Herpes Zoster Consultations Rise Post COVID-19 Vaccination: Insights from Dutch Study

A large Dutch primary‑care analysis detected a small but measurable rise in herpes zoster consultations after COVID‑19 vaccination, concentrated after the third mRNA dose.

Quantitatively, the primary measure reported an adjusted incidence rate ratio of 1.07 for all doses combined, with a larger point estimate after the third mRNA dose (≈1.21), indicating a modest relative rise in GP visits within the 28‑day risk window. The absolute increase in consultations is small but consistent enough to be noticed in practice.

Methodologically, the investigators used a retrospective self‑controlled cohort design among persons aged ≥12 years captured in two national general‑practice electronic health record databases (PHARMO and Nivel), comparing incidence during a predefined 28‑day post‑vaccination risk window with non‑exposed periods. That within‑person approach reduces confounding by fixed patient characteristics and supports unbiased temporal comparisons after vaccination.

Statistically, the adjusted IRR for all doses combined was 1.07 (95% CI 1.02–1.13), a result that reached conventional statistical significance; the third mRNA dose had a larger estimate (≈1.21, 95% CI ≈1.05–1.38), although subgroup precision varied. These figures imply a small absolute increase in zoster consultations, with some residual uncertainty in finer stratifications.

For clinical management, prioritize early recognition of new dermatomal pain or vesicular rash within 28 days of vaccination, assess promptly for herpes zoster, and initiate standard antiviral therapy when indicated — without changing current antiviral eligibility criteria. Timely antiviral treatment, when appropriate, reduces the risk of complications such as postherpetic neuralgia.

Implications for practice and communication are straightforward: the observed increase is small relative to vaccine benefits but justifies transparent risk communication and routine monitoring in primary care, particularly during booster campaigns.