What Is Herpes Zoster
Shingles, like a number of itchy, highly communicable skin conditions, is caused by the herpes virus. Herpes zoster, the specific form of the herpes virus, is also responsible for chickenpox. Unlike some forms of herpes, herpes zoster is not a sexually transmitted infection. The shingles and chickenpox viruses are unique because they can lie dormant in the body for years. During herpes zosters resting phase, a person will notice no symptoms. Its only when the virus resurfaces that symptoms crop up again. Once a person has herpes zoster, their chances of having another flare up are high. Herpes zoster is highly contagious, and is spread by skin to skin contact, or contact with the fluids that may be contained in shingles or chickenpox lesions.
What Are The Symptoms Of Chickenpox
The main symptom of chickenpox is an itchy red rash. During the illness, the rash turns into fluid-filled blisters that may burst and crust over.
People with chickenpox may also have these symptoms:
What Everyone Should Know About The Shingles Vaccine
CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
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Can The Chickenpox Vaccine Cause Shingles Later In Life
The rate of the painful skin condition shingles appears to be rising in at least some parts of the United States, leading many to wonder why.
Although shingles is related to chickenpox the varicella zoster virus causes both experts say the rise in shingles is not linked with the use of the chickenpox vaccine.
In fact, children who receive a chickenpox vaccination have a much lower risk of getting shingles later in life than those who are not immunized, said Dr. William Schaffner, doctor of preventative medicine at Vanderbilt University Medical Center in Nashville, Tennessee, and a leading infectious disease expert.
Although chickenpox vaccines do contain a weakened version of the live virus, which can reactivate later in life and cause shingles, this is very rare, he said. “Nearly 99 percent of children who receive the vaccine will not get chickenpox at all,” Schaffner told Live Science. “The remaining 1 percent who do get it will get a much milder version of it. Therefore, a vast majority of people receiving the immunization will not develop shingles later in life.”
Once someone recovers from chickenpox, the virus remains dormant, but can reactivate years later, causing shingles, which is characterized by a painful rash, often on one side of the face or body. About half of all cases of shingles occur in people ages 60 and older, according to the Center for Disease Control and Prevention .
Why Is Vaccination Against Chickenpox Important
In most people, chickenpox is a mild disease that doesn’t cause any lasting problems. Around 1 in 20 healthy children develop a bacterial skin infection from chickenpox, which needs antibiotic medicine. Untreated bacterial skin infections can lead to bacterial infection in other parts of your body, including pneumonia and blood stream infection . Other complications of chickenpox are rare and include encephalitis and inflammation of your joints, kidneys and liver. Chickenpox tends to be more severe in adolescents and adults, pregnant women and their unborn babies and people of any age with poorly functioning immune systems. Read more about chickenpox.
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Chickenpox Is Itchy But Shingles Is Painful
Despite sharing a viral cause, the two conditions have decidedly different symptoms.
A chickenpox rash starts out with pink bumps that become more blister-like. The bumps are usually all over the body and itch like crazy. You also feel like you do when you have a cold or fluyou just really dont feel good, Dr. Parsons says. Your eyes might get watery, your body might ache, and you could spike a fever.
A shingles rash, on the other hand, looks more like a fever blister, Dr. Parsons says, and the bumps are usually clustered in groups of three to nine pink lesions. Once they blister, they ooze, then eventually dry out and crust over. A shingles rash is also usually in a band that wraps around a part of the body, like across one shoulder and down your arm, or covering your butt and down your leg, Dr. Parsons explains. The lesions crop up in spots related to where the nerves are that are inflamed by the virus. And because shingles affects the nerves, the pain may feel like burning or even start before the rash appears, she adds.
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Chickenpox Vaccine Shields Against Shingles Too
MONDAY, June 10, 2019 — Shingles isn’t usually considered a kids’ disease, but children can get this painful condition. Fortunately, the chickenpox vaccine can also protect them against it, a new study finds.
“The virus that causes chickenpox also causes shingles. It’s pretty uncommon in kids, but we wanted to see what would happen to the rates of shingles among children over time as more kids received the vaccine,” said study lead author Sheila Weinmann. She’s a senior investigator and epidemiologist at Kaiser Permanente Northwest in Portland, Ore.
What the researchers found was that kids who were vaccinated against chickenpox had a 78% lower risk of developing shingles. And the rate of shingles dropped in the entire group — vaccinated and unvaccinated — by 72% between 2003 and 2014.
Weinmann said the overall drop was large because so much less of the virus was circulating in the general population.
The study was published online June 10 in Pediatrics.
Dr. Anne Gershon from Columbia University wrote a companion editorial that argued all children should get the vaccine for the dual protection it offers.
“The vaccine is not only highly protective against chickenpox, but it protects against shingles as well,” she said. “Now we have to find out how long the protection will last.”
Since 2007, a booster at 4 and 6 years of age also has been recommended.
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How Is Chickenpox Treated
Most people with chickenpox have mild symptoms and recover quickly, but chickenpox can still be uncomfortable.
Chickenpox blisters can be very itchy, and it can be difficult to avoid scratching them especially in the case of children. However, scratching increases the chance of blisters becoming infected and of leaving scars. Some people find it helpful to keep their fingernails short to make scratching more difficult.
You can also try to relieve your symptoms with these tips:
- Use lotions, such as calamine lotion, to reduce itching.
- Apply cool compresses to itchy blisters.
- Have lukewarm baths with baking soda or oatmeal added.
- Get plenty of rest.
- Take paracetamol to reduce fever always follow the dose instructions on the packet.
Your doctor may prescribe an antiviral medicine if you are very unwell, or if you have a weakened immune system.
What Is Causing The Shingles Epidemic
While there has been a rise in cases of shingles, despite what you will read on most anti-vax websites, it is not because of the chickenpox vaccine .
In fact, it has been shown that:
- The trend in rising shingles cases in adults began before we even started giving kids the chickenpox vaccine in the United States
- The trend in rising shingles cases in adults did not continue to increase after we started giving kids the chickenpox vaccine in the United States
- The trend in rising shingles cases in adults also exists in other countries that do not routinely give kids the chickenpox vaccine
Whatever the reason for the trend in rising shingles cases in adults, it isn’t because more kids are protected from chickenpox now.
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What If Youre Over 50 And Have Never Had Chickenpox
If youre over 50 and confident that youve never had exposure to chickenpox, a primary doctor can run a blood test to determine your level of chickenpox immunity.
If it turns out that youve never been exposed to chickenpox, consider getting vaccinated against the virus to protect against any future exposure.
Most adults between 30 and 50 years old dont need to worry about racing to get either the chickenpox or shingles vaccine.
Consider getting the shingles vaccine before turning 50 if you:
- work in an industry that might have higher exposure to chickenpox, like healthcare or teaching
Do not get a chickenpox vaccine if you:
- previously had a life-threatening allergic reaction to a previous dose of chickenpox vaccine or any ingredient of the vaccine
- are moderately or severely ill
Talk with a doctor before getting a chickenpox vaccine if you:
- have HIV or another condition that affects your immune system
- are taking a medication that affects your immune system for 2 weeks or longer
- have cancer of any kind or are taking medications for cancer
- have recently had a blood transfusion
Before shingles appear, youll normally develop:
- pain in the body
The shingles rash typically starts as a single strip rash around the side of the body. It may eventually break out to another nearby area if you spread it by scratching.
How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
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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.
When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
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Do You Need To Worry About Shingles If You Had Chickenpox Vaccine
Q: My 38-year-old pregnant coworker has shingles. She received the chickenpox vaccine during childhood. I am 28 years old, vaccinated and have no history of chickenpox. Do I need to worry about shingles?
The chickenpox vaccine was first recommended for children in 1995. Prior to this, nearly all people had chickenpox during childhood. Common symptoms include blisters covering the body, ulcers in the mouth and fever. During the infection, the chickenpox virus moves into the nerve roots along the spinal cord and stays there for the rest of a persons life. During stressful periods or when the immune system falters, the virus travels down nerves and infects the overlying skin. This painful blistery rash is called shingles.
You cannot catch shingles from people with shingles. Rather, unvaccinated people who have never had chickenpox can develop chickenpox when they come in contact with a shingles rash. Your vaccination should keep you from catching chickenpox.
Why did your coworker develop shingles if she was vaccinated? The most likely explanation is that she had chickenpox before she was vaccinated. The natural or wild-type virus set up house in her nerve roots. Vaccinating after the wild-type virus is in the nerve roots does nothing to it. The reason your coworker has shingles now is probably due to the temporary changes in her immune system that allow her to carry a baby.
What Causes Chickenpox And How Is It Spread
Chickenpox is caused by the varicella zoster virus. You are most likely to catch chickenpox if you come into contact with an infected persons respiratory fluids for example, when they cough or sneeze nearby. You can also catch chickenpox by touching fluid from an infected persons chickenpox blister.
If you have chickenpox, you should stay home from childcare, school or work to avoid spreading the infection to others while you are contagious. Chickenpox is no longer contagious once the blisters have crusted over.
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Who Should Not Be Vaccinated Against Chickenpox
Chickenpox vaccine is a live vaccine. This means that it can cause chickenpox, although it is usually milder, and it should not be used for certain groups of people who have reduced infection-fighting ability , such as if you:
- are taking high-dose oral steroids such as prednisone or dexamethasone
- are getting chemotherapy or radiation
- have a condition that reduces your immunity such as cancer or HIV
- have active untreated TB
- have had another live vaccine within the past 4 weeks.
Great News For Us Bad News For Varicella Zoster
William Schaffner, MD, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, told Verywell the findings are great news.
I didnt think it was pretty good dataI thought it was great data. I mean, this is a spectacular vaccine, he said.
Greg Poland, MD, the director of the Vaccine Research Group at the Mayo Clinic and the editor-in-chief of the journal Vaccine, agreed, adding the vaccine is great news for us but bad news for the virus.
Once you have chickenpox, you never get rid of it, said Poland. Its always in your body as a chronic infection.
That may not be a major concern for healthy, young people. However, Poland explained that as we get older, our immune systems start to have a harder time keeping a chronic infection in checkwhats called immunosenescence.
Given the decline in immune function with age, there have been concerns that a shingles vaccine for older people would not be successful. However, according to Poland, the fact that shingles shot can still offer protection 10 years after an older person receives it is a testament to the immunogenicity of the vaccine.
Indeed, the data show that the efficacy rate for Shingrix during the first few years after vaccination is well above 90% and is still between 80% and 90% 10 years later.
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You Can Get Shingles Multiple Times Sadly
The virus can go into hiding again, only to rear its ugly head down the road. It just goes and hides in the nerve root again, Dr. Parsons explains. For my young adult patients who get it, Ill recommend getting the shingles vaccine sometime in the next few years. Insurance may not cover vaccination before 50, so youll have to discuss the risks and benefits with your doctor.
What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
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