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Relationship between shingles and coronavirus disease 2019: a self-controlled case series study
Tomoki Mizuno1,2, Jun Suzuki1,2,3, Shota Takahashi2
1Division of Infectious Diseases, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, Japan.
International Journal of Epidemiology
|September 26, 2025
Summary
This study found a significant increase in shingles risk after COVID-19 infection. Early vaccination against varicella-zoster virus is recommended in the COVID-19 era.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Limited real-world data exists on shingles risk post-COVID-19.
- Previous studies suggest a potential link between SARS-CoV-2 infection and shingles.
- This research addresses the gap by examining clinical data.
Purpose of the Study:
- To investigate the association between COVID-19 and shingles.
- To evaluate the risk of shingles following SARS-CoV-2 infection in a real-world setting.
- To inform public health strategies regarding vaccination.
Main Methods:
- Utilized a Japanese claims database (Jan 2020-Jan 2023).
- Employed self-controlled case series methods to analyze 399,381 COVID-19 patients.
- Assessed shingles diagnosis within 90 days of COVID-19 diagnosis.
Main Results:
- 558 COVID-19 patients developed shingles.
- Significantly elevated shingles incidence rate ratios (IRR) observed in weeks 1-2 (5.1), 3-4 (1.7), and 5-6 (1.5) post-COVID-19.
- The risk remained elevated for up to six weeks after infection.
Conclusions:
- A clear association exists between COVID-19 and shingles.
- Shingles may be a characteristic manifestation of SARS-CoV-2 infection.
- Recommends varicella-zoster vaccination alongside COVID-19 vaccination.
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