- LATIN AMERICA
- MIDDLE EAST
- United Kingdom
- United States
- New Zealand
- South Africa
- iHaveNet.com: Health
Harvard Health Letters
Harvard Health Letters
Question: If you've had shingles, should you get the vaccine to protect yourself from getting it again?
Answer: Shingles is caused by the reactivation of varicella-zoster virus -- the virus that causes chickenpox -- that has lingered, often for decades, in a dormant state in the nervous system. The most common symptom is a bad rash on the torso or face that can be quite painful. In 10 percent to 20 percent of cases, the rash is followed by postherpetic neuralgia -- pain emanating from an affected nerve, which can be excruciating and last for many months.
Shingles can also affect the eyes, causing significant pain and, in the most serious cases, loss of vision. It's safe to say that those who've had shingles don't want to have it again -- especially if they've had postherpetic neuralgia or eye problems as a result.
But is a second case of shingles something we need to worry about, or does the first one give immunity against a repeat episode? And if it doesn't, does that mean that people who have had shingles should get the shingles vaccine?
The same piece notes that the effectiveness of Zostavax in preventing repeat episodes of shingles "has not been demonstrated in clinical studies." And the
In 2008, the
About a million Americans get shingles every year, and the numbers have been rising, so the ambiguity about whether to get vaccinated after an episode affects a lot of people. What makes it an even tougher choice for many is that the vaccine, which costs about
There's not much doubt now that shingles can recur, so if an initial case gives some immunity against a subsequent one, it's not absolute. In the large, industry-sponsored Shingles Prevention Study that was the basis for
But there are other data. One study that's often cited was conducted in Olmsted County, Minn., where the
If the Olmsted County study accurately reflects the risk of getting shingles a second time, then vaccination to prevent it seems worthwhile.
One sticking point might be that 26 of the recurrent cases were confirmed with lab tests, so it's possible that the recurrence risk is less than 5.6 percent, which, depending on how much less, could weaken the case for vaccination after having had shingles. Another complication is that no study has been done that shows the vaccine prevents second episodes. It's a reasonable assumption that it would, but the study hasn't been done to show it.
So there's no easy answer to whether people who've had shingles should get the shingles vaccine. Some pretty good data suggest that the risk of recurrence is quite high and, particularly if you've had a bad case, getting the vaccination would seem to be a prudent precaution. But it's also possible to make a case for the evidence not being all that solid.
All other things being equal, an 80-year-old is more likely to suffer from shingles than a 60-year-old. So it was disappointing when results from the industry-sponsored study that led to approval of the shingles vaccine showed that the vaccine, while still effective, was less so among people in their 80s than those in their 60s and 70s. Moreover, people in their 80s are more likely to have an adverse reaction to the vaccine, so some commentators have said the risks of the shingles vaccine for octogenarians may, in fact, outweigh the benefits.
But results reported in 2011 in The Journal of the
Available at Amazon.com:
Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder
Copyright © Harvard Health Letters. All rights reserved.
AGING | ALTERNATIVE | AILMENTS | DRUGS | FITNESS | GENETICS | CHILDREN'S | MEN'S | WOMEN'S
Health - The Shingles Vaccine: Would You Use It?