SHINGLES VACCINE: 

Patients who are at least 50 years old should receive a vaccine to prevent shingles, even if they already have had an episode of this condition, according to a vote by the Advisory Committee on Immunization Practices at its meeting in Atlanta in October 2006. 

Zostavax, manufactured by Merck, was approved by the FDA in May, 2006.  Studies have shown that a single shot reduces the risk of shingles by 50%.  The chance of post herpetic neuralgia is decreased by 67%.  The effectiveness of the vaccine declines with age, although the chance of developing chronic pain as a result of shingles is still reduced.   

“This vaccine represents an important medical breakthrough aimed at improving health in older people,’ said Anne Schuchat, MD, assistant surgeon general and director of the CDC and Prevention’s National Center for Immunizations and Respiratory Diseases. 

Those who have a history of chicken pox are at risk of developing shingles. About 25% of adults are expected to do so if they are not immunized.

While some insurances cover Zostavax at this time, the recommendation of the Advisory Committee  is likely to improve coverage.

Please check with your insurance to see if it is a covered benefit before making an appointment. 

Even if you do not have coverage (for example, Medicare does not cover Zostavax), we continue to recommend it.  However, please be advised that the vaccine is expensive. The self-pay cost is $225! 

Shingles is caused by the reactivation of the Chicken Pox Virus and usually occurs when we are under some kind of stress.  It is not only more common in older adults, but is more likely to have devastating consequences in older age groups.  These can include post-herpetic neuralgia, a chronic pain syndrome that can last for months or years after an attack, paralysis in the distribution of the involved nerve, and blindness.

Shingles typically presents as a blistering rash, which can look like poison ivy.  It generally occurs on one side of the body and causes severe pain and itching. It can damage vision permanently by affecting the cornea.

Medicines that are currently available to treat Shingles may shorten viral shedding time (vulnerable people can actually catch the Chicken Pox from someone with Shingles, so this can be important) and decrease the likelihood of developing severe complications such as pain, loss of vision or paralysis.  HOWEVER, AS WITH ALL THINGS,  PREVENTION IS THE BEST MEDICINE.

Links to:

• CDC Shingles vaccine pdf
• Original New England Journal of Medicine article on vaccine effectiveness
• Shingles information page

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