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Risk of herpes zoster following mRNA COVID-19 vaccine administration

Ana Florea1, Jun Wu1, Lei Qian1

  • 1Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, USA.

Expert Review of Vaccines
|July 7, 2023
PubMed
Abstract

Insights

mRNA COVID-19 vaccines may slightly increase the risk of herpes zoster (HZ) after the second dose, particularly in individuals aged 50 and older who haven't received the zoster vaccine.

Area of Science:

  • Immunology
  • Vaccinology
  • Epidemiology

Background:

  • Adverse events following mRNA COVID-19 vaccination have been reported.
  • Herpes zoster (HZ) is one such reported adverse event.
  • A study was conducted to investigate the association between mRNA COVID-19 vaccination and subsequent HZ development.

Purpose of the Study:

  • To evaluate the association between mRNA COVID-19 vaccination and the incidence of herpes zoster (HZ).
  • To compare HZ risk in vaccinated versus unvaccinated individuals following mRNA COVID-19 vaccine administration.

Main Methods:

  • A cohort study was conducted at Kaiser Permanente Southern California (KPSC).
  • mRNA COVID-19 vaccine recipients (mRNA-1273 and BNT162b2) were matched with unvaccinated individuals.
  • Incident HZ cases within 90 days of follow-up were identified using diagnosis codes and antiviral prescriptions.
  • Cox proportional hazards models were used to estimate adjusted hazard ratios (aHR).

Main Results:

  • The study included over 1 million recipients for each mRNA vaccine (mRNA-1273 and BNT162b2) and over 1 million unvaccinated comparators.
  • A modest increased risk of HZ was observed within 90 days after the second dose of both mRNA-1273 (aHR: 1.14) and BNT162b2 (aHR: 1.12) compared to unvaccinated individuals.
  • In individuals aged 50 years and older without prior zoster vaccination, the aHR for HZ after the second vaccine dose was also increased for both mRNA-1273 (aHR: 1.18) and BNT162b2 (aHR: 1.15).

Conclusions:

  • Findings suggest a potential increased risk of herpes zoster following the second dose of mRNA COVID-19 vaccines.
  • This increased risk appears to be more pronounced in individuals aged 50 years and older who have not received the zoster vaccine.
  • Further research may be warranted to understand the mechanisms behind this association.
Keywords:
Bnt162b2COVID-19Mrna-1273herpes zostermRNA vaccines

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