Recombinant Zoster Vaccine (Shingles) RZV – 5 Important Facts

Recombinant Zoster Vaccine (Shingles) RZV: What You Need to Know

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1. Why get vaccinated?

Shingles (also called herpes zoster, or just zoster) is a painful skin rash, often with blisters. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body and can cause shingles later in life.

You can’t catch shingles from another person. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.

A shingles rash usually appears on one side of the face or body and heals within 2 to 4 weeks. Its main symptom is pain, which can be severe. Other symptoms can include fever, headache, chills and upset stomach.

Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death.

For about 1 person in 5, severe pain can continue even long after the rash has cleared up. This long-lasting pain is called post-herpetic neuralgia (PHN).

Shingles is far more common in people 50 years of age and older than in younger people, and the risk increases with age. It is also more common in people whose immune system is weakened because of a disease such as cancer, or by drugs such as steroids or chemotherapy.

At least 1 million people a year in the United States get shingles.

2. What is Recombinant Zoster Vaccine

Recombinant shingles vaccine was approved by FDA in 2017 for the prevention of shingles. In clinical trials, it was more than 90% effective in preventing shingles. It can also reduce the likelihood of PHN.

Two doses, 2 to 6 months apart, are recommended for adults 50 and older.

This vaccine is also recommended for people who have already gotten the live shingles vaccine (Zostavax). There is no live virus in this vaccine.

Zoster vaccine, recombinant is an adjuvant vaccine for the prevention of herpes zoster (shingles) in adults at least 50 years of age.

Herpes zoster (a vesicular rash) and postherpetic neuralgia (a neuropathic pain syndrome which accompanies the vesicular rash) occurs after reactivation of the varicella-zoster virus; therefore, healthy adults 50 years of age and older should be vaccinated with zoster vaccine, recombinant to prevent shingles and related complications.

The CDC recommends that all adults 50 years of age and older and without a contraindication receive herpes zoster vaccination with zoster vaccine, recombinant (Shingrix), even those adults who previously received varicella-zoster virus vaccine, live (Zostavax).

3. Who should not get this vaccine

Tell your vaccine provider if you:

  • Have any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of recombinant shingles vaccine, or has a severe allergy to any component of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components.
  • Are pregnant or breastfeeding. There is not much information about use of recombinant shingles vaccine in pregnant or nursing women. Your healthcare provider might recommend delaying vaccination.
  • Are not feeling well. If you have a mild illness, such as a cold, you can probably get the vaccine today. If you are moderately or severely ill, you should probably wait until you recover. Your doctor can advise you.

4. Risks of a vaccine reaction

With any medicine, including vaccines, there is a chance of reactions.

After recombinant shingles vaccination, a person might experience:

  • Pain, redness, soreness, or swelling at the site of the injection
  • Headache, muscle aches, fever, shivering, fatigue

In clinical trials, most people got a sore arm with mild or moderate pain after vaccination, 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.

About 1 out of 6 people who got recombinant zoster vaccine 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 should still get the second dose of recombinant zoster vaccine even if you had one of these reactions after the first dose.

Other things that could happen after this vaccine:

  • People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
  • Some people get shoulder pain that can be more severe and longer-lasting than routine soreness that can follow injections. This happens very rarely.
  • Any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

The safety of vaccines is always being monitored. For more information, visit:  

5. What are the side effects of Recombinant Zoster Vaccine?

What should I look for?

  • Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior.

Here are the most common and less severe side effects of Recombinant Zoster Vaccine

  1. abdominal pain
  2. arthralgia
  3. chills
  4. diarrhea
  5. dizziness
  6. edema
  7. edema
  8. erythema
  9. erythema
  10. fatigue
  11. fatigue
  12. fever
  13. fever
  14. gout
  15. headache
  16. headache
  17. injection site reaction
  18. malaise
  19. myalgia
  20. myalgia
  21. nausea
  22. pruritus
  23. shivering
  24. shivering
  25. vomiting

Side effects indicating severe allergic reaction are

  • hives
  • swelling of the face and throat
  • difficulty breathing
  • a fast heartbeat
  • dizziness
  • weakness
  • These would usually start a few minutes to a few hours after the vaccination.

What should I do?

  • If you think it is a severe allergic reaction or other emergency that can’t wait, call 9-1-1 and get to the nearest hospital. Otherwise, call your health care provider.

Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor should file this report, or you can do it yourself through the VAERS web site at  or by calling 1-800-822-7967.

VAERS does not give medical advice.

Monitoring Parameters

  • laboratory monitoring not necessary


  • agammaglobulinemia
  • anticoagulant therapy
  • breast-feeding
  • children
  • coagulopathy
  • corticosteroid therapy
  • hemophilia
  • human immunodeficiency virus (HIV) infection
  • hypogammaglobulinemia
  • immunosuppression
  • infants
  • neonates
  • neoplastic disease
  • pregnancy
  • radiation therapy
  • severe combined immunodeficiency (SCID)
  • thrombocytopenia
  • vitamin K deficiency


There are no drug interactions associated with Zoster Vaccine, Recombinant products.

Seek Additional Information

  • Ask your healthcare provider. He or she can give you the vaccine package insert or suggest other sources of information.
  • Call your local or state health department.
  • Contact the Centers for Disease Control and Prevention (CDC):
    • Call 1-800-232-4636 (1-800-CDC-INFO) or
    • Visit the CDC’s website at

CDC Vaccine Information Statement (VIS) Recombinant Zoster Vaccine (02/12/2018)


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