Common side effects of the second dose of the Shingrix vaccine include pain, swelling, and fever. Some side effects are more likely to occur after the second dose than after the first dose.

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Shingrix is a Food and Drug Administration (FDA)-approved vaccine that helps prevent shingles, an infection caused by the reactivation of the varicella-zoster virus, in adults ages 50 and older.

People contract the virus through exposure to chickenpox, where it remains dormant in the nervous system.

Healthcare professionals administer the Shingrix vaccine in two doses, with the second dose being given 2 to 6 months after the first.

As with any vaccine, there are potential side effects. However, some side effects may be more common after receiving a second dose, like:

  • muscle pain
  • chills
  • fatigue
  • headache

In this article, we review all the potential side effects of Shingrix. We also explore how to ease symptoms and when to seek medical help.

Pain at the injection site is a common side effect of many vaccines, including Shingrix. This pain is generally mild but can feel like anything from slight discomfort to deep bruising. In some cases, injection site pain can be severe enough to limit arm movement.

To ease this discomfort, you can apply cold packs to the affected area for 20 minutes at a time.

If these aren’t effective, over-the-counter (OTC) pain remedies may help. However, if you have injection site pain that is severe or lasts longer than 2 to 3 days, follow up with your doctor.

Redness at and around the injection site is common and may appear immediately or some days after receiving Shingrix. This redness commonly develops due to a localized immune system response, which shouldn’t cause further concern.

Arm redness should disappear within a few days after receiving the vaccine. However, if you experience redness with a rash or severe pain, let your doctor know as soon as possible.

Swelling around the injection site is another common side effect of Shingrix. Like pain and redness, minor swelling can usually result from a localized immune system response, which isn’t necessarily dangerous.

You can apply hydrocortisone cream on or around the injection site to reduce redness and swelling. However, if you experience severe swelling that doesn’t go away, or the swelling accompanies other symptoms of an allergic reaction, seek medical attention right away.

Itchy skin, also called pruritus, can potentially occur near the injection site after receiving Shingrix. Itching, swelling, and redness aren’t usually a huge cause for concern, as they often occur together as a localized reaction.

Applying Benadryl gel (or spray) or hydrocortisone cream around the injection area can help reduce itchy, swollen, or red skin. If the itching worsens or spreads away from the injection site, get in touch with your doctor.

Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches. A fever indicates that the body’s immune system is doing its job of responding to the vaccine.

Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F (39.4°C) or higher, reach out to your doctor immediately.

Muscle pain, also known as myalgia, is another common side effect of most vaccines, including Shingrix. The symptom is more common after receiving the second dose, as the body continues to build stronger immunity to the virus.

You can take OTC remedies to help ease muscle pain. This symptom generally peaks within the first few days after the vaccine and disappears as the immune system settles back down.

Joint pain, also called arthralgia, is a potential side effect of Shingrix that commonly occurs with muscle pain. This type of pain after a vaccine is generally due to a temporary increase in inflammation, which can affect the fluid around the joints.

Like muscle pain, taking an OTC pain reliever can help reduce joint pain from the vaccine. However, ask a doctor to look at any joint or muscle pain that doesn’t go away within a few days.

Chills and muscle pain can occur together as a side effect of the Shingrix vaccine. Like muscle pain, body chills are more common after the second dose due to an increased immune system response to the vaccine.

Wrapping up in warm clothes and blankets, increasing the room temperature, and even taking a warm bath or shower can help ease body chills and aches. This symptom should disappear within 2 to 3 days after receiving the vaccine.

Fatigue is a common side effect of the second dose of Shingrix that can range from mild to severe. This symptom often occurs after vaccination when the body exerts extra energy to keep the immune system working.

Resting throughout the day, getting extra sleep, and making sure not to overexert yourself can help reduce fatigue levels. Energy levels should usually return to normal within a few days of adequate rest, hydration, and nutrition.

Headaches are another common side effect from the second dose of Shingrix and often occur in conjunction with fever. People who frequently get headaches or migraine attacks when sick may be more susceptible to developing a headache after vaccination.

OTC pain medications and adequate water and sleep can help relieve headache symptoms. However, if you have been experiencing headaches or head pain that worsens or persists without medication, reach out to your doctor.

Dizziness is a potential side effect of the Shingrix vaccine that often accompanies other symptoms, like fever and headache. Inflammation within the sensory system is a common cause of dizziness after receiving a vaccine.

Lying down and resting when you start to feel dizzy can help ease this symptom. Speak with your doctor right away if you’re unable to move around without feeling dizzy or you’ve been experiencing frequent dizzy spells.

Nausea, vomiting, diarrhea, and abdominal pain are all side effects of the Shingrix vaccine. It’s common for gastrointestinal side effects — especially nausea or upset stomach — to accompany other side effects like fever, headache, and dizziness.

Eating a bland diet and staying hydrated are two of the most important steps for easing gastrointestinal discomfort. However, if you’re experiencing vomiting or diarrhea that doesn’t go away, or your abdominal pain gets worse, seek medical attention right away.

Although serious side effects of the Shingrix vaccine are rare, they can happen. Symptoms of a severe allergic reaction to the vaccine may include:

  • hives
  • face swelling
  • throat swelling
  • difficulty breathing
  • fast heart rate
  • dizziness
  • weakness

If you experience any of the above symptoms after receiving the Shingrix vaccine, seek medical attention immediately.

Older adults are often more susceptible to shingles and the long-term complications it can cause, so Shingrix is intended for adults ages 50 and older. According to the Centers for Disease Control and Prevention (CDC), you should receive Shingrix if you:

  • are healthy
  • had a previous shingles vaccine called Zostavax
  • aren’t sure if you previously had chickenpox

Healthcare professionals can administer Shingrix to anyone who has had shingles or chickenpox in the past, including those who aren’t sure if they’ve already had chickenpox.

Who shouldn’t receive Shringrix

Although vaccines go through rigorous safety testing to ensure they are safe, they aren’t suitable for everyone. You shouldn’t receive Shingrix if you:

  • have an active shingles infection
  • have a severe illness or a fever of 101.3°F (38.5°C) or higher
  • have had a severe allergic reaction to Shingrix or any ingredient in the vaccine
  • have no immunity to varicella based on a blood test carried out for other reasons
  • are pregnant or breastfeeding

If you currently have shingles, another serious illness, or a fever of 101.3°F (38.5°C), wait until these issues have resolved to receive a Shingrix vaccination.

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Shingrix is a two-dose vaccine that helps prevent shingles in adults ages 50 years and older.

Both doses of Shingrix can trigger side effects, but muscle pain, chills, fatigue, and headache are more common after the second dose.

Side effects from the second dose of Shingrix are generally mild and should last no longer than 2 to 3 days.

If you’ve received Shingrix and have side effects that have become worse or don’t go away within a few days, book an appointment with your doctor to follow up.