Shunning Shingles with a sure shot of Shingrix
August 20, 2018
There is a buzz in the world of vaccinations, and it is called Shingrix. If you have ever had chickenpox, you will want to know more about this vaccine. Why? Because once a person has chickenpox, the virus lies dormant in the nervous system. As people age, the cells in the immune system lose the ability to maintain a strong and effective response to varicella zoster virus (VZV) reactivation, which can lead to shingles.
Shingles (herpes zoster) is a viral infection that affects one of every three people age 60 and older. The condition is painful, and it also can be serious. A typical shingles outbreak causes an agonizing, blister-like rash along a dermatome – a section of the body supplied by a particular nerve (see image). For some people, the rash can lead to long-lasting, severe pain called post-herpetic neuralgia. There is no cure for this pain, but it can be managed with oral medication.
Shingles also can lead to serious complications involving the eyes, and, though very rarely, to pneumonia, hearing problems, blindness, encephalitis, or death. People who develop shingles typically have only one episode in their lifetime. In rare cases, however, a person can have a second or even a third episode, and it also can occur in children.
A shingles outbreak can be contagious. People most at risk include those who:
• Are seniors
• Have cancer or chronic lung or kidney disease
• Have a weakened immune system
• Were not vaccinated against varicella
Fortunately, shingles can be prevented with appropriate vaccinations, including the two-dose Shingrix vaccine.
Who should be vaccinated against shingles?
To prevent shingles, the first step is to vaccinate children with the varicella vaccine as part of routine childhood immunization. Adults who have never had chickenpox and did not get vaccinated as a child should also receive the vaccine.
For adults who had chickenpox as children, there are two vaccines on the market for shingles prevention – Zostavax and Shingrix. The goal of these two vaccines is to decrease the risk of developing shingles and post-herpetic neuralgia among individuals who are 50 and older.
Shingrix vaccine is given in two doses. After the first dose, the second can be administered anytime between two and six months later. Even those who have already had shingles can still receive the vaccine to help prevent future occurrences of the disease. Shingrix is also recommended for adults who previously received the Zostavax vaccine.
Certain patients should not receive Shingrix, including those who:
• Have had a severe allergic reaction to the vaccine
• Have immune system problems (discuss Shingrix with your doctor before getting vaccinated)
• Are pregnant or breastfeeding
• Have a severe illness with a temperature of 101 F or higher at the time of vaccination
"Once a person has chickenpox, the virus lies dormant in the nervous system. As people age, the cells in the immune system lose the ability to maintain a strong and effective response to varicella zoster virus (VZV) reactivation, which leads to shingles."
How do Zostavax and Shingrix compare?
Zostavax reduces the risk of developing shingles by 51 percent in adults age 60 and older. However, Shingrix was 97 percent effective in preventing shingles in adults age 50 to 69 and 91 percent effective in adults age 70 and older.
In adults age 50 to 69 who got two doses, Shingrix was 91 percent effective in preventing post-herpetic neuralgia; in adults age 70 and older, it was 89 percent effective.
• Became available in 2006
• Approved for adults age 50 to 59 but recommended by the CDC for adults age 60 and older
• Live, attenuated varicella-zoster virus; not typically safe for patients with immune problems
• Lasts about five years; getting vaccine later in life is recommended
• Subcutaneous injection
• One dose only
• Became available in fall 2017
• Approved for adults age 50 and older
• Not a live virus; safe for patients with immune problems
• Can be administered with other inactive or live vaccines; if so, it should be given in a different part of the body
• Intramuscular injection
• Two doses; second dose is 2-6 months later
If you’re concerned about shingles, ask your doctor about the Shingrix vaccination to reduce your risk of developing the painful disease – and spreading it to others. To schedule your vaccination, call 214-645-8300 or request an appointment online.
• National Foundation for Infectious Diseases
• United States Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices (ACIP) Advisory committee on immunization practices https://www.cdc.gov/vaccines/acip/committee/charter.html (2016), Accessed 16 July, 2018.
• Centers for disease control and prevention. Monitoring the Impact of Varicella vaccination (2016). https://www.cdc.gov/chickenpox/surveillance/monitoring-varicella.html, accessed 16 July, 2018.