Varicella-Zoster Reactivation after COVID-19 Illness versus SARS-CoV-2 Vaccination

Larger Ongoing Threat is COVID-19 Vaccination

By Peter A. McCullough, MD, MPH

Many papers in the medical literature seem to pit a consequence such as myocarditis or stroke as either occurring as a consequence of COVID-19 illness compared with COVID-19 vaccination. Because the denominator is so large for acutely ill hospitalized patients with COVID-19 especially during the first two years of the pandemic allowing ICD code capture of comorbidities, authors erroneously conclude the illness is “more dangerous” or a “bigger risk factor.” These arguments are daft in my opinion since COVID-19 respiratory illness is treatable and a recent paper from Klaassen et al has estimated 94% are already recovered from COVID-19—so it is water under the bridge. Not true for COVID-19 vaccines which are still mandated by some ill-advised schools, employers, and agencies. One way of looking for what is a more pressing and continued problem is to survey the medical literature.

Martinez-Reviejo et al completed a literature review of varicella-zoster reactivation (shingles) and compared cases arising after vaccination and those with the respiratory infection. There were more manuscripts and cases after vaccination. However, the manifestations of varicella-zoster were more severe in those with acute COVID-19 illness which was also high in disease severity.

Martinez-Reviejo R, Tejada S, Adebanjo GAR, Chello C, Machado MC, Parisella FR, Campins M, Tammaro A, Rello J. Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights. Eur J Intern Med. 2022 Oct;104:73-79. doi: 10.1016/j.ejim.2022.07.022. Epub 2022 Aug 1. PMID: 35931613; PMCID: PMC9340059.

I found it curious the authors did not disclose the shingles vaccine status in the tables. The bottom line is that shingles can occur with severe COVID-19 and it is treatable. Acute COVID-19, however is amenable to early therapeutics so severe cases can be avoided and most of us have recovered SARS-CoV-2 infection. COVID-19 vaccination continues to be an ongoing threat for varicella-zoster reactivation syndromes, some of which are very serious including ocular damage and long-lasting painful cutaneous syndromes.

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Klaassen F, Chitwood MH, Cohen T, Pitzer VE, Russi M, Swartwood NA, Salomon JA, Menzies NA. Changes in population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States between December 2021 and November 2022. medRxiv [Preprint]. 2022 Nov 23:2022.11.19.22282525. doi: 10.1101/2022.11.19.22282525. PMID: 36451882; PMCID: PMC9709792.

Martinez-Reviejo R, Tejada S, Adebanjo GAR, Chello C, Machado MC, Parisella FR, Campins M, Tammaro A, Rello J. Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights. Eur J Intern Med. 2022 Oct;104:73-79. doi: 10.1016/j.ejim.2022.07.022. Epub 2022 Aug 1. PMID: 35931613; PMCID: PMC9340059.