The new vaccine to help prevent it is being touted by doctors as a breakthrough in the battle to protect seniors from preventable illnesses. Shingrix is recommended for people 50 and older. It is taken in two doses, a few months apart.
^ Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS (2007). “A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction”. Mayo Clin. Proc. 82 (11): 1341–49. doi:10.4065/82.11.1341. PMID 17976353.
The news raised questions about how likely adults are to get chicken pox and how chicken pox is related to a condition that’s more common among adults, shingles. So here are some quick facts about the infections.
Department of Health and Ageing (DOHA). The Australian Immunisation Handbook. 9th ed. [online] Canberra, ACT: Commonwealth of Australia. 2008 [Last updated Sept 2010, accessed 12 Jul 2011] Available from: http://www.health.gov.au
In this situation, since you’ve tested the patient and the results were negative, the patient should receive varicella vaccine. A person age 50 years or older who has no medical contraindication is eligible for recombinant zoster vaccine regardless of their memory of having had chickenpox. However, if an adult age 50 years or older is tested for varicella immunity for whatever reason, and the test is negative, he/she should be given 2 doses of varicella vaccine at least 4 weeks apart, not zoster vaccine.
^ Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA (2005). “The incidence of herpes zoster in a United States administrative database”. J. Gen. Intern. Med. 20 (8): 748–53. doi:10.1111/j.1525-1497.2005.0150.x. PMC 1490195 . PMID 16050886.
It’s important to understand that both vaccines do not guarantee an individual will not be infected with the virus. They do substantially decrease a person’s chances of developing the diseases, however.
The shingles vaccine is very safe. There is no evidence that it can cause shingles. Common reactions to the vaccine may include soreness, redness, swelling, itching, or a rash where the vaccine was given. Headache may also occur.
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.
In some cases, shingles can affect the nerves of the face, ears or eyes and cause complications. Complications include the development of facial paralysis, impaired vision and hearing. Another complications is called postherpetic neuralgia, in which the pain of shingles lasts for months or even years. People with compromised immune systems are at a higher risk for developing serious complications of shingles….more about Shingles »
The rashes are irritating and can last for days or weeks. Many can begin treating their shingles pain by taking over the counter medications. Some also report finding relief with creams or antihistamines, but usually require a doctor’s care to fully heal. If you feel you are experiencing shingles rash pain, your regular doctor can prescribe you stronger medications to keep the pain at bay.
“In groups such as the elderly, who often don’t maintain vigorous responses to vaccines, this represents extremely strong disease protection,” said Dr. Kathleen Dooling, an epidemiologist at the C.D.C.
Classic symptoms of shingles are painful blisters in a band along a nerve distribution on one side of the body. These blisters usually break open and ooze fluid. This may last about five to seven days. The pain in the area of the rash can be intense as the nerve is irritated. The individual is contagious and can spread the virus when blisters are forming and until all of the blisters have crusted over. The rash may heal in about two to four weeks, and some skin areas may scar.
The CDC recommends that healthy adults ages 50 and older get the shingles vaccine, Shingrix, which provides greater protection than Zostavax. The vaccine is given in two doses, 2 to 6 months apart. Zostavax is still in use for people ages 60 and older.
Shingles, or herpes zoster, is a very common painful, blistering viral rash. Shingles is caused by reactivation of the chickenpox virus called varicella zoster virus (VZV). Shingles occurs in people who have previously been infected with the chickenpox virus at some point in their lives. Shingles usually occurs as a unilateral (one side of the body) pain, burning, or tingling and blistering rash extending in a local pattern in the distribution of nerves. Common areas affected by shingles include the face, abdomen, back, buttocks, and chest. Red, itchy patches form across these areas and become small blisters that may be similar in appearance to chickenpox. The rash begins to clear after the blisters break and dry into scabs within two to three weeks.
It’s not clear at this point whether people who’ve received Zostavax should come back immediately for Shingrix or wait. The point did not come up during the panel’s discussion, Glaxo spokesman Sean Clements said.
We have a patient with a severe allergy to vancomycin who wants to receive zoster vaccine. According to the Zostavax prescribing information, an allergy to neomycin would be a contraindication to vaccination but we are not sure about allergy to vancomycin.
An antiviral medicine is most useful when started in the early stages of shingles (within 72 hours of the rash appearing). However, in some cases your doctor may still advise you have an antiviral medicine even if the rash is more than 72 hours old – particularly in elderly people with severe shingles, or if shingles affects an eye.
The rash could form as a band around your rib cage, abdomen, face or forehead, or down an arm or a leg (although this is less common). Spots will appear and then turn into blisters, which will dry up to form a crust or scab over the top.
A doctor is usually able to identify shingles from the rash they see on either the left or right side of the body. It’s not usually necessary to do tests, however, if necessary, your doctor will test cells taken from a blister, or use the test for herpes.
Shingles can affect any part of the body, including the face. Classically, the rash caused by shingles often takes the shape of a belt from the midline on one side of the body. The rash forms its characteristic pattern because the virus works down the nerves that branch out from the spinal cord. The chest and lumbar region are most commonly affected.
Clinical Knowledge Summaries. Shingles. [online] London: National Institutes for Health and Clinical Excellence. 2008 [last updated Sept 2010, accessed 11 Jul 2011] Available from: http://www.cks.nhs.uk/shingles
Shingles, which is also called herpes zoster, occurs when the chickenpox virus (varicella zoster), which is dormant in those who’ve had the illness, reawakens later in life. Almost all adults older than 40 carry the chickenpox virus—and the older we get, the more the risk of getting shingles climbs. According to the CDC, the infection strikes about 1 million people in the U.S. each year and nearly one in three adults will experience a bout of shingles in their lifetime.
While chickenpox—and, by association, shingles—used to be something that nearly everyone got at some point in their lives, both are becoming less common thanks to vaccines for each disease. Children now routinely are given the chickenpox vaccine as part of their regular shots, Dr. Adalja says, and the shingles vaccine, Zostavax, reduces the risk of developing shingles by 51 percent and postherpetic neuralgia by 67 percent, the CDC says.
Living with a shingles rash can be made more comfortable by taking steps to relieve the symptoms. Keeping any rashes clean and dry helps to reduce the risk of them becoming infected. Wearing loose clothing can also help people to feel less uncomfortable while waiting for a rash to clear.
^ a b c Gagliardi, AM; Andriolo, BN; Torloni, MR; Soares, BG (3 March 2016). “Vaccines for preventing herpes zoster in older adults”. Cochrane Database of Systematic Reviews. 3: CD008858. doi:10.1002/14651858.CD008858.pub3. PMID 26937872. Archived from the original on 9 March 2016.