I have received a lot of questions about the shingles vaccine, and since I have gotten a bunch of emails related to it, I am now seeing it offered at every single pharmacy and the push is really on!  I want to clarify what shingles is, how the vaccine works, how effective it is, and who should be getting it.  Shingles is more prominent a risk than most people realize, at least 1 million people a year in the US get shingles and a large majority of them are over 50 years old.

What is Shingles?

Shingles is also known as the herpes zoster and it is caused by the Varicella zoster, the same virus that causes chickenpox. It is most common in people over 50 years of age with a weakened immune system (due to cancer, chemotherapy, HIV/AIDS, or steroid use).  It is a very similar disease process in that you have pain along with an itchy/painful blistery rash that lasts from 2 to 4 weeks.  Only someone who has had chicken pox can usually get shingles, because the virus lays dormant in the body (in a nerve) for a while then reactivates (which can be years later).  It is often started with one sided pain, burning, or intense tingling, then you start to have red patches which eventually start blistering; the path of the blisters are usually from the spine around the front of the body over the belly and/or chest, but the face, neck, eyes, and ears can also be involved.   The blisters eventually break open and start to crust, causing ulcerations in the skin, and the crusts eventually fall off in 2 to 3 weeks. Some other side effects you may have are: pain, muscle weakness, fever and chills, abdominal pain, headache, hearing loss, genital blisters, swollen glands, loss of vision (if in eyes), taste changes (if in mouth), and joint pain/decreased mobility. There can be scarring, although there usually isn’t, and depending on the extent of the virus in your eyes and ears, you can have long term vision and hearing loss.  All in all, not a fun virus to get! You can be treated with antivirals, but the virus usually still lasts 2 to 4 weeks, it can help to reduce they symptoms of the disease, and you can also take ibuprofen to help with the pain, swelling, fevers, and steroid creams/antihistamines can help with the rash and itching.  All of these help to alleviate some of the issues associated with the virus but will not make it go away.

Does the vaccine work?

The vaccine, Zostavax, was first approved for use in 2006 by the FDA.  I want to be very clear that the herpes zoster vaccine is NOT the same as the chicken pox vaccine.  It is a one time vaccination for people 60 years old and up, and is usually covered by Medicare and most other private insurance companies.  In clinical trials, the vaccine reduced the risk of getting active shingles by 50% and for people who did manage to get shingles after receiving the vaccine had significantly less pain and their symptoms were not as severe as those that did not take the vaccine.  So, yes it does work, and it is really helpful even if you do get the virus; the pain associated with shingles can be very debilitating and the worst part for many people, so reducing that makes the virus much more tolerable.

Are there any Side Effects?

There are some side effects associated with the vaccine, unfortunately. As with any medication that you take, you can have a serious allergic reaction, in which you should call emergency services (911) right away.  The only side effects are very mild: redness and swelling at the site of injection (1 in 3 people in clinical trials) and about 70% of people had a headache the night after getting the injection.  There have been no other documented side effects but it is constantly being monitored for long term and short term reactions.  If you do have a mild reaction, you should call your HCP right away, but if the reaction is more serious and you feel unwell (such as hives, wheezing, fast heart rate, dizziness, throat closing up, or difficulty breathing) you should go to the nearest emergency room or call 911 immediately.

Who should get the Vaccine?

Anyone who has had chicken pox and is 50 years old or above. Even if you have had shingles, you are recommended to get the vaccine, just wait a year after the virus has ended to be administered the vaccine.

Who should skip getting vaccinated?

If you are under 50 years of age, are currently immunocompromised (your immune system isn’t working perfectly) due to cancer with chemotherapy/radiation treatment, if you have HIV/AIDS, prolonged high-dose steroid treatments, or cancer affecting the bone marrow.  You should skip getting vaccinated if you are currently pregnant (or might be pregnant) and should wait at least 4 weeks from the time of vaccine to become pregnant. If you have every had a severe allergic reaction to gelatin or the antibiotic neomycin, you should not take this vaccine, as you will be at risk for another severe reaction.  Also, if you have a fever 101.3F or greater and/or signs of current bacterial or viral illness (a general feeling of unwell).

Overall, shingles can be a pretty nasty virus, and at 60+ years old, it can take you out of the game a while, even if you are otherwise completely healthy.  I do encourage all who qualify for the vaccine to get it, especially if your insurance pays for it, there is no reason not to, especially with minimal side effects.  It seems like a no brainer to me!

Yours in Good Health

B