Tuesday, January 13, 2009

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


Anonymous said...

If someone that had Gilliann Barre and is 80 and has already had Shingles have the vaccine?

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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