Those who are severely allergic to any component of Shingrix should not get the vaccine, and anyone with active shingles should wait until symptoms resolve. The vaccine hasn’t been studied in pregnant or breastfeeding women.
There are a few important points to consider when discussing the varicella zoster virus and transmissibility. If an individual who has never had chickenpox or the chickenpox vaccine comes in direct contact with the fluid from the shingles rash, they may go on to develop chickenpox, but they will not immediately develop shingles. It is possible, however, for them to develop shingles later in life, just as it is with others who have previously been exposed to the virus and developed chickenpox. Also, if you have previously been exposed to the varicella zoster virus and you have had chickenpox, you will not contract the virus from others with shingles.
Dooling said the majority of members of the working group supported the idea. They were concerned, she said, that if a preference wasn’t named, insurance companies might opt to reimburse for the cost of the cheaper vaccine — regardless of which is best. And it would require time-strapped doctors to try to figure out which vaccine to give their patients.
Shingles is a notifiable disease. This means doctors, hospitals and laboratories must inform the Department of Health of your diagnosis to assist the Department in determining the frequency of this infection in the community. Notification is confidential.
Wearing loose clothing can help avoid extra pain from clothing rubbing against the rash. Avoid close skin-to-skin contact with others who have not had chickenpox, are ill, or who have a weakened immune system to avoid spread of the virus.
Although the earliest appearance of shingles symptoms is sometimes confused with hives (raised areas of itchy skin), bedbug bites, or scabies (skin infection by scabies mite), the classic pain, and blistering in a band on one side of the body may be all that is necessary for a doctor to clinically diagnose herpes zoster infection (shingles). This is the most frequent way shingles is presumptively diagnosed. The rash may occasionally extend outside of this band or, infrequently, to the other side of the body. Rarely, there may be only pain in a dermatome band without a rash.
You can’t get shingles through contact with the saliva or nasal secretions of someone who has shingles, except in rare cases. That means you usually can’t get shingles if someone who has it coughs or sneezes on you.
The affected area should be kept clean. Bathing is permitted, and the area can be cleansed with soap and water. Cool compresses and anti-itching lotions, such as calamine lotion, may also provide relief. An aluminum acetate solution (Burow’s or Domeboro solution, available at your pharmacy) can be used to help dry up the blisters and oozing.
You’re typically less likely to transmit the varicella-zoster virus with shingles than with chickenpox. However, you can spread the varicella-zoster virus from the time that your symptoms start until your rash and blisters have crusted dry.
Shingles is hardly a minor menace. “A million cases occur in the United States each and every year,” Dr. Schaffner said. “If you’re fortunate enough to reach your 80th birthday, you stand a one-in-three to one-in-two chance of shingles.”
Where slates are particularly heavy, the roof may begin to split apart along the roof line. This usually follows rot developing and weakening the internal timbers, often as a result of poor ventilation within the roofspace. An important aspect to slate roofs is the use of a metal flashing which will last as long as the slates. Slate shingles may be cut in a variety of decorative patterns and are available in several colors.
In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine is known as Zostavax and is approved for use in adults ages 50 and over who have had chickenpox. The U.S. Centers for Disease Control and Prevention (CDC) recommends the vaccine for people 60 years of age and over who have had chickenpox. It is a onetime injection that contains a booster dose of the chickenpox vaccine that is given to children.
The vaccine is not indicated for the prevention of chickenpox as the dose of virus in the zoster vaccine is significantly higher than that in the varicella vaccine. It is, however, not considered necessary to test an adult over the age of 50 years for past exposure to VZV prior to administering the zoster vaccine.
Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can spread from a person with active shingles to cause chickenpox in someone who had never had chickenpox or received chickenpox vaccine.
This is one of the hallmark symptoms of shingles, also called herpes zoster. “Shingles is always on one side of the body,” says Randy Wexler, MD, a family physician at the Ohio State University Wexner Medical Center. “It never crosses the midline.” If you find a rash on both sides of your body, use these home remedies for rashes to get relief. (Dermatologists say you should never ever do these 12 things to your skin.)
A version of this article appears in print on November 14, 2017, on Page D3 of the New York edition with the headline: Promising? A New Shingles Vaccine Fits the Bill. Order Reprints| Today’s Paper|Subscribe
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Each year more than one million Americans suffer with shingles, an itchy, blistering rash caused by herpes zoster, the same viral infection that afflicts the nerve roots and causes chickenpox. In fact, those who’ve had the chicken pox, can end up with shingles years later (most likely after the age of 50) due to the fact that the infection can live dormant and become active again due to mounting age, lowered immunity, a treatment (i.e., radiation) or medication that suppress immunity, or an infection (i.e., HIV).
It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. There is no documentation of a person getting chickenpox from someone who has received the shingles vaccine (which contains varicella zoster first sign of shingles, which is also called herpes zoster, is pain that might feel like burning or tingling on one side of your face, chest, back, or waist. It can be intense. You might also feel like you’re coming down with the flu, with symptoms such as:
But the new vaccine protects nearly as well in older groups as in the middle-aged. Shingrix racked up a 97 percent effectiveness rate in adults over age 50 and, in a separate study of people over age 70, prevented 90 percent of shingles in those 70 to well past age 80.
^ Weaver BA (1 March 2007). “The burden of herpes zoster and postherpetic neuralgia in the United States”. J. Am. Osteopath. Assoc. 107 (3 Suppl): S2–57. PMID 17488884. Archived from the original on 13 January 2008.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha’s educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
^ Colebunders R, Mann JM, Francis H, et al. (1988). “Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection”. J. Infect. Dis. 157 (2): 314–18. doi:10.1093/infdis/157.2.314. PMID 3335810.
The earliest symptoms of shingles, which include headache, fever, and malaise, are nonspecific, and may result in an incorrect diagnosis. These symptoms are commonly followed by sensations of burning pain, itching, hyperesthesia (oversensitivity), or paresthesia (“pins and needles”: tingling, pricking, or numbness). Pain can be mild to extreme in the affected dermatome, with sensations that are often described as stinging, tingling, aching, numbing or throbbing, and can be interspersed with quick stabs of agonizing pain.
In studies, most older recipients said they’d experienced pain, redness or swelling in their upper arms for a day or two after the shot, and 8.5 percent of those over age 70 deemed those symptoms uncomfortable enough to interfere with normal activities.
Both lyophilized RZV and the adjuvant solution must be stored at refrigerator temperature, between 2° and 8°C (between 36° and 46°F). Protect the vials from light. Do not freeze. Vaccine or adjuvant solution that has been frozen must be discarded. If vaccine that was frozen was administered, the dose does not count and should be repeated. The repeat dose can be administered immediately. There is no interval that must be met between these doses.
Pain medication can be used to help relieve the discomfort caused by the rash, which can sometimes be severe. For some individuals with mild shingles pain, over-the-counter analgesics such as acetaminophen (Tylenol) or the anti-inflammatory drug ibuprofen (Motrin or Advil) may be all that is needed. Individuals with more severe pain may require stronger opioid pain medication.
If you’ve ever had the chickenpox — and almost all adults have — there’s a good chance the virus is still at large in your body. The varicella zoster virus can lie dormant for decades without causing any symptoms. In some people, the virus wakes up and travels along nerve fibers to the skin. The result is a distinctive, painful rash called shingles.
^ Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF (2005). “Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002”. J. Infect. Dis. 191 (12): 2002–07. doi:10.1086/430325. PMID 15897984.