The Shingles Vaccine


Who should receive the Shingles vaccine?

Shingles (Aka: herpes zoster) is caused by a retrograde transport of the chickenpox virus from the ganglia (nerve root) to the skin. Ten to 30% of people develop Shingles in their lifetime and most of the time it occurs in the elderly. Normal aging causes immunity against zoster to go down.

Shingles causes a discrete rash that can be painful and lasts several weeks. Twenty percent of people develop postherpetic neuralgia, a painful condition that can last long after the Shingles outbreak.

In 2006 a Shingles vaccine called Zostavax was approved by the FDA. The Advisory Committee on Immunization Practices recommends giving a single dose of the live vaccine to healthy people age 60 or older. The vaccine prevents Shingles and postherpetic neuralgia.

Some points to know about Zostavax:
  • It is not the chickenpox vaccine (Varivax). Zostavax is 14X more potent than Varivax.
  • Zostavax can be administered with other vaccines (Tetanus, influenza, pneumococcus) but it should be given at different sites.
  • Even people who do not recall having chickenpox should receive the vaccine.
  • People who have had Shingles should have the vaccine because you can get Shingles again.
  • The adverse effects include local swelling and pain, headache. There have been no serious adverse effects compared to placebo.
  • People with immune deficiency, cancer, leukemia, lymphoma,(unless in remission) or organ transplant should not receive the vaccine.
The vaccine is expensive (total cost can be over $300) and it is seldom covered by insurance. It is covered by Medicare Part D (the pharmacy coverage) but not Part B. Usually the patient needs to take a prescription to a local pharmacy, the vaccine is placed on ice and the patient brings it back to the physician for administration.
Information Source: Cleveland Clinic Journal of Medicine, 2009

Comments

Anonymous said…
If someone that had Gilliann Barre and is 80 and has already had Shingles have the vaccine?
KM
Toni Brayer MD said…
Anon: Yes, a prior episode of Gillian Barre would not be a barrier to receiving the vaccine.
Anonymous said…
Is there a special diet for shingles patients? Such as no red meat or sweets. I have heard conflicting reports on this.

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