Supplementary Material for: Unexpected Herpes Zoster in a Healthy 22-Month-Old: A Pediatric Case Report

Introduction: Herpes zoster (HZ), caused by varicella-zoster virus reactivation, is uncommon in immunocompetent children without prior varicella exposure.
Case Presentation: We describe a 22-month-old boy who developed HZ four months after varicella vaccination, presenting with a unilateral dermatomal vesicular rash. Serological testing suggests acute infection (IgM-positive). No maternal or postnatal varicella exposure was reported, and the child had no immunodeficiency.
Conclusion: This case underscores the rare possibility of HZ in vaccinated young children lacking traditional risk factors, highlighting the need for clinical vigilance even in atypical populations. Further investigation into triggers of early VZV reactivation post-vaccination is warranted.