The claim: Herpes infection could be a rare side effect of COVID-19 vaccination

The good news in the fight against the coronavirus: New infection cases continue to decline, according the latest data from the U.S. Centers for Disease Control and Prevention.

The bad news: So are daily vaccinations, which had peaked in mid-April. 

Health officials state part of the deceleration may correlate with the timing of the Johnson & Johnson vaccine pause announced on April 13 but lifted on April 23. Part of it may also be due to lingering fears surrounding COVID-19 vaccines.

One such recent claim connects the shot with herpes infection. 

"Herpes infection could be a rare side effect of the COVID-19 vaccine, according to a new study," claims a May 1 Instagram post from The Raging Patriot, an account that advertises itself as "Real News by Real Patriots."

These purported findings have been disseminated widely on social media and refer to an Israeli study published in April in the journal Rheumatology.

USA TODAY has reached out to The Raging Patriot for comment. 

Citing a scientific report might sound convincing and concerning, especially since many people would associate herpes with the sexually transmitted disease.

"No honey I did not have sex with anyone. It was that damn vaccine that gave me the herpes!" commented one Instagram user on the post. 

But that's not the kind of herpes referenced here. And that's not exactly what the study found.

Herpes zoster infection, not genital herpes

The Israeli study was actually evaluating whether mRNA vaccines, such as Pfizer-BioNTech and Moderna's shots, are safe for people with autoimmune inflammatory rheumatic diseases (AIIRD) – a group of conditions that affect the body's joints, bones, muscles and connective tissue – since clinical trials have excluded this specific patient group.

The observational study conducted at the Tel Aviv Medical Center and Carmel Medical Center in Haifa monitored 491 people with AIRD and 99 controls for six weeks after they received Pfizer's COVID-19 vaccine.

Six women between the ages of 36 to 61 with stable rheumatic diseases developed herpes zoster (or HZ) infection. Five cases occurred after the first dose and one after the second.  

With the exception of one woman getting HZ affecting the eyes, all five cases were mild and resolved after antiviral treatment. 

"We haven't seen any additional cases so far," Dr. Victoria Furer, lead author of the report and rheumatologist at the Tel Aviv Medical Center, told MedPage Today

HZ is caused by the varicella-zoster virus, part of the same family of viruses that cause cold sores and genital herpes. But HZ doesn't itself cause these conditions.

In children, HZ infections leads to chickenpox, a common but highly contagious and transmissible illness characterized by itchy, blister-like rashes, according to the U.S. Centers for Disease Control and Prevention. Because the virus lies dormant within the nervous system after recovery, it can reactivate years later, as with the six women, who all had a past history of HZ infection. This reactivation leads to shingles, a condition also marked by painful rashes that can present anywhere on the body, though usually appears as a stripe around the torso, according to the Mayo Clinic.

There have been reports in the past of vaccines causing shingles, Dr. Amesh Adalja of Johns Hopkins University told Health, so the phenomenon is not unheard of. But it's important to note the authors of the Israeli report emphasize the study wasn't structured to determine if there was an actual relationship between the COVID-19 vaccine and HZ, as non-vaccinated AIIRD patients were not included. 

"Our report does not establish any causality or definite link but draws the attention to a possible association between mRNA COVID-19 vaccine and herpes zoster," Furer told the Associated Press

In the U.S. so far, there have been no increased reports of shingles after COVID-19 vaccination, Dr. William Schaffner of Vanderbilt University also told the Associated Press.

"We have been emphasizing the vaccination of older adults," Schaffner said. "That's the very population in which shingles is the most common, and so you would expect some cases of shingles to occur after vaccination ... because it's going to occur anyway."

Almost one in three people in the U.S. will develop shingles in their lifetime. The risk increases the older a person gets and even more so for anyone with weakened or compromised immune systems such as people with cancer, HIV or taking certain medications like steroids.

But Adalja said the overall risk of HZ was low, especially for people with no autoimmune conditions. And any infections should resolve after treatment with antiviral medications. 

Our ruling: Missing context

We rate this claim MISSING CONTEXT because without additional context it might be misleading. An Israeli study found the COVID-19 vaccine may be associated with HZ reactivation in some people with immune conditions, but their findings do not prove a definite link since the number of cases were small and the study was not designed to determine causality. And the herpes being discussed here is not the sexually transmitted disease many will associate with that term. Varicella-zoster virus, which causes herpes zoster and chickenpox in children, does not cause genital herpes or cold sores. The infection is caused by reactivation of the virus in people who had the childhood disease.

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