First, Shingrix requires two doses, administered at least two months apart. Prodding the older population to get a single shot has proved tough: barely 31 percent of those over age 60 have been vaccinated against shingles. How much harder will it be to persuade people to get two Shingrix injections?
Today, shingles is usually treated with a combination of medications, which are used to lower the severity of pain and help the scabs heal more quickly. However, many people have also successfully turned to alternative therapies to lower their odds of getting shingles in the first place, building up their immunity and managing pain.
Many adults seem to skipping other recommended vaccines, too. Typically, about 45 percent get the annual flu shot, and only 23 percent of those the CDC says should get the pneumococcal and tetanus-diphtheria-pertussis vaccines are up-to-date with those immunizations.
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Almost one out of three people in the U.S. will develop shingles during a lifetime. As you get older, your risk goes up, since studies show that most people (over half) who develop shingles are over the age of 60.
Shingles is a painful rash that’s caused by varicella zoster, the same virus that’s responsible for chickenpox. If you had chickenpox as a child, the virus hasn’t completely gone away. It hides dormant in your body and can reemerge many years later as shingles. There are about 1 million cases of shingles each year, according to the Centers for Disease Control and Prevention (CDC). About half of these cases occur among people over the age of 60.
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.
Pregnant women who have not had chickenpox should avoid people with shingles. See separate leaflet called Chickenpox Contact and Pregnancy for more details. Also, if you have a poor immune system (immunosuppression), you should avoid people with shingles. (See below for a list of people who have a poor immune system.) These general rules are to be on the safe side, as it is direct contact with the rash that usually passes on the virus.
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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.
Anti-viral medications can help ease the pain and shorten an attack of shingles. The medication works best if administered within three days, and ideally within 24 hours, of the onset of a rash. If you think you have shingles, seek urgent medical attention. Analgesic medication may also ease post-herpetic neuralgia, but consult your doctor first.
For this reason, people affected by shingles should stay away from babies, children, pregnant women, people with a weak immune system, people who have not had chickenpox, or people who have not been vaccinated against chickenpox. Once a person develops chickenpox, he/she cannot contract the virus from others. The virus remains dormant in their body. However, people who have not had chickenpox, are at a risk of getting exposed to the virus, and developing chickenpox. Once infected, these people can develop shingles later in life.
Though most people will experience only one episode of shingles during their lifetime, recurrence can occur in certain individuals. In order to help prevent recurrent episodes of shingles, individuals with no contraindications can receive the zoster vaccine (Shingrix), which can prevent recurrent episodes of shingles. Otherwise, people who do experience a recurrent case of shingles should see their doctor as soon as the rash appears to promptly receive antiviral medication.
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Shingles is contagious and can be spread from an affected person to babies, children, or adults who have not had chickenpox. But instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus) from someone else. Once infected, however, people have the potential to develop shingles later in life.
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The vaccine is not recommended for people who allergic to gelatin, the antibiotic neomycin, or any other vaccine components. People with weakened immune systems, including individuals with HIV/AIDS, leukemia, lymphoma, or other lymphatic or bone marrow cancers, or people taking immune-suppressing drugs should not get Zostavax. Neither should women who are pregnant or planning to get pregnant.
Testing for shingles may include viral cultures, Tzanck prep (microscopic exam and staining of skin), and blood testing for titers of antibodies to the varicella virus. However, these tests are rarely necessary, as diagnosis is usually made based upon the characteristic clinical presentation.
In some cases, shingles cannot be diagnosed by signs and symptoms alone, especially in people with weak immune systems whose rash strays from the typical girdle-like pattern, or in individuals who may be experiencing complications from other conditions. Some people show up at their doctor’s office having pain or other symptoms before a shingles rash appears. And, in rare instances, a person may have shingles with pain and itching but no rash. In each case, additional testing may be required to pinpoint the exact cause.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Older adults are most likely to develop shingles, which is why the shingles vaccine is recommended for people age 60 and older. Zostavax is currently the only vaccine approved by the U.S. Food and Drug Administration (FDA) to prevent shingles. According to the CDC, the vaccine can reduce your risk of getting shingles by more than half, but the older you are the less effective the vaccine becomes. As a result, some people who get the vaccine may still get shingles. The ideal time for getting vaccinated is between 60 and 69 years old.
^ a b c d e Stankus SJ, Dlugopolski M, Packer D (2000). “Management of herpes zoster (shingles) and postherpetic neuralgia”. Am. Fam. Physician. 61 (8): 2437–44, 2447–48. PMID 10794584. Archived from the original on 2007-09-29.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
There are no available data to establish whether RZV is safe in pregnant or lactating women and there is currently no ACIP recommendation for RZV use in this population. Consider delaying vaccination with RZV in such circumstances.
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.
Barbara Walters’ co-hosts on The View informed viewers that Walters has been hospitalized with the chicken pox. She’s 83, and the infection, which is more common among young children, is rare among older adults. According to her co-host Whoopi Goldberg, Walters has never had chicken pox before.
Talk with your healthcare provider if you have questions about shingles vaccine. Shingles vaccine is available in doctor’s offices and pharmacies. To find doctor’s offices or pharmacies near you that offer vaccine, visit Zostavax or HealthMap Vaccine Finder.
Ramsay Hunt syndrome, which can occur if shingles affects the nerves in your head and can result in partial facial paralysis or hearing loss if left untreated (if treated early, most patients make a full recovery)
It may also vote to recommend the vaccine on a preferential basis — in other words, suggest that doctors use the GSK vaccine over the Merck one. At a meeting of the committee in June, a CDC vaccine expert who heads a Shingrix work group, Dr. Kathleen Dooling, alerted the ACIP to the fact the work group was leaning toward proposing a preferential recommendation for the new vaccine.
Once the pain starts, the impact on your life can be devastating. Within days, a chickenpox-like rash develops on either the left or right side of the body, forming a cluster of blisters which begin to dry and scab three to five days after they first appear. But contracting shingles can lead to a complication known as post-herpetic neuralgia (PNH).
Each of these factors can weaken the immune system, resulting in shingles. However, usually a cause for the reactivation of the virus is never found. If the virus reactivates, it can only cause shingles, and does not cause widespread chickenpox again.
Postherpetic neuralgia (PHN) may require additional medications such as opioids (for example, oxycodone, morphine) to control pain. PHN is the pain that remains in some people even after the rash goes away. Some patients do not respond to common pain-management therapies and may need to be referred to a pain-management specialist. Drugs usually prescribed for seizures and other nerve-related problems, gabapentin and pregabalin, have been effective in reducing pain in some patients with shingles, including those with PHN.
A version of this article appears in print on October 26, 2017, on Page A13 of the New York edition with the headline: C.D.C. Panel Is Endorsing New Vaccine For Shingles. Order Reprints| Today’s Paper|Subscribe
