Shingles Vaccine Available to More Senior Citizens

Shingles (herpes zoster) is a condition caused by the reactivation of chicken pox virus, living dormant in the nerve cells. It causes symptoms similar to chicken pox, but is characterized by the rash being located only on one side of the body - typically on the torso, face or neck, buttock or leg, but sometimes around one eye.

While most cases of shingles heal on their own after a short time, some patients later suffer from a painful condition known as post-herpetic neuralgia. This can last months or even years, and leads to permanent nerve and skin damage. Other complications of shingles include severe pain, bacterial skin infections, pneumonia and encephalitis.

Although anyone who has had chicken pox can get shingles, it is most common in people 50 or older. Risk of having shingles grows with age.

Reasons to Consider Getting the Zostavax Shot

Many of the people most at risk for getting shingles are also those for whom vaccination is not recommended:

People living with HIV/AIDS;

People whose immune systems are suppressed by medical treatments such as steroids (e.g. prednisone) or anti-rejection drugs;

Cancer patients receiving radiation or chemotherapy for cancer.

As many of these conditions can arise suddenly, it is wise to consider vaccination at age 60 or as soon as the vaccine becomes available. Research to determine effectiveness of the vaccine for individuals in the 50-59 year age group has not been completed, but this is an area of interest at present.

In the past being exposed to children with chicken pox has provided a sort of natural booster that helped prevent shingles in adults who have themselves had chicken pox. Now that children are being routinely offered the varicella vaccine, there are few cases of chicken pox and therefore few opportunities for an adult to develop extra immunity through re-exposure to varicella.

Finally, shingles is contagious. An adult who develops shingles can infect others with chicken pox. While today's varicella vaccines offer some immunity, there is no guarantee they will work perfectly. If you have not had chicken pox but have received varicella vaccine, you should discuss getting the shingles vaccine with your doctor. If you have a family member who has been vaccinated against varicella, getting the shingles vaccine may help protect them.

What You Should Know About the Shingles Vaccine

Zostavax is a single dose live vaccine. It does not guarantee immunity, but does improve it significantly. People who have been vaccinated and do get shingles will generally have less severe symptoms and are less likely to suffer post-herpetic neuralgia. It is recommended for all individuals age 60 or older, for whom the vaccination does not pose a health risk (see below) even if they do not recall having chicken pox. The majority of Canadians alive today have had chicken pox, so you are likely to be among them. If you have previously had shingles you can still be vaccinated to prevent new outbreaks.

Adverse reactions are similar to those experienced after any vaccination: pain, itching, redness or swelling at the injection site, and headache. Because the vaccination is made from live virus, you may have a rash similar to chicken pox near the injection site. It should be kept covered, as this rash can transmit chicken pox to individuals without immunity. If you have regular contact with individuals in risk groups, including pregnant women and small children, talk to your doctor about precautions that will safeguard them.

People Who Should Not Take Zostavax

People who should not take the vaccine are those who may be allergic to a component of the vaccine, and those whose immune systems are depressed. Vaccination is not recommended, or must be administered with greater caution, if:

You are severely allergic gelatin or neomycin, as these are components in the vaccine. If you have any serious allergies notify your doctor before deciding if the vaccine is right for you;

Your immune system is depressed due to HIV/AIDS, leukemia/lymphoma or other conditions;

You take medications that may suppress your immune response, such as anti-rejection drugs, chemotherapy or radiation for cancer, or high doses of steroids (e.g. prednisone);

You have active, untreated tuberculosis (TB);

You are pregnant or trying to get pregnant.

Cost of the Vaccine

Zostavax costs about $150, both in the United States and Canada. Coverage in the US varies. In Canada the vaccine may be covered by private health plans, but is not included in public health insurance at this time.

Sources:

"Canada OKs vaccine to prevent painful shingles in seniors" CBC News

"FDA approves first shingles vaccine" Todd Zwillich (WebMD)

"People over 60 should get shingles vaccine: CDC" CBC News

"Risk factors" Shingles (Mayo Clinic)

"Shingles vaccine now available for seniors" CBC News

"Shingles vaccine: Can I transmit the vaccine virus to others?" James M. Steckelberg, M.D. (Mayo Clinic)

"Shingles vaccine: Should I get it?" James M. Steckelberg, M.D. (Mayo Clinic)