Is A Vaccine Available To Prevent Shingles
Two vaccines are available in the United States to reduce your chance of developing shingles and postherpetic neuralgia. One vaccine, Zostavax®, has been available since 2006. The second vaccine, Shingrix®, has been available since 2017. Shingrix is recommended as the preferred vaccine by the Advisory Committee on Immunization Practices, a group of medical and public health experts.
Shingrix is given as a two-dose shot in your upper arm. You should receive the second dose two to six months after receiving the first. Shingrix has been shown to be more than 90% effective in preventing shingles and postherpetic neuralgia. Its effectiveness remains above 85% for at least four years after receiving the vaccine.
How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles
No. Just like most vaccines, getting vaccinated with a shingles vaccine doesnt provide 100% protection from disease. However, getting the shingles vaccine reduces your risk of developing shingles.
Even if you do develop shingles, youll be more likely to have a mild case. Also, youll be much less likely to develop postherpetic neuralgia, a painful condition that can follow a shingles outbreak.
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Where A Shingles Rash Forms
A shingles rash typically occurs on the face, neck, or chest, on just one side of the body.
The affected area of skin is called a dermatome, a region supplied by the sensory fibers of a specific spinal nerve. Outbreaks can involve two adjacent dermatomes, but rarely two non-adjacent dermatomes.
The exception may be in people whose immune systems are severely comprised, such as those with advanced HIV infection. They’re often at risk of disseminated shingles , shingles of the eyes or internal organs, and a recurrence of shingles within six months.
The Stages Of Shingles
Clinical manifestations divided into 3 phases.
Shingles, or herpes zoster , is an infection caused by the varicella zoster virus which remains in the body following an episode of chickenpox. After lying dormant and forgotten for decades in the neurons of a spinal nerve, it reactivates as shingles.
The primary symptom associated with shingles is a painful red rash that erupts along 1 side of the body. Most commonly presenting as a band around the patients waistline or trunk, the rash can also break out in other locations like the face, neck, eyes, and ears.
Shingles clinical manifestations are divided into 3 distinct phases: preeruptive, acute eruptive, and chronic.
The preeruptive phase usually lasts about 48 hours but can stretch to 10 days in some cases. It is characterized by sensory phenomena along 1 or more dermatomes, which correspond to an area of skin mainly supplied by a single spinal nerve. Symptoms common to this stage include headache, general fatigue, sensitivity to light, and fever.
The chronic phase, also known as postherpetic neuralgia occurs in up to 20% of all patients with shingles. It is defined as recurrent pain lasting more than 4 weeks after the vesicles have healed. Other symptoms include abnormal skin sensations like tingling, burning, and numbness caused by pressure on a nerve and nerve damage . The resulting pain, which can be excruciating and disabling, can last months and even years.
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What Are The Symptoms Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
How Well Does Shingrix Work
Two doses of Shingrix provide strong protection against shingles and postherpetic neuralgia , the most common complication of shingles.
- In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles in adults 70 years and older, Shingrix was 91% effective.
- In adults 50 years and older, Shingrix was 91% effective in preventing PHN in adults 70 years and older, Shingrix was 89% effective.
- In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
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When To Call A Doctor
- Have a rash or blisters on your face, especially near an eye or on the tip of your nose. This can be a warning of eye problems. Treatment can help prevent permanent eye damage.
- Think you have shingles. Early treatment with antiviral medicines may help reduce pain and prevent complications of shingles, such as disseminated zoster or postherpetic neuralgia .
If you still feel intense pain for more than 1 month after the skin heals, see your doctor to find out if you have PHN. Getting your pain under control right away may prevent nerve damage that may cause pain that lasts for months or years.
Weighing The Risks Vs Benefits
The vaccine to prevent shingles will help you to avoid shingles symptoms, which in most cases are quite mild but may cause intense pain in some people.
Shingles symptoms come in two stages: the prodromal stage and the eruptive stage. In the first stage, your symptoms may include:
About three to five days later, you develop a prickly and painful pimple-like rash. These pimples turn into blisters during this eruptive stage, and your skin may be red and swollen. Shingles sores also can affect your mouth, which is another symptom the vaccine can prevent.
Shingles isn’t generally life-threatening. It can be, though, if your immune system is compromised. During an outbreak and after the rash clears up, some people may experience complications that require immediate medical attention.
Common ones include:
- Postherpetic neuralgia : Damaged nerves cause lingering pain for three months or more.
- Bacterial skin infections: When shingles blisters pop, bacteria can get in.
- Eye damage: One branch of the trigeminal nerve goes to the eye. Damage there can lead to eye damage, which can be severe.
While you may experience side effects with the vaccine, the benefits outweigh the risks of shingles symptoms and complications in most people.
If you were vaccinated with Zostavaxa shingles vaccine that is no longer being givenask your healthcare provider about getting the Shingrix vaccine.
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When Should I See My Doctor
See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.
See your doctor straight away if you have symptoms of shingles and are experiencing the following:
- symptoms that affect your eye area
- a temperature of 38°C or higher
You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.
What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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Questions To Ask Your Surgeon
- What is the success rate of the operation? How many of these operations have you done successfully?
- What problems occur with this surgery? What kind of pain or discomfort can I expect?
- What kind of anesthesia will I have? Are there any risks associated with its use in older people?
- Will I have to stay in the hospital overnight? How long is recovery expected to take? What does it involve? When can I get back to my normal routine?
Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
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Key Points About Shingles
- Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
- Shingles is caused when the chickenpox virus is reactivated.
- It is more common in people with weakened immune systems, and in people over the age of 50.
- Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
- The rash is typically affects just one area on one side of the body or face.
- Treatment that is started as soon as possible helps reduce the severity of the disease.
What Triggers Shingles Flare
Most people who get shingles will have a one and done type of experience. In other words, theyll get it and likely never have it again. That said, there are some people who get shingles more than once.
Heres how it happens: the varicella-zoster virus, the same virus that causes chickenpox, lies dormant in nerve cells after you recover from chickenpox or shingles.
For the most part, the virus stays inactive after your shingles symptoms subside and youve healed. But certain risk factors can trigger flare-ups and cause the virus to reactivate. Experts call this recurrent shingles.
A 2021 review looked at the incidences of first and recurrent shingles episodes and found that the average time between infections was 2 years for people ages 45 to 54 and 3 years for those ages 55 and older.
In addition, of the participants who experienced a flare-up, the incidence was higher in those who were immunosuppressed compared with people with healthy immune systems.
In other words, if you have a compromised or weakened immune system, you have a greater chance of getting shingles again. This can happen if you:
- are undergoing chemotherapy
Am I At Risk For Shingles
Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:
- Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
- Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.
Most people only have shingles one time. However, it is possible to have it more than once.
First Signs And Symptoms Of Shingles
Among the systemic symptoms that may appear in the first few days of the prodromal stage of shingles are:
- Pain in a specific, localized area of the body
- Sensitivity to light
The most telling first symptom of shingles typically is the pain. Often excruciating, the discomfort has been described as burning, stinging, tingly, prickly, itchy, numbing, achy, or shooting. It can be persistent or intermittent, but will always be limited to one side of the body.
Because the pain from shingles is localized, it can be mistaken for other conditions depending on where it’s focused.
For example, a stabbing or persistent pain on one side of the lower back may mistakenly be attributed to sciatica or a kidney problem. Shingles pain around the lips could suggest a cold sore coming on, while pain focused on the eye or ear might seem like the start of a migraine.
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Will Shingles Go Away On Its Own
Shingles isn’t life-threatening, but it can be incredibly painful and, in some cases, complications can arise. While this rash typically goes away its own, prompt treatment can reduce your pain and help shingles go away faster.
“Several antivirals can be used to treat shingles. These drugs can help you heal more quickly and reduce your pain, but they are most effective when started within 72 hours of your rash appearing. This means it’s important to see your doctor as soon as you suspect shingles,” says Dr. Brown. “When it comes to the pain associated with shingles, most people are able to manage it using over-the-counter pain relievers. But, pain can be severe for some people. In these cases, your doctor can prescribe stronger pain medications.”
Beyond treating your immediate pain and rash, seeing your doctor is also important since serious complications can occur as a result of shingles, such as:
- Postherpetic neuralgia pain that lasts for months to years after the rash clears, with this pain being debilitating in some cases
- Skin infection occurs if the open sores of your rash become infected with bacteria, which can require antibiotics and delay healing
- Vision problems while rare, if your rash develops near your eye, the associated inflammation can damage your retina and, in some cases, result in vision loss
Who Is At Risk For Getting Shingles
People who have had chickenpox who are more likely to develop shingles include those:
- With a weakened immune system .
- Over the age of 50.
- Who have been ill.
- Who have experienced trauma.
- Who are under stress.
The chickenpox virus doesnt leave your body after you have chickenpox. Instead, the virus stays in a portion of your spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. Researchers aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.
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What Are The Risk Factors For Internal Shingles
Many of the risk factors for internal shingles are the same as those for the skin rash of shingles. They include:
- Having a weakened immune system. Diseases and conditions such as HIV/AIDS, organ transplant, and autoimmune conditions like lupus, rheumatoid arthritis, or inflammatory bowel disease can make you more susceptible to shingles.
- Undergoing cancer treatment. Cancer, along with radiation and chemotherapy, also weaken your immune system and can increase your risk of a herpes zoster infection.
- Being older than 60. Shingles can occur in people of any age. However, its more common in older adults. About half the cases of shingles develop in people over 60 .
- Taking certain medications. Drugs that lower your chance of rejecting an organ transplant or treat autoimmune diseases will increase your risk of shingles. Examples include cyclosporine and tacrolimus . Extended use of steroids will also increase your risk. These medications suppress your immune system, making your body more vulnerable to infection.
Not receiving the shingles vaccine will also increase your chances of getting the condition. Even if you dont remember ever having chickenpox, you should get the shingles vaccine. Studies have shown that 99 percent of people over 40 have had chickenpox. According to the