Pros and Cons of the Shingles Vaccine
Should Seniors Get the Herpes Zoster Vaccination?
Studies estimate that approximately one million, or one in three, Americans suffer from shingles each year. This painful condition is more common in those over the age of 60, and current recommendations encourage most seniors to receive the zoster (or shingles) vaccine.
Basic Information about Shingles
Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chicken pox. Once a person has been infected with chicken pox, that virus lives dormant in the person’s nerve cells. If the person is later exposed to VZV and his immunity is lowered due to advanced age or certain other conditions, then the person may develop a painful rash that typically appears on one side of the body or face. This condition is called shingles, also known as herpes zoster or zoster. Read Shingles – Seven Facts Seniors Should Know for more information about shingles.
If you suspect that you have been exposed to the chicken pox virus or have developed a rash that might be shingles, you should contact your healthcare provider immediately.
What does a shingles rash look like? View pictures of shingles on various parts of the body. Some of these pictures may be a bit graphic. The MayoClinic provides additional information regarding shingles symptoms and treatment recommendations.
Risk Factors for Shingles
- Older age – approximately 99.5% of older Americans have had a chicken pox infection and therefore have the virus in their nerves.
- Other conditions that alter the immune system, such as certain cancers and their treatments, HIV infection, and certain chronic conditions.
- Those who are around people who are likely to develop a chicken pox infection.
Complications of Shingles
- Postherpetic Neuralgia (PHN) occurs in 10-18% of people with a shingles infection. PHN often leaves people with pain, itching, or numbness in the area of the initial infection that may be debilitating for months and even years after the shingles rash has healed.
- Eye complications occur in 10-25% of people with a shingles infection and may result in prolonged pain, scars, or impaired vision.
- Hospitalization occurs in 3% of people with a shingles infection, usually in those who are immunocompromised.
- Other complications are less common and include Ramsay Hunt syndrome, motor weakness called zoster paresis, urinary retention, colon pseudo-obstruction, death, and others.
Recommendations for Zoster Vaccine
- Zoster vaccine has been available in the U.S. since May 2006.
- Americans 60 and older who do not have contraindications are encouraged to consider the vaccine.
- People may receive the vaccine even if they have had a previous chicken pox and/or shingles infection. There is some conflicting information regarding this as some sources say that people who have had a shingles infection are unlikely to get it again. People can get a shingles infection multiple times, and many sources are now recommending the vaccine regardless of a past history of shingles and/or the chicken pox.
- The zoster vaccine is one of several recommended vaccines for seniors.
The Downside to the Zoster Vaccine
- People who have had a life-threatening allergic reaction to gelatin or neomycin should avoid getting the zoster vaccine with those ingredients.
- Those who have active tuberculosis that is not treated should discuss TB treatment first.
- People who have an altered immune system due to infection or treatments should discuss risks and timing of the vaccine.
- Those who have a moderate to severe illness should wait to take the zoster vaccine, particularly if they have a high fever.
- The zoster vaccine is not recommended for people who are pregnant.
- If you are going to be around a newborn baby, anyone who has a weakened immune system, someone who is pregnant, or other people who might be affected by a live (but weakened) vaccine, you should discuss this with your healthcare provider before getting the vaccine.
- The vaccine is expensive and may cost hundreds of dollars. Many insurance companies do not cover this vaccine; however, according to the CDC's web site, the shingles vaccine is covered by all Medicare Part D plans but Medicare Part B plans do not cover the shingles shot. It is recommended to contact the insurance company to see if the individual plan covers this vaccine.
- Some people fear getting a shingles outbreak from the vaccine. Data regarding this is difficult to interpret because someone who develops shingles after vaccination may have been exposed to the virus in another way.
- The vaccine has been shown to be approximately 50% effective in preventing a shingles infection and approximately 66% effective in preventing PHN.
- Reported common side effects of the vaccine are usually mild and include a red, tender injection site (one in three) or headache (one in seventy). If you have any negative effects to this vaccine, you should report them to your healthcare provider. You may also report negative effects to the Food and Drug Administration (FDA) online.
Is the Shingles Vaccine Right for You?
Hindsight is often very telling but not very helpful to the person who experiences a case of the shingles or complications due to a shingles infection. Vaccines are a bit like insurance. People often purchase it with the hopes that their outcome will be one of the positive ones. There are no guarantees that people who have received the zoster vaccine will never develop a shingles infection. Evidence suggests that the likelihood of developing shingles and resulting complications is lessened with the vaccine, but the cost of the vaccine is substantial.
You may wish to read more information about Zostavax before making your decision.
If your healthcare provider has suggested that you get the zoster vaccine, you may wish to consider this option and explore your individual pros and cons related to the shingles shot. Information in this article is for informational purposes only and should not be considered medical advice.
Sources:
"Shingles: Painful Return of Chicken Pox Virus" MayoClinic Web Site
“Should you get the shingles vaccine?” October 2008 Harvard Health Letter
"Prevention of Herpes Zoster" June 6, 2008 Morbidity & Mortality Weekly Report
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