Woman frowns while looking over her shoulder at red splotchy patch on her arm

MS and Shingles

Shingles is a condition that causes painful blisters to develop on one side of the face or body. It affects about 1 out of every 3 people in the United States. But for people living with multiple sclerosis (MS), the risk may be much higher. Research has found possible connections between MS and shingles that may help improve treatment plans.1,2

Before we dive into the connection between MS and shingles, here are the basics of each.

What is MS?

MS is an autoimmune disease that causes damage to the central nervous system, which includes the brain, spinal cord, and optic nerves. With MS, the immune system attacks the protective covering (myelin) that surrounds nerve fibers. This leads to communication problems between the brain and the body.3

Medicines that suppress the immune system – called immunosuppressants – are often prescribed to help treat symptoms. Some of these medicines are called disease-modifying therapies (DMTs).2,3

What is shingles?

Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Once you have chickenpox, the virus becomes inactive but stays in your body. The virus can be reactivated by stress, a weakened immune system, or certain medicines. When it is, it results in shingles.1,4

Shingles can affect anyone, but it is most common in older adults and those with a compromised immune system. Complications with shingles can include:4

  • Prolonged nerve pain (postherpetic neuralgia, or PHN). PHN causes burning, shooting pain, numbness and tingling, sensitivity, and itching. It lasts long after the shingles rash has healed.
  • Vision problems or blindness. Inflammation and damage to the retina can develop if the rash blisters are around the skin near the eye.
  • Skin infections. If bacteria enter the sores of the rash, it can get infected.
  • Ear inflammation. This swelling can lead to hearing problems, balance issues, and temporary drooping on one side of the face.

The connection between MS and shingles

There are several possible links between MS and shingles. Interestingly, the links seem to go in both directions.

Researchers suspect that a virus or infection, like shingles, may trigger a reaction in the body that makes a person more at risk for developing MS later in life. A 2017 study found that a history of shingles appears to be more common in people with MS than would be expected in the general MS population.1,2

And since MS causes damage to the central nervous system, people with MS who get shingles are more likely to have more severe shingles symptoms and complications like PHN.1,2

The connection in the other direction relates to people with MS having a weakened immune system. This can be due to both the illness itself and taking immunosuppressants in order to treat symptoms. Because their immune systems are not working at full strength, people with MS have a greater chance of developing shingles.2

A 2021 study found that people who had suppressed immune systems from taking DMTs to treat their MS were at increased risk for shingles.2

Prevention of shingles

Thankfully, there is a way to greatly reduce the chances of getting shingles and PHN. The shingles vaccine, Shingrix, is approved by the US Food and Drug Administration (FDA) and is safe for use in people with MS. It can reduce a person’s chance of getting shingles by about 90 percent.1,2

Shingrix is given in 2 doses, spaced a couple of months apart. As opposed to earlier shingles vaccines, Shingrix is not a live vaccine. It contains only a part of the virus. This makes it safer for people with MS to be vaccinated.1,2

Things to consider

DMTs can suppress the immune system, so they may make Shingrix less effective. Talk with your doctor about any medicines you are currently taking. They may advise you to modify your treatment plan before getting the shingles vaccine.2

If you are having an MS flare-up or relapse, your doctor may advise you to wait before getting the shingles vaccine. This allows your body to be at its healthiest when receiving the vaccine so you get the best protection possible.2

Experts are still learning about the connection between MS and shingles. Talk to your doctor and healthcare team about side effects and any questions you may have. They can help you decide whether the shingles vaccine is right for you.

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