ArticleIDCases2026
Severe disseminated VZV in an immunocompromised host temporally associated with recent recombinant adjuvanted herpes zoster vaccination.
Article in IDCases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Recombinant adjuvanted herpes zoster vaccine (Shingrix) effectively prevents varicella-zoster virus (VZV) reactivation and is recommended for older and immunocompromised adults. Case presentation: We report a severe early disseminated VZV reactivation occurring 14 days after primary Shingrix vaccination in an 80-year-old man with a history of lymphocytic lymphoma in biological relapse and secondary hypogammaglobulinemia. Initial presentation featured multimetameric necrotic and hemorrhagic thoracic lesions, which progressed despite oral valaciclovir to a diffuse cephalocaudal vesicular eruption with fever and severe pain, prompting hospitalization. Workup identified VZV-associated bone marrow involvement with acute anemia requiring transfusion; PET imaging excluded lymphoma transformation. The patient improved under intravenous acyclovir (10 mg/kg every 8 h) with daily local care, followed by extended valaciclovir prophylaxis. Given the severity and timing, the second Shingrix dose was withheld. Discussion: Causality is difficult to establish: primary varicella could not be fully excluded, and vaccine-induced immunity would not yet be established after a single early dose. Nonetheless, the short latency, immunocompromised status, and concordance with rare reports of early post-vaccination zoster suggest a possible association. This case highlights the importance of reporting to pharmacovigilance systems and differentiating adverse events from vaccine failure, without undermining the overall favorable safety profile of Shingrix in high-risk populations.
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