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more articles by Yoon, Serena H , FACP, MD  |  author's bio

Talk to Your Doctor About the Shingles Vaccine

By Serena Yoon, MD

 

According to the Centers for Disease Control (CDC), one in three people will experience shingles in their lifetime and 70 percent of these people will be over age 50. If you are 50 or older, you should talk with your doctor about receiving the shingles vaccine. It has been safely in use for six years and is approved by the Federal Drug Administration for individuals ages 50 and up.

 

What is shingles?

 

Shingles, also known as herpes zoster, is a very painful rash that occurs in individuals who have had chickenpox in their lifetime. The name is derived from the Latin word “cingulus” or belt, due to the characteristic distribution of the rash.  Following the infection, the chickenpox virus (varicella zoster) remains latent in the body. As we age, the immunity developed during the childhood bout of chickenpox declines and we may no longer be able to suppress the virus. Shingles occurs when this virus is reactivated. According to the CDC, 99.5 percent of adults in the United States age 40 and over are at risk for h. zoster because they’ve had chickenpox.

 

What are the symptoms of shingles?

 

The hallmark of h. zoster is the appearance of painful blistering lesions in the region of a single sensory nerve (dermatome). Often, the involved dermatome is on the torso, creating a belt-like distribution of the rash, hence the descriptive name, shingles. Sometimes people have a prickling or burning sensation for several days to a week before the rash actually appears on the skin. Once the rash appears it is characterized by multiple blistery, red lesions, which start out as raised fluid-filled bumps then progress to scabbed over lesions.

 

Chronic pain is the most common complication of

h. zoster, which can be severe and is frequently characterized as “burning”, “stabbing” and “stinging.” Typically, the symptoms of shingles last from two to four weeks; however, for about one in five people the pain becomes chronic and can continue long after the rash goes away. This condition is called post-herpetic neuralgia (PHN) and can last for months or years. There are no curative strategies for PHN, but there are some medications available that can palliate some of the associated pain. The incidence of PNN increases with age.

 

Why is shingles vaccination important?

 

Approximately 10-25 percent of patients with shingles will develop ophthalmic zoster, which occurs in and around the eye and can lead to permanent blindness. While rare, a shingles infection can also lead to hearing loss, bacterial super-infection, scarring, and motor nerve palsies.  Post-herpetic neuralgia can be quite severe and disabling, especially among the elderly.

 

Is the shingles vaccine safe and effective?

 

The shingles vaccine was first released in 2006 and since that time no serious problems have been identified with it. This is the same vaccine we administer to children for chickenpox, but in a stronger dose for adults. In clinical trials, the shingles vaccine reduced the risk of shingles by approximately 50 percent. People who do get shingles after being vaccinated typically experience milder symptoms and an abbreviated course of the illness.

 

Is shingles contagious?

 

You cannot catch shingles from another person. However, if you never had chickenpox as a child and were never vaccinated for it, you could get chickenpox from someone with shingles if you were directly exposed to the shingles rash. This is very uncommon.

 

If I suspect I have shingles, what should I do?

 

Timing is important. If you think you may have shingles, call your doctor immediately. There are antiviral medications available that can attenuate the severity and duration of the shingles experience; however, it is important to start these medications within 36 hours of the rash becoming apparent.

 

Shingles can be a life-changing event but it is very preventable. Talk to your primary care physician about the shingles vaccine if you are 50 or older.

 

Dr. Yoon is board certified in internal medicine, a fellow of the American College of Physicians and serves on the medical staff of Cayuga Medical Center. She is in practice with Cayuga Medical Associates where she can be reached at (607) 266-7500.

 

 

 

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