Cutaneous Events After Recombinant Zoster Vaccination and Shoulder Injury Related to Zoster Vaccine Administration: A Narrative Review
6 affiliations
- 1Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Politecnica University of Marche, 60126 Ancona, Italy
- 2Department of Medicine, Infectious Diseases Unit, San Salvatore Hospital, 67100 L’Aquila, Italy
- 3Rheumatology Unit, Università Politecnica delle Marche, Ospedale “Carlo Urbani”, 60035 Jesi, Italy
- 4IRCCS INRCA, 60126 Ancona, Italy
- 5Clinic of Dermatology, Department of Clinical and Molecular Sciences, Politecnica University of Marche, 60126 Ancona, Italy
- 6ASD Dental Clinic, 61121 Pesaro, Italy
Abstract
Background: Herpes zoster results from the reactivation of varicella–zoster virus (VZV), with incidence increasing with age and immunosuppression. The recombinant zoster vaccine (RZV, Shingrix®, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) has demonstrated high efficacy in preventing herpes zoster and its complications. Methods: We conducted a narrative review of English-language publications addressing cutaneous events, musculoskeletal events, and shoulder injury related to vaccine administration following recombinant zoster vaccination. Original studies, pharmacovigilance analyses, case reports, case series, and relevant reviews published up to 31 January 2026, were considered. Results: Available evidence on cutaneous and musculoskeletal events following recombinant zoster vaccination was limited and heterogeneous. Reported cutaneous events included inflammatory and hypersensitivity-type reactions, vesicular or bullous eruptions, and episodes of VZV reactivation occurring in temporal proximity to vaccination. In virologically confirmed cases, the detected VZV strains were wild-type, consistent with reactivation of latent wild-type virus. Musculoskeletal symptoms, including arthralgia and myalgia, were more commonly reported but were generally mild and self-limiting. Evidence concerning SIRVA was limited and restricted to a single case report following intramuscular zoster vaccine administration. Conclusions: Current evidence supports a favorable safety profile for Shingrix®. Cutaneous events are uncommon and heterogeneous, while evidence concerning SIRVA is limited to a single case report following zoster vaccination, precluding estimates of incidence or a product-specific association. Proper injection technique and continued pharmacovigilance remain essential.
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BibTeX
@article{ciccullo2026cutaneous,
title = {{Cutaneous Events After Recombinant Zoster Vaccination and Shoulder Injury Related to Zoster Vaccine Administration: A Narrative Review}},
author = {Carlo Ciccullo and Arturo Ciccullo and Sonia Farah and Claudia Bevilacqua and Marco Grassi and Luca Farinelli and Edoardo De Simoni and Elisa Molinelli and Oriana Simonetti and Simone Domenico Aspriello and Antonio P. Gigante},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207962},
url = {https://www.mdpi.com/2077-0383/15/20/7962},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cutaneous Events After Recombinant Zoster Vaccination and Shoulder Injury Related to Zoster Vaccine Administration: A Narrative Review
AU - Carlo Ciccullo
AU - Arturo Ciccullo
AU - Sonia Farah
AU - Claudia Bevilacqua
AU - Marco Grassi
AU - Luca Farinelli
AU - Edoardo De Simoni
AU - Elisa Molinelli
AU - Oriana Simonetti
AU - Simone Domenico Aspriello
AU - Antonio P. Gigante
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207962
UR - https://www.mdpi.com/2077-0383/15/20/7962
AB - Background: Herpes zoster results from the reactivation of varicella–zoster virus (VZV), with incidence increasing with age and immunosuppression. The recombinant zoster vaccine (RZV, Shingrix®, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) has demonstrated high efficacy in preventing herpes zoster and its complications. Methods: We conducted a narrative review of English-language publications addressing cutaneous events, musculoskeletal events, and shoulder injury related to vaccine administration following recombinant zoster vaccination. Original studies, pharmacovigilance analyses, case reports, case series, and relevant reviews published up to 31 January 2026, were considered. Results: Available evidence on cutaneous and musculoskeletal events following recombinant zoster vaccination was limited and heterogeneous. Reported cutaneous events included inflammatory and hypersensitivity-type reactions, vesicular or bullous eruptions, and episodes of VZV reactivation occurring in temporal proximity to vaccination. In virologically confirmed cases, the detected VZV strains were wild-type, consistent with reactivation of latent wild-type virus. Musculoskeletal symptoms, including arthralgia and myalgia, were more commonly reported but were generally mild and self-limiting. Evidence concerning SIRVA was limited and restricted to a single case report following intramuscular zoster vaccine administration. Conclusions: Current evidence supports a favorable safety profile for Shingrix®. Cutaneous events are uncommon and heterogeneous, while evidence concerning SIRVA is limited to a single case report following zoster vaccination, precluding estimates of incidence or a product-specific association. Proper injection technique and continued pharmacovigilance remain essential.
SN - 2077-0383
ER -