Protecting Your Health with Adult Vaccinations
By John-Paul Mead, MD
The evidence is clear that vaccines
play a very positive role in disease prevention at every stage of life. This is
why it is important to see your doctor regularly and to stay current with
immunizations that can help you avoid serious illnesses.
A vaccine that is relatively new is
the first vaccine for adult shingles. Zostavax was approved in 2006 by the FDA,
and is advised for adults between sixty and eighty years of age.
What is shingles?
Shingles, which comes from the
varicella-zoster (chickenpox) virus, causes neuropathic tingling and burning
pain on the skin, accompanied by a rash with blisters. The rash typically goes
away in a couple of weeks; however, for about one in seven people, severe pain
continues after the rash is gone. This pain is called post herpetic neuralgia
and it can last for weeks or months. Severe cases leave people suffering with
constant neuropathic pain for years. In the very worst cases, shingles infections
can lead to blindness, pneumonia, and hearing loss, but these instances are
How effective is this new vaccine?
Zostavax is not a hundred percent
effective. In the age group tested, the vaccine prevented shingles in about
half of the people. Most vaccinated individuals who eventually developed
shingles experienced milder symptoms, so the vaccine did give them a benefit
even though it did not completely protect them.
If I had chickenpox as a child,
don’t I have immunity for shingles?
No, having had chickenpox does not
convey protection for adult shingles. Once the chickenpox
virus is in your system, its DNA lies dormant in your nerves. Shingles
occurs when one of those affected nerves becomes infected with the dormant
chickenpox virus. So, whether or not you had chickenpox as a child, Zostavax is
recommended for adults over sixty and younger than eighty.
Why not get the shingles
vaccination before age sixty?
The chance of developing shingles
is significantly lower in adults who are in their forties and fifties. But the
risk rises for people over the age of sixty. For that reason, both the Centers
for Disease Control and Prevention and the Advisory Committee on Immunization
Practices have officially recommended that the shingles vaccination be routine
for Americans sixty and older. These recommendations mean that health insurance
companies are more likely to cover shingles vaccinations for this age group.
However, you should check with your insurance carrier ahead of time to
determine if you are covered. At this time, Medicare Part B does not pay for
Is shingles contagious?
A person with shingles can pass the
virus on to someone who has never had chickenpox; however, that person will
develop chickenpox, not shingles. A person with shingles cannot pass shingles
on to someone else.
Who should not have the shingles
If your immune system is
significantly weakened from chemotherapy, radiation, or HIV/AIDS, you should
not get the vaccine. However, if your immune system is only mildly suppressed (from
steroid treatment for chronic illness, for example), you should talk to your
doctor about being vaccinated because with a slightly suppressed immune system,
you may be at higher risk for shingles.
Are there other adult vaccines I
should discuss with my doctor?
You should talk with your doctor
about three vaccinations, in addition to the annual flu shot. The first is the
vaccine for pneumonia, which is recommended for people over age sixty-five.
The second is a new tetanus vaccine
that contains adult pertussis (the TDaP vaccine), providing additional
protection for whooping cough. The recommendation is to substitute the TDaP one
time for the standard tetanus shot you should be receiving every ten years.
The third vaccination is for hepatitis
B. This is recommended for people who are sexually active with more than one
partner or who use IV drugs and share needles. It is also recommended for
health care providers, police, medics, and people in other occupations that
place them at a higher than normal risk for needle sticks and exposure to
blood. Your doctor may also recommend
this vaccine if you are traveling abroad.
Mead is board certified in internal medicine. He is a member of the medical
staff at Cayuga Medical Center and in practice with Cayuga Medical Associates,
where he can be reached at 277-2170.