Risk Factors For Shingles
According to the Centers for Disease Control and Prevention , one in three people will develop shingles in their lifetime. Children who receive varicella vaccination have a lower risk of later contracting shingles compared to those who do not. Despite this, there are certain factors that can increase your risk of contracting shingles.
These include:
- Your age:While the incidence among younger people is on the rise, the risk of shingles increases significantly after 50 years of age. This is because the immune system’s response to identifying and fighting off pathogens becomes reduced or delayed, and decreases substantially after 65 years of age.
- If you have an underlying health condition:Certain cancers and human immunodeficiency virus increase your risk of getting shingles. These conditions hinder the immune system’s ability to function properly.
- If you take immunosuppressants: Immunosuppressants are drugs that reduce the immune system’s ability to fight infections. If you take immunosuppressants you are also at greater risk for developing shingles.
What Are The Advantages Of Getting The Shingles Vaccine
The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month.
Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach.
For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia , and it is the most common complication of shingles.
Counseling Patients About Shingrix
Know the benefits and side effects of Shingrix so youre prepared to talk with your patients before administering the vaccine.
What to tell patients about Shingrix benefits:
- You can protect yourself against shingles. Shingles is a very painful disease, and your risk of getting it increases as you age. Also, you are more likely to have severe, long-term pain if you get shingles when you are older. About 1 out of every 3 people in the United States will develop shingles in their lifetime.
- Shingrix provides strong protection against shingles and long-term pain from the disease. Two doses of Shingrix are more than 90% effective at preventing shingles. So its very important that you get this vaccine.
What to tell patients about Shingrix side effects:
What to tell patients about dose two:
- You need to come back in 2 to 6 months for your second dose. We can make that appointment now.
- Even if you have side effects from the first dose, it is important to get the second dose to build strong protection against shingles. Your reaction to each dose may be different just because you have a reaction to the first dose does not mean that you will have a reaction to the second.
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How Much Does The Shingles Vaccine Cost
Shingles vaccines are not publicly funded in B.C. One dose of Zostavax costs about $200 each dose of Shingrix is about $150. Both vaccines are available at most travel clinics and pharmacies. Check with your health insurance provider to see if your plan covers the cost of these vaccines.Get immunized against shingles by making an appointment with your doctor, pharmacist or travel clinic.
Is There Anyone Who Should Not Have The Shingles Vaccination
There are 2 shingles vaccines available in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses
If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
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Is There Anything Else You Think Is Important For People To Know About The Shingles Virus Or The Vaccine
The best way to prevent shingles and avoid its complications is to get vaccinated. Data shows that almost everyone older than age 40 has been exposed to chickenpox at some point. Even if you dont remember having chickenpox as a child, you should get the vaccine.
Glen P. Carlson, MD, HealthPartners
*According to the CDC website: Zostavax is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
Who Should Not Get Shingrix
You should not get Shingrix if you:
- Have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
- Currently have shingles.
- Currently are pregnant. Women who are pregnant should wait to get Shingrix.
If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.
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How Is Shingles Diagnosed
A doctor will examine the rash on your skin and ask you about your symptoms. This is usually how healthcare professionals diagnose shingles.
A healthcare professional may remove some fluid from a blister for testing, but typically this is not necessary.
recommends:
- two doses of chickenpox vaccine regardless of age
- two doses of Shingrix for adults over age 50 and adults with weakened immune systems
According to the , you should get the vaccine even if, in the past, you:
- received Zostavax, another vaccine that is no longer on the market
- received the varicella vaccine
Creating and maintaining healthy lifestyle habits such as stress management, a healthy diet, regular exercise, and getting plenty of sleep can also help prevent or lessen flare-ups.
Reasons To Get The Shingles Vaccine
Once a person develops chickenpox after contracting the varicella-zoster virus, the virus never leaves the body. It remains dormant in the nerve roots and can reappear as shingles later in life.
The primary symptom of shingles is a painful rash on one side of the body, most often on the torso or face. People initially have pain or a burning sensation on the skin without a rash, and then painful blisters develop. The rash lasts approximately seven to 10 days and fully clears within two to four weeks.
The likelihood of developing shingles increases dramatically after age 50. Therefore, the Centers for Disease Control and Prevention recommends that all adults age 50 and over receive two doses of Shingrix to prevent shingles. The vaccine is recommended even if a person is unsure if they have ever had chickenpox.
People with weakened immune systems are at higher risk for shingles. Therefore, the Food and Drug Administration also recently approved Shingrix vaccination for adults age 18 and older who are at risk for shingles due to immunodeficiency or immunosuppression caused by an underlying disease or medication.
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Are Chickenpox And Shingles Serious Illnesses
The symptoms may be more severe in newborns, persons with weakened immune systems, and adults. Serious problems can occur and may include pneumonia , brain infection , and kidney problems. Many people are not aware that before a vaccine was available, approximately 10,600 persons were hospitalized, and 100 to 150 died, as a result of chickenpox in the U.S. every year.
Who Should Not Get The Shingles Vaccine
Some people shouldnt get the shingles vaccine. These people include those:
- Who currently have shingles.
- Who have had a severe allergic reaction to the shingles vaccine in the past.
- Who have tested negative for immunity to the varicella-zoster virus, meaning youve never had chickenpox. If youve never had chickenpox, you should get the chickenpox vaccine.
- Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
- Who are pregnant or breastfeeding.
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How Effective Is Shingrix
The risk of getting shingles increases as you get older, so its important to get vaccinated. Shingrix also provides strong protection against PHN, the most common complication from shingles.
- Among adults age 50 to 69 years who got two doses, Shingrix was 97 percent effective in preventing shingles. In this age group, it was also 91 percent effective in preventing PHN.
- Among adults age 70 years and older who got two doses, Shingrix was 91 percent effective in preventing shingles. In this age group, it was also 89 percent effective in preventing PHN.
- Among adults age 70 years and older who got two doses, Shingrix is more than 85 percent effective in preventing shingles for four years following vaccination.
Main Complications Of Shingles
Shingles may cause health complications like Post-herpetic neuralgia and Herpes zoster ophthalmicus . Post-herpetic neuralgia can occur when shingles pain persists even after the rash has faded. Its caused by damaged nerve fibers on the skin that create discomfort. Youre more prone to get severe post-herpetic neuralgia as you get older.
In severe circumstances, if a shingle rash appears on your face, your cornea may be damaged, affecting your vision.
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Make A Plan To Get 2 Doses
- You can get Shingrix at your doctors office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Five years later, I still take prescription medication for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalized. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.
A 63-year-old harpist who was unable to continue playing due to shingles
What To Know About The Shingles Vaccine
Who needs it? The CDC recommends that everyone 50 and older get Shingrix, even if they had the earlier recommended vaccine Zostavax, or if theyve already had a bout of shingles. Older adults should also get this vaccine, whether or not they remember having had chickenpox as a child. Why? More than 99 percent of Americans over the age of 40 have been exposed to the varicella-zoster virus, even if they dont recall getting chickenpox.
How often? The CDC recommends that older adults, as described above, get this vaccine, which is given in two doses spaced two to six months apart. The shot is more than 90 percent effective after youve had both shots.
Why you need it: One in 3 people will get painful, occasionally debilitating shingles, usually after age 50, and the risk increases with age. By age 85, half of adults will have experienced at least one outbreak.
An important note: Beginning Jan. 1, 2023, Medicare enrollees with Part D wont have any out-of-pocket costs for vaccines that the CDC Advisory Committee on Immunization Practices recommends for adults, including the shingles vaccine, under the Inflation Reduction Act of 2022.
A COVID connection?
A large observational study, published in the journal Open Forum Infectious Diseases, makes clear how important it is for older adults to get both the COVID-19 vaccine and the shingles vaccine.
However, the researchers stress that people should not use these results as an excuse not to get COVID-19 shots.
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Who’s Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
Is Shingles Contagious
Shingles is not considered to be contagious. However, the varicella-zoster virus can be spread through skin-to-skin contact with someone who has never had chickenpox before. The newly infected will then experience chickenpox, not shingles. Coming into contact with fluid from a shingles blister can spread the virus. Only fully healed, dry blisters are reliably non-infectious.
If you still have a fresh shingles blister, try not to come in social contact with:
- Children under 12 months old
- Individuals who have never had chickenpox
- Individuals with chronic conditions like cancer or AIDS
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Who Shouldn’t Get It
A person should not get Shingrix if:
- They have ever had a severe allergic reaction to any component of the vaccine or the first dose of the vaccine.
- They test negative for immunity to varicella-zoster virus.
- They currently have shingles.
- They are pregnant.
If you are experiencing a moderate to severe illness, with a fever or not, you should consider waiting until you are better before getting the vaccine.
How Do I Know If I Have The Shingles And What Should I Do
Shingles is a reactivated virus which often causes pain and skin lesions, says Asfana Alam, DO, MPH, a family medicine doctor at NewYork-Presbyterian Medical Group Hudson Valley. The rash usually presents on one side of the body with an eruption of little blisters called vesicles, which causes fever and inflammation.
Symptoms include:
If shingles is caught earlywithin the first 72 hours of the rash, we can treat it with anti-viral medication, says Dr. Alam. Without treatment, the rash usually goes away within two weeks. But, some people develop a condition called called postherpetic neuralgia a persistent pain in the area of the rash even after it has cleared up which can last for months and, in rare cases, years, Dr. Alam says.
Shingles can only be spread to someone who never had chickenpox and it actually causes chickenpox, not shingles. However, the only way it is spread is through direct contact with the fluid from the blistery rashes.
Fortunately, medications are available that can both shorten the duration of the rash and decrease the likelihood of postherpetic neuralgia if given quickly.
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How Well Does Zostavax Work
Zostavax®, the shingles vaccine, reduced the risk of shingles by 51% and the risk of post-herpetic neuralgia by 67% based on a large study of more than 38,000 adults aged 60 years or older. Protection from shingles vaccine lasts about 5 years.
While the vaccine was most effective in people 60 through 69 years old, it also provides some protection for people 70 years old and older.
Adults vaccinated before age 60 years might not be protected later in life when the risk for shingles and its complications are greatest.
How Is Shingles Spread
You cannot get shingles from someone with shingles. However, if you have never had chickenpox or the chickenpox vaccine, you can get chickenpox by being in direct contact with shingle blisters. Shingles is not spread by sneezing or coughing. Once the blisters crust over the person can no longer spread the virus.
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Who Should Get Shingrix
Adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. Adults 19 years and older who have or will have weakened immune systems because of disease or therapy should also get two doses of Shingrix. If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
You should get Shingrix even if in the past you:
- Received varicella vaccine
There is no maximum age for getting Shingrix.
If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.
Chickenpox and shingles are related because they are caused by the same virus . After a person recovers from chickenpox, the virus stays dormant in the body. It can reactivate years later and cause shingles.
Shingrix is available in doctors offices and pharmacies.
If you have questions about Shingrix, talk with your healthcare provider.
* A shingles vaccine called zoster vaccine live is no longer available for use in the United States, as of November 18, 2020. If you had Zostavax in the past, you should still get Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix.
Who Can Have The Shingles Vaccination
Shingles vaccination is available to everyone aged 70 to 79.
When you’re eligible, you can have the shingles vaccination at any time of year.
The shingles vaccine is not available on the NHS to anyone aged 80 or over because it seems to be less effective in this age group.
Read more about who can have the shingles vaccine.
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