Shingles cases in COVID-19 shot context represent increased risk, not increased reporting: a response to a recent investigation

P.S. Not having a proper control group is never a good thing...

Update: an email from a reader

Your review of the recent JAMA study hit home for me. My mom died 3/17/22 and I believe it was an indirect result of her Covid booster she got 21 days before she developed opthalalamic herpes zoster complicated by post herpetic neuralgia. Ultimately the eye infection never went away and she had some skin breakdown around the rash and was having severe pain attacks. I believe the infection got into her brain. I’ll never forget one day her saying this has “changed me” and later found she was putting food in the closet. When I tried to tell her doctor that the vaccine weakened her immune system she did not want to hear it, she said it does the exact opposite. Needless to say I was infuriated. I never did file a VAERS report but felt I probably should have. I am a critical care RN and thankfully was granted a religious exemption. I question everything now and am having a hard time trusting any medical research. It is interesting to see who funded this study from JAMA (national eye institute) I wonder why they funded this study? I honestly have lost trust with the entire medical and public health establishments. Keep up your great work!

An Original Investigation got published on November 16, 2022 in JAMA Network Open entitled: “Assessment of Herpes Zoster Risk Among Recipients of COVID-19 Vaccine”, and I do love this title because it means someone took the time to do this assessment. But…

It has been clear since the onset of the roll-out of the COVID-19 shots from datasets, case studies and from increased sales of Acyclovir¹, that herpes zoster re-activations are being prompted by the COVID-19 injections.

Their research question:

Question  Is there an increased risk of herpes zoster infection after COVID-19 vaccination?

This is the very first line in this Original Investigation. This published, Original Investigation. And if I may, this is the wrong question to ask. The right question to ask is this:

“Is there an increased risk of varicella-zoster virus re-activation after COVID-19 injection?”

To be really definitive here, there are many herpes viruses. Herpes simplex I and II, cytomegalovirus (CMV), Epstein-Barr Virus (EBV), varicella-zoster virus, and more. All of these herpes viruses can establish latent infections² in various tissues in our bodies, and this means that these viruses go to sleep once the ‘infection’ is subdued by the immune system, only to wake up really grumpy one day. One of the herpes viruses that has re-surfaced in the context of clinical and adverse event reports (and cases studies) is herpes zoster, also known as shingles caused by the varicella-zoster virus (VZV): the virus that causes chicken pox (varicella) and shingles (herpes zoster), upon infection and re-activation, respectively.

These herpes zoster viruses remain dormant in the sensory ganglia of the cranial nerve (or the dorsal root ganglia) of the human for years, and if re-activated, they manifest as a painful, nasty and potentially contagious rash, oftentimes around the mid-section of the body, having been triggered by ‘something’ related to immune suppression. This immune suppression can be in form of stress, toxins or exogenously injected experimental immunomodulatory agents. “When your immune system isn’t functioning properly, VZV can reactivate.”³ It’s neat how the rash only occurs on one side of the body, wherever it occurs. VZV can re-activate to cause shingles and does so in approximately 1/3 of people, later in life. The photo below is not such an angry example of shingles, but I thought to spare my readers’ eyes because this rash can be gnarly with a silent capitol ‘G’.

.Figure 1: https://www.epiphanydermatology.com/services/shingles/.

To be obstinately clear, the authors’ objective was the following:

Objective  To assess whether COVID-19 vaccination is associated with an increased risk of herpes zoster infection.

(That’s not what shingles data would ever show. It would show indications of re-activation of VZV.)

So having admitted that ‘herpes zoster infection after COVID-19 vaccination has been reported in numerous case studies’, the authors wanted to show that ‘these cases [simply] represent increased reporting [and not] a true increase in risk’. What they really meant to write was that in spite of the fact that case studies have provided strong evidence of VZV re-activation in temporal proximity to administration of the COVID-19 shots, this evidence is merely the result of increased reporting, and not increased incidence. I can believe that people got stressed out because of the lockdown-mandate-coercion mania and subsequently got shingles, but what I don’t buy is that they all immediately reported it to VAERS inducing a frenzy of shingles reporting. Most people mightn’t have even gone to the doctor to find out what their rash was since it was discouraged to ‘go out’, let alone seek medical attention.

On increased/over reporting

If I may interject, one way to provide evidence of an increase in reporting could be to compare the number of reports of herpes zoster/shingles in a pharmacovigilance database, such as VAERS, for the past few years, to the number of reports filed since the onset of the roll-out of the COVID-19 shots. They did not do this, so their analysis is incomplete, from this perspective.

Just to be clear, the absolute number of reports of herpes zoster/shingles filed to VAERS in the context of the Moderna, Pfizer and Janssen shots in the U.S. when compared to the past 5 years of reports in the context of all the vaccines combined looks like this:

Figure 2: Absolute count of VAERS reports of herpes zoster for 2016-2022 by year. Source: https://vaers.hhs.gov/data/datasets.html.

Looks like there’s a discrepancy in the absolute number of reports filed to VAERS in 2021 and 2022 when compared to the past 5 years. I am actually really stunned by the number of herpes zoster reports in the past 5 years though. Wow. I wonder if this is from Shingrix (also Glaxosmithkline)?

Wait now, I am curious. What percentage of the VAERS reports of shingles is associated with the Shingrix vaccine?

Figure 3: Percentage of VAERS reports of herpes zoster for 2016-2020 by year made in the context of Shringrix versus all other vaccines. Source: https://vaers.hhs.gov/data/datasets.html.

This is shocking. For 2018 and 2019, 95% of the reports filed to VAERS of shingles was in the context of the Shingrix vaccine. The next step for me would be to find out how many Shingrix vaccines were administered each year, but that’s for another Substack. The other half of the reports of shingles in 2021 and 2022 and being made in the context of the COVID-19 shots, so we have a new contender for position #1!

Back to the Original Investigation. The authors write:

Herpes zoster, also known as shingles, is caused by a reactivation of latent varicella zoster virus and manifests as a blistering dermatomal rash that can lead to long-term pain and reduced quality of life. It is unknown whether these case reports represent increased reporting of randomly occurring herpes zoster cases given the increased attention on the COVID-19 vaccine or a true increase in risk.

So they acknowledge that the case reports refer to shingles - a re-activation of a latent virus - (so not sure why they use the word ‘infection’), but they wonder if these increases in case reports are not just due to people obsessed with reporting adverse events in the context of the COVID-19 shots.

I have to say something else here. Narrativers: there is far less reporting of suspected adverse events than you are purporting. The incentivization, even subconsciously, to not report adverse events in the context of the COVID-19 shots, especially in the medical setting, is enormous. Many people I have spoken to tell me that the mere mention of a causal effect of an adverse event and the COVID-19 shots can result in threats of job loss, at worst, and marginalization from all peers, at best. I know people who have gone to their GPs with the mere suggestion of a causal effect of their ailment by their COVID shot, who have been turned away by these so-called GPs. It doesn’t matter that Walensky is ranting about the necessity to report even a suspected adverse event in the context of these shots; this is not the reality.

It is often the case that the idea of something does not align with the reality of something.

The authors concluded the following:

Conclusions and relevance: In this study, there was no association found between COVID-19 vaccination and an increased risk of herpes zoster infection, which may help to address concerns about the safety profile of the COVID-19 vaccines among patients and clinicians.

So not only do they ‘conclude’ that there is ‘no association found between COVID-19 vaccination and an increased risk of herpes zoster infection’, they claim this lends to the narrative that these products should be promoted in the patient/clinician community.

Ok, if I was going to be really litigious, I would say, yes, you’re right. The COVID-19 shots probably don’t increase new infection rates of VZV. I mean, it might not help if dozens of children are going to school with shingles outbreaks that they got from their parents having already had chicken pox, thus spreading it to children without prior VZV immunity, but, I would argue that the COVID-19 shots do increase re-activation rates of VZV. They do not ask the relevant question as I formerly stated. Which again is:

“Is there an increased risk of varicella-zoster virus re-activation after COVID-19 injection?”

The answer to this question had it been asked is a definitive, YES, in my opinion. I am basing this on case reports, data and the word of mouth of clinicians.

Bottom line

THERE IS NO CONTROL GROUP IN THIS STUDY.

They needed to have recruited individuals who have had VZV (chicken pox - which is almost everybody), and NOT received any COVID-19 shots (none of this 14 days within 1st shot shit = unvaccinated), to assess this wonderful question in a scientifically-valid fashion. Their idea of a control group involves the same people who got the shots who didn’t have a re-activation in the form of a shingles outbreak between 60 and 90 days following the last injection. I mean, what the hell is that?

Furthermore, they state the following:

Eligible participants were further required to be continuously enrolled in both medical and pharmacy coverage from 270 days before the date of first recorded COVID-19 vaccine dose (index date) through July 31, 2021, to allow for determination of baseline characteristics and herpes zoster cases after vaccination.

Individuals with a previous diagnosis of herpes zoster (identified by ICD-10 code B02.xx) in the 270 days before the index date were excluded.

So to be in the study, you had to be injected and you could not have had a herpes zoster diagnosis within 270 days of your first shot. So no shingly shingles for almost a year or no entry to Original Investigation soup for you. I guess this makes sense since a shingles outbreak 270 days before first shot might imply an inclination toward an outbreak in the face of an immune system modulator. Or does it?

P.S. I made this little graphical abstract and I personally think this is a better experimental design and removes confounders and confusion.

Figure 4: Graphical abstract for the study design that I think would show definitive results.

Do you like my little dancing guys? I thought this was a nice touch since they don’t want us to dance or to be happy. My experimental design is simple, makes sense, and does have to involve the 60-90 days after the last shot in the injected group as the control. I mean, seriously? I sure hope I got those stats right. Boy, would I have egg on my face.

In any case, I do not agree with the conclusions of the authors, whatsoever. I think they ought to have done a better experiment. And I think they ought to have sleuthed a little harder in the over reporting realm.

My two cents.

1. https://marketpublishers.com/report/life_sciences/healthcare/global-acyclovir-drug-market-status-trends-n-covid-19-impact-report-2021.html (I’m not giving them money but feel free to.)

2. https://www.ncbi.nlm.nih.gov/books/NBK8157/

3. https://www.healthline.com/health/what-causes-shingles-to-activate#causes