Cutaneous Events After Recombinant Zoster Vaccination and Shoulder Injury Related to Zoster Vaccine Administration: A Narrative Review

This is the authors' abstract. We don't add key points for this paper.

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.