According to the CDC, Shingrix may be used in people with weakened immune systems. At this point, no studies have examined Shingrix in patients with autoimmune disease, cautions Dr. Calabrese. Shingrix includes a compound called an adjuvant that helps the vaccine create a stronger immune response. The adjuvant revs up the immune system, so there is a concern for exacerbating autoimmune diseases, explains Dr. Calabrese. Rheumatologists are awaiting further data on Shingrix in this patient population.