Question

As I’m 70 I’ve been offered the shingles vaccine. I have had ME since 2016, consider myself to be severe, and already suffer from nerve pain. So I do not want to make things worse. But I’m also aware of people with ME who have had a significant exacerbation of symptoms following a vaccination. So should I have this vaccine?

Answer

As you say, there is a considerable amount of anecdotal evidence to indicate that vaccinations can sometimes trigger ME/CFS, or cause an exacerbation of existing ME/CFS symptoms. In relation to shingles and the shingles vaccine:

• Shingles is caused by reactivation of the chickenpox virus. It can be very painful and sometimes leads to a long-lasting painful condition called post-herpetic neuralgia. It can occasionally be fatal.
• Shingles can occasionally trigger ME/CFS, or cause a significant exacerbation of existing symptoms.

The shingles vaccine appears to be a safe and effective option. Although it does not provide 100% protection, it will reduce the severity and length of an attack and reduce the chances of developing post-herpetic neuralgia. There are two shingles vaccines: Zostavax (a live vaccine) and Shingrix (a non-live vaccine). With both vaccines, it’s quite common to get redness and discomfort at the vaccination site, headaches, and fatigue, but these side-effects should not last more than a few days. See your GP if you have side-effects that last longer than a few days, or if you develop a rash after having the shingles vaccination.

• You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella (chickenpox) vaccine.
• If you have a weakened immune system your GP will assess which vaccine is suitable for you. Discuss any health concerns with your GP before you have the vaccine.
• Zostavax (the live vaccine) is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.

Although the feedback is limited, we have not received any reports from people with ME/CFS who have had this vaccine and then experienced a significant exacerbation or relapse of their ME/CFS. So, there are several good reasons why people with ME/CFS should consider having this vaccine.

• Please note that it is normally sensible to defer being vaccinated if you are currently having any significant flu-like symptoms (i.e sore throats, tender glands) in relation to your ME/CFS. This is a decision that patients and doctors have to discuss and I hope you will find this information helpful in coming to a decision.

More information

• The NHS: The Shingles Vaccine: Frequently Asked Questions | August 2021
• The NHS: Chickenpox: Signs and Symptoms | November 2021
• Please let us know if you have had shingles vaccine and whether it caused any adverse effects: Feedback@meassociation.org.uk