"Shingles Vaccine" by Allen Weiss, MD, MBA, President & CEO

Shingles Vaccine

August 15th, 2013 - You have probably heard about a vaccine being able to prevent shingles. This painful, localized recurrence of chicken pox always occurs on only one side of the body, usually later in life, in people who have had chicken pox as a child. Should you ask your physician for this prevention?

Healthcare has come so far in so many ways over this past half century. Understanding how best to take advantage of what is new and effective is very important; shingles vaccine is a perfect example. Unfortunately, only about 4% of Medicare recipients have received the almost painless and safe injection. If you are treated, your chances of having shingles drops from 1.7% to 0.5% according to a recent study in the Public Library of Science.

People who have had chicken pox, which is most of us born before the vaccine was offered in America to children in 1995, are harboring the virus in our nerve tissue. When we are stressed in later life, either physically or emotionally, and our immune system is experiencing an aging process, out spreads the virus across nerve fibers on one side of the body.

Typically, only the head, face, or trunk of the body are affected, with the first symptoms being burning, tingling, numbness, and itching. This is followed, over the next day or two, by a blistery rash. This rash is the same as one sees with chicken pox except it is localized to one area of the body and is band-like in distribution, following the nerve which serves that location. The pain and itch can be intense and followed by persistent pain lasting years. This latter complication can be disabling and is mostly avoidable by either prevention with the vaccine or prompt treatment with anti-viral medication.

The shingles vaccine, Zostavax, contains a much weakened chicken pox virus. This attenuated dose stimulates your immune system to continue to fight the latent virus which is then kept dormant in nerve tissue. The vaccine is approved for people over the age of 50, with the Centers for Disease Control and Prevention—CDC—recommending the treatment for those aged 60 and older. Insurance coverage and cost vary greatly, so please do your homework to understand cost and availability.

You should not get the vaccine if you have a life-threatening allergic reaction to gelatin, the antibiotic neomycin or any component of the vaccine. If your immune system is weakened from treatment of drugs, cancer, HIV/AIDS, or active Tuberculosis don’t take the vaccine. It is best to postpone the injection for at least three months if you are in contact with pregnant women.

If you have a mild cold it is OK to get the vaccine, but if you have a severe illness it is better to wait until you have recovered. The vaccine is administered in a manner similar to the flu shot, with the location being the back of the arm. A slight redness, soreness, swelling, and itching at the site of the injection may occur, but disappear quickly and rarely need treatment.

If you have already had the misfortune of experiencing shingles, the current accepted advice is to still get the shot to prevent a recurrence. Medical lore of the past, however, was that you could only get shingles once in a life time because your immune system was re-stimulated by the first recurrence.

It is important to check with your physician, nurse-practitioner, or physician’s assistant before proceeding with shingles vaccine. We can prevent a great deal of misery and pain with modern healthcare … but we have to be aware of what is new and available.

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.