It’s fine to have the shingles vaccine if you’ve already had shingles. The shingles vaccine works very well in people who have had shingles before and it will boost your immunity against further shingles attacks.
Advocates for older Canadians are calling on provincial governments to cover the cost of a new vaccine against shingles that will soon be available. Shingles is a painful illness to which seniors are more susceptible and advocates say vaccine coverage should be treated as a public health issue.
In those with poor immune function, disseminated shingles may occur (wide rash). It is defined as more than twenty skin lesions appearing outside either the primarily affected dermatome or dermatomes directly adjacent to it. Besides the skin, other organs, such as the liver or brain, may also be affected (causing hepatitis or encephalitis respectively), making the condition potentially lethal.:380
Antiviral drugs may reduce the severity and duration of shingles; however, they do not prevent postherpetic neuralgia. Of these drugs, aciclovir has been the standard treatment, but the new drugs valaciclovir and famciclovir demonstrate similar or superior efficacy and good safety and tolerability. The drugs are used both for prevention (for example in HIV/AIDS) and as therapy during the acute phase. Complications in immunocompromised individuals with shingles may be reduced with intravenous aciclovir. In people who are at a high risk for repeated attacks of shingles, five daily oral doses of aciclovir are usually effective.
Shingles is a viral infection that is caused by the varicella-zoster virus. People often wonder if shingles is contagious, and for how long does shingles remain contagious. Well, the virus that causes shingles can be transmitted to others. The following Buzzle write-up provides information on this condition.
I asked Thomas Fekete, MD, infectious diseases physician, College of Physicians Fellow and Trustee, and interim chair of the department of medicine at Temple University School of Medicine, for his thoughts about the new vaccine. His response is below.
Zoster vaccines are given to people who presumably had chickenpox earlier in life and so have immunity to varicella virus. The cancer chemotherapy will not change the person’s immunity to varicella virus. If the person received RZV no action is necessary. However, if ZVL was given the patient should be monitored for the next two weeks for symptoms that might indicate an adverse reaction, such as fever and rash. If symptoms suggestive of varicella develop, the patient can be started on antiviral therapy, such as acyclovir.
Transmission only occurs through direct contact with blisters, and it can cause chickenpox in someone who has never been infected with the virus. During the time before blisters appear and after crusting, there is no risk of viral transmission.
The CDC also recommends that people who have already gotten Zostavax should now get Shingrix as well and that Shingrix is officially the preferred vaccine over Zostavax, a single-dose vaccine. Those who’ve had shingles, which occasionally recurs, should also receive Shingrix.
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Neither CDC nor the vaccine manufacturer recommends transporting live varicella-containing vaccines. If these vaccines must be transported (for example during an emergency), CDC recommends transport in a portable freezer unit that maintains the temperature between -50°C and -15°C (-58°F and +5°F). Portable freezers may be available for rent in some places. If live varicella-containing vaccines must be transported and a portable freezer unit is not available, do NOT use dry ice. Dry ice may subject varicella-containing vaccines to temperatures colder than -50°C (-58°F).
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.
Shingles is less contagious than chicken pox and cannot be passed from person person. However, the varicella zoster virus can be spread from a person with shingles to someone who has never had chicken pox. The unfortunate recipient might develop chicken pox, but not shingles.
Getting vaccinated can also help you avoid painful nerve complications from the disease. Although the shingles vaccine is approved by the FDA for people ages 50 to 59, the CDC recommends waiting until age 60 to get the vaccine. This is because it’s not clear how long immunity from the vaccine lasts. It appears to be most effective the first five years after getting it. Even if you’ve had shingles before, you can still get the vaccine to decrease the likelihood of a future reoccurrence of it.
Senior citizens with shingles are more likely to experience complications than the general population, including more extensive rashes and bacterial infections from open blisters. They are also more susceptible to both pneumonia and brain inflammation, so being seen by a doctor early on for anti-viral treatment is important.
Until the mid 1990s, infectious complications of the Central Nervous System (CNS) caused by VZV reactivation were regarded as rare. The presence of rash, as well as specific neurological symptoms, were required to diagnose a CNS infection caused by VZV. Since 2000, PCR testing has become more widely used, and the number of diagnosed cases of CNS infection has increased.
The use of wooden roof shingles has existed in parts of the world with a long tradition of wooden buildings, especially Scandinavia, and Central and Eastern Europe. Nearly all the houses and buildings in colonial Chiloé were built with wood, and roof shingles were extensively employed in Chilota architecture.
Topical corticosteroids are sometimes used to decrease inflammation and pain, but these should be used only under the supervision of a health care professional since in some patients, corticosteroids may make the condition worse.
The heightened effectiveness of the vaccine is likely due in large part to the adjuvant the vaccine uses (an adjuvant is a vaccine component that heightens immune response – an aluminum compound is the most common adjuvant used in U.S. vaccines). The proprietary adjuvant in Shingrix includes two immune-stimulating compounds, a lipid and a purified saponin. As Didierlaurent et al. (2016) note, “Both immunostimulants in [the adjuvant] contribute to the local and transient induction of innate immunity immediately after the vaccine’s injection, and this induction appears to be critical for the promotion of antigen-specific cell-mediated and antibody-mediated immunity.”
Antiviral medicines include aciclovir, famciclovir and valaciclovir. An antiviral medicine does not kill the virus but works by stopping the virus from multiplying. So, it may limit the severity of symptoms of the shingles episode. It had also been hoped that antiviral medicines would reduce the risk of pain persisting into PHN. However, the research so far has shown that the current antiviral medicines taken during an episode of shingles do not seem to have much impact on the prevention of PHN. Further research is needed in this area to determine if newer antiviral drugs can prevent PHN.
Topical treatments – Products containing capsaicin, an ingredient in hot peppers, or lidocaine, a numbing agent, may help ease shingles pain. There are creams and lotions that contain capsaicin. Lidocaine comes in different forms, including sprays and patches.
The shingles rash can be a distinctive cluster of fluid-filled blisters — often in a band around one side of the waist. This explains the term “shingles,” which comes from the Latin word for belt. The next most common location is on one side of the forehead or around one eye. But shingles blisters can occur anywhere on the body.
The rash usually lasts about 10 to 15 days. During that time, a scaly crust might appear. Once the attack is over, the skin usually returns to normal, but there can be some scarring or a secondary bacterial infection in severe cases.
So while the old vaccine will remain on the market, the C.D.C. committee voted to make Shingrix the preferred vaccine and recommended it for all adults over age 50 — a group younger by a decade than those earlier encouraged to get Zostavax.
Some patients with shingles can be treated appropriately by their primary-care physicians, including internal medicine or family medicine specialists; initial care may be started by an emergency medicine physician. However, if there is a chance the eye may be involved, an ophthalmologist should be consulted. If a person is pregnant and gets shingles, they should consult with their OB/GYN physician immediately. For long-term or chronic pain involved in postherpetic neuralgia, a neurologist and/or pain specialists may be involved in the care of the patient.
The virus that causes shingles usually presents itself as two distinct entities: chickenpox (the primary infection) and herpes zoster (the secondary condition). Unlike chickenpox, shingles normally isn’t considered a contagious virus, so likely you won’t catch it from being around someone who has an active virus. That being said, although it’s not very common, it’s not impossible to spread the virus from person to person if the receiver never had chickenpox or got the chickenpox vaccine.
Fibre (fiber) cement shingles are often known by their manufacturer’s name such as eternit or transite. Sometimes the fiber in the cement material was asbestos which has been banned for health reasons since the 1980s. Removal of asbestos shingles requires extra precautions and disposal methods.
Serologic studies indicate that almost everyone born in the United States before 1980 has had chickenpox. As a result, there is no need to ask people age 50 years and older for their varicella disease history or to perform a laboratory test for serologic evidence of prior varicella disease. A person age 50 years or older who has no medical contraindications, is eligible for recombinant zoster vaccine regardless of their memory of having had chickenpox.