prevention.Signs and symptoms of shingles (herpes zoster).Calabrese LH, Abud-Mendoza C, Lindsey SM, et al.Live zoster vaccine in patients with rheumatoid arthritis treated with tofacitinib with or without methotrexate, or adalimumab with methotrexate: a post hoc analysis of data from a phase IIIb/IV randomized study.Arthritis Care Res (Hoboken). 2020;72(3):353-359. doi:10.1002/acr.24010Calabrese LH, Xie F, Yun H, et al.Herpes zoster and the risk of stroke in patients with autoimmune diseases.Arthritis Rheumatol. 2017;69(2):439-446. doi:10.1002/art.39855Yun H, Yang S, Chen L, et al.Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.Arthritis Rheumatol. 2016;68(9):2328-2337. doi:10.1002/art.39670Maltz F, Fidler B.Shingrix: a new herpes zoster vaccine.P T. 2019;44(7):406-433.NHS.Rheumatoid arthritis - treatment.Segan J, Staples MP, March L, Lassere M, Chakravarty EF, Buchbinder R.Risk factors for herpes zoster in rheumatoid arthritis patients: the role of tumour necrosis factor-α inhibitors.Intern Med J. 2015;45(3):310-318. doi:10.1111/imj.12679Sunzini F, McInnes I, Siebert S.JAK inhibitors and infections risk: focus on herpes zoster.Ther Adv Musculoskelet Dis. 2020;12:1759720X20936059. doi:10.1177/1759720X20936059Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 2019;23(1):50-74. doi:10.1177/1203475418811335American College of Rheumatology.ACR vaccine information for members to share with patients.Dagnew AF, Rausch D, Hervé C, et al.Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials.Rheumatology (Oxford). 2021;60(3):1226-1233. doi:10.1093/rheumatology/keaa424Heydari-Kamjani M, Vante I, Uppal P, Demory Beckler M, Kesselman MM.Uveitis sarcoidosis presumably initiated after administration of Shingrix vaccine.Cureus. 2019;11(6):e4920. doi:10.7759/cureus.4920Izurieta HS, Wu X, Forshee R, et al.Recombinant zoster vaccine (Shingrix): real-world effectiveness in the first 2 years post-licensure.Clin Infect Dis. 2021;73(6):941-948. doi:10.1093/cid/ciab125Department of Health and Human Services.Vaccine types.Centers for Disease Control and Prevention.Adjuvants and vaccines.Centers for Disease Control and Prevention.What everyone should know about Zostavax.Cao Y, Zhao D, Xu AT, Shen J, Ran ZH.Effects of immunosuppressants on immune response to vaccine in inflammatory bowel disease.Chin Med J (Engl). 2015;128(6):835-838. doi:10.4103/0366-6999.152683Centers for Disease Control and Prevention.Clinical considerations for use of recombinant zoster vaccine (RZV, Shingrix) in immunocompromised adults aged >19 years.Centers for Disease Control and Prevention.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.Food and Drug Administration.Shingrix.Food and Drug Administration.Clinical review, October 20, 2017 - Shingrix.Centers for Disease Control and Prevention.Shingles vaccine recommendation.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rheumatoid arthritis: diagnosis, treatment, and steps to take.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Shingrix shingles vaccination: what everyone should know.Stevens E, Weinblatt ME, Massarotti E, Griffin F, Emani S, Desai S.Safety of the zoster vaccine recombinant adjuvanted in rheumatoid arthritis and other systemic rheumatic disease patients: a single center’s experience with 400 patients.ACR Open Rheumatol. 2020;2(6):357-361. doi:10.1002/acr2.11150MedlinePlus.Rheumatoid arthritis.Centers for Disease Control and Prevention.Rheumatoid arthritis.Redeker I, Albrecht K, Kekow J, et al.Risk of herpes zoster (shingles) in patients with rheumatoid arthritis under biologic, targeted synthetic and conventional synthetic DMARD treatment: data from the German RABBIT register.Ann Rheum Dis. 2022;81(1):41-47. doi:10.1136/annrheumdis-2021-220651MedlinePlus.Shingles (herpes zoster).Centers for Disease Control and Prevention.Signs and symptoms of shingles (herpes zoster).Calabrese LH, Abud-Mendoza C, Lindsey SM, et al.Live zoster vaccine in patients with rheumatoid arthritis treated with tofacitinib with or without methotrexate, or adalimumab with methotrexate: a post hoc analysis of data from a phase IIIb/IV randomized study.Arthritis Care Res (Hoboken). 2020;72(3):353-359. doi:10.1002/acr.24010Calabrese LH, Xie F, Yun H, et al.Herpes zoster and the risk of stroke in patients with autoimmune diseases.Arthritis Rheumatol. 2017;69(2):439-446. doi:10.1002/art.39855Yun H, Yang S, Chen L, et al.Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.Arthritis Rheumatol. 2016;68(9):2328-2337. doi:10.1002/art.39670Maltz F, Fidler B.Shingrix: a new herpes zoster vaccine.P T. 2019;44(7):406-433.NHS.Rheumatoid arthritis - treatment.Segan J, Staples MP, March L, Lassere M, Chakravarty EF, Buchbinder R.Risk factors for herpes zoster in rheumatoid arthritis patients: the role of tumour necrosis factor-α inhibitors.Intern Med J. 2015;45(3):310-318. doi:10.1111/imj.12679Sunzini F, McInnes I, Siebert S.JAK inhibitors and infections risk: focus on herpes zoster.Ther Adv Musculoskelet Dis. 2020;12:1759720X20936059. doi:10.1177/1759720X20936059Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 2019;23(1):50-74. doi:10.1177/1203475418811335American College of Rheumatology.ACR vaccine information for members to share with patients.Dagnew AF, Rausch D, Hervé C, et al.Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials.Rheumatology (Oxford). 2021;60(3):1226-1233. doi:10.1093/rheumatology/keaa424Heydari-Kamjani M, Vante I, Uppal P, Demory Beckler M, Kesselman MM.Uveitis sarcoidosis presumably initiated after administration of Shingrix vaccine.Cureus. 2019;11(6):e4920. doi:10.7759/cureus.4920Izurieta HS, Wu X, Forshee R, et al.Recombinant zoster vaccine (Shingrix): real-world effectiveness in the first 2 years post-licensure.Clin Infect Dis. 2021;73(6):941-948. doi:10.1093/cid/ciab125Department of Health and Human Services.Vaccine types.Centers for Disease Control and Prevention.Adjuvants and vaccines.Centers for Disease Control and Prevention.What everyone should know about Zostavax.Cao Y, Zhao D, Xu AT, Shen J, Ran ZH.Effects of immunosuppressants on immune response to vaccine in inflammatory bowel disease.Chin Med J (Engl). 2015;128(6):835-838. doi:10.4103/0366-6999.152683Centers for Disease Control and Prevention.Clinical considerations for use of recombinant zoster vaccine (RZV, Shingrix) in immunocompromised adults aged >19 years.Centers for Disease Control and Prevention.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.Food and Drug Administration.Shingrix.Food and Drug Administration.Clinical review, October 20, 2017 - Shingrix.Centers for Disease Control and Prevention.Shingles vaccine recommendation.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rheumatoid arthritis: diagnosis, treatment, and steps to take.
Centers for Disease Control and Prevention.Shingrix shingles vaccination: what everyone should know.
Stevens E, Weinblatt ME, Massarotti E, Griffin F, Emani S, Desai S.Safety of the zoster vaccine recombinant adjuvanted in rheumatoid arthritis and other systemic rheumatic disease patients: a single center’s experience with 400 patients.ACR Open Rheumatol. 2020;2(6):357-361. doi:10.1002/acr2.11150
MedlinePlus.Rheumatoid arthritis.
Centers for Disease Control and Prevention.Rheumatoid arthritis.
Redeker I, Albrecht K, Kekow J, et al.Risk of herpes zoster (shingles) in patients with rheumatoid arthritis under biologic, targeted synthetic and conventional synthetic DMARD treatment: data from the German RABBIT register.Ann Rheum Dis. 2022;81(1):41-47. doi:10.1136/annrheumdis-2021-220651
MedlinePlus.Shingles (herpes zoster).
Centers for Disease Control and Prevention.Signs and symptoms of shingles (herpes zoster).
Calabrese LH, Abud-Mendoza C, Lindsey SM, et al.Live zoster vaccine in patients with rheumatoid arthritis treated with tofacitinib with or without methotrexate, or adalimumab with methotrexate: a post hoc analysis of data from a phase IIIb/IV randomized study.Arthritis Care Res (Hoboken). 2020;72(3):353-359. doi:10.1002/acr.24010
Calabrese LH, Xie F, Yun H, et al.Herpes zoster and the risk of stroke in patients with autoimmune diseases.Arthritis Rheumatol. 2017;69(2):439-446. doi:10.1002/art.39855
Yun H, Yang S, Chen L, et al.Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.Arthritis Rheumatol. 2016;68(9):2328-2337. doi:10.1002/art.39670
Maltz F, Fidler B.Shingrix: a new herpes zoster vaccine.P T. 2019;44(7):406-433.
NHS.Rheumatoid arthritis - treatment.
Segan J, Staples MP, March L, Lassere M, Chakravarty EF, Buchbinder R.Risk factors for herpes zoster in rheumatoid arthritis patients: the role of tumour necrosis factor-α inhibitors.Intern Med J. 2015;45(3):310-318. doi:10.1111/imj.12679
Sunzini F, McInnes I, Siebert S.JAK inhibitors and infections risk: focus on herpes zoster.Ther Adv Musculoskelet Dis. 2020;12:1759720X20936059. doi:10.1177/1759720X20936059
Papp KA, Haraoui B, Kumar D, et al.Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies.J Cutan Med Surg. 2019;23(1):50-74. doi:10.1177/1203475418811335
American College of Rheumatology.ACR vaccine information for members to share with patients.
Dagnew AF, Rausch D, Hervé C, et al.Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials.Rheumatology (Oxford). 2021;60(3):1226-1233. doi:10.1093/rheumatology/keaa424
Heydari-Kamjani M, Vante I, Uppal P, Demory Beckler M, Kesselman MM.Uveitis sarcoidosis presumably initiated after administration of Shingrix vaccine.Cureus. 2019;11(6):e4920. doi:10.7759/cureus.4920
Izurieta HS, Wu X, Forshee R, et al.Recombinant zoster vaccine (Shingrix): real-world effectiveness in the first 2 years post-licensure.Clin Infect Dis. 2021;73(6):941-948. doi:10.1093/cid/ciab125
Department of Health and Human Services.Vaccine types.
Centers for Disease Control and Prevention.Adjuvants and vaccines.
Centers for Disease Control and Prevention.What everyone should know about Zostavax.
Cao Y, Zhao D, Xu AT, Shen J, Ran ZH.Effects of immunosuppressants on immune response to vaccine in inflammatory bowel disease.Chin Med J (Engl). 2015;128(6):835-838. doi:10.4103/0366-6999.152683
Centers for Disease Control and Prevention.Clinical considerations for use of recombinant zoster vaccine (RZV, Shingrix) in immunocompromised adults aged >19 years.
Centers for Disease Control and Prevention.Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines.
Food and Drug Administration.Shingrix.
Food and Drug Administration.Clinical review, October 20, 2017 - Shingrix.
Centers for Disease Control and Prevention.Shingles vaccine recommendation.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Rheumatoid arthritis: diagnosis, treatment, and steps to take.
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