Shingles Vaccine
The Shingles Vaccine, Should you take it?

Shingles ( Herpes Zoster) is an infection caused by the reactivation of the chicken pox virus you may have contracted as a child. Once you get chicken pox the virus never leaves your body. It goes into a dormant stage and resides inside the nerve roots. Later in life as your immunity to the virus decreases the virus may re-emerge. When it does it causes a different sort of infection commonly referred to as shingles.

Shingles differs from chicken pox in several important ways. First, you can not catch shingles from someone. You can only get it when your own virus becomes reactivated. Shingles is also much less contagious than chicken pox since the virus is not present in your saliva. In rare cases it may be possible to transmit the virus to someone who has no immunity to the virus and they could then develop chicken pox, but this is very uncommon.

Unlike chicken pox, shingles is a localized infection usually involving one nerve root on one side of the body. Patients who have an outbreak of shingles often notice vesicles ( small blisters) on a patch of their body, most often on the head, face, or trunk. Shingles also differs from chicken pox in that the rash tends to be very painful instead of itchy. The pain is thought to be due to inflammation in the affected nerve root and is the most disabling feature of shingles. Patients often compare the pain to a bad sunburn except that it can last weeks and even months in some cases. Because the pain is due to nerve root inflammation most pain medications give only limited relief. Treated early with special antiviral drugs the course of the disease can be shortened but treatment must begin in the first few days to have any effect.

 As with most things, prevention is often the best approach. Zostavax is the currently available shingles vaccine. Like most vaccines, it is not 100% effective but it can reduce the risk of shingles by 51% and the risk of prolonged pain ( called Post Herpetic Neuralgia - PHN) by 67%. It is more effective in people who are under 70 years old. Studies are still being done to determine if booster doses may be needed at some point. The vaccine is recommended for all people 60 and older regardless of whether they recall having chicken pox as a child since nearly everyone over the age of 60 has been infected even if they have no memory of it. Patients 50-59 may also consider the vaccine.

Zostavax is a live virus vaccine. Studies have shown no serious side effects from the vaccine. The most common side effects are localized redness or pain at the injection site. There have been no documented cases of patients transmitting the virus after vaccination.‚Äč

Note:

Unlike other vaccines many insurance companies will only pay for the shingles vaccine if it is provided through your pharmacy benefits. Because the rules regarding this vaccine are complex and varied from one company to the next we can not possibly keep up on them. In additon the vaccine is very expensive at about $200.  For this reason we have adopted an approach for the shingles vaccine which is different from that for other vaccines. We do not stock the shingles vaccine in the office. If a patient wishes to get the vaccine we ask that they fill out a request form which we then send to their insurance company. If the insurance company approves it they will ship the vaccine to us and when the vaccine arrives we will notify the patient to come in to have it administered. The request form can be picked up in our office or we can fax it. Call our office at 516-829-2016 if you would like a shingles vaccine request form or if you have any other questions.