The Risk Of Shingles For People In Their 20s 30s And 40s
In 1995, the chickenpox vaccine became available in the U.S. for children ages 12 months and older. This means that people born before then could have gotten chickenpox as children or might not remember if they were vaccinated.
“This is probably why we occasionally see shingles cases in younger patients,” Dr. Thomassian says. “If you were born in the ’70s or early ’80s, presumably you had chickenpox when you were younger and it wouldn’t be much of a shock if you got shingles.
“But I’ve also had patients born in the late ’80s and early ’90s who contracted shingles and we ask them, ‘Do you know if you’ve been vaccinated?’ Some of them know they were not vaccinatedsome of them don’t know if they had chickenpox or not.”
What Problems Can Happen
Most cases of shingles heal on their own, with or without treatment, and won’t lead to any other problems. In rare cases, shingles can lead to complications, including:
- Ongoing pain : Damaged nerve fibers in the skin send confused messages to the brain, leading to pain. Pain can go on for a long time after the shingles rash is gone. This is the most common shingles complication.
- Vision problems: Shingles near or in an eye can lead to vision loss.
- Skin infections: A shingles rash can become infected with bacteria, leading to impetigo or cellulitis.
- Nervous system problems: Shingles on the face can involve different nerves that connect to the brain. This can lead to nerve-related problems such as facial paralysis, hearing problems, and problems with balance. In very rare cases, shingles can lead to encephalitis .
Who Should Avoid Contact With Shingles
One way of preventing the spread is to avoid contact with people who have shingles blisters.
If a person gets chickenpox, they usually only have it once. This is for shingles. A person is unlikely to have shingles more than once, unless they have a weakened immune system, which may result from a health issue or immunosuppressant treatments, such as chemotherapy or radiation therapy.
Anyone with shingles blisters should especially avoid contact with:
- Pregnant people who have never had chickenpox or its vaccination: If chickenpox develops during pregnancy, especially 521 days before birth, it can be dangerous for the fetus.
- Children who have not had chickenpox or its vaccination: Until a child is vaccinated, they should avoid contact with anyone who has chickenpox or shingles blisters.
- People with weakened immune systems, such as:
- infants born early or with a low birth weight
- people with HIV, leukemia, lymphoma, or other health issues that have this immune effect
- people who take immunosuppressant medications, such as chemotherapy
- people who have had organ transplants
After contact with the varicella virus, a person in any of the above groups may be unable to ward off the infection. Their risk of developing chickenpox, then shingles and its complications may be higher.These groups are also likely to have the illnesses for longer, and the symptoms may be more severe.
increase the risk of shingles.
Ways of managing the symptoms include:
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Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
How Is Shingles Spread
A person must have already had chickenpox in the past to develop shingles. A person cannot get shingles from a person that has shingles. However, the virus that causes chickenpox and shingles can be spread from a person with active shingles to a person who has never had chickenpox or had the chickenpox vaccine. The person exposed to the virus would develop chickenpox, not shingles. A person with shingles can spread the virus when the rash is in the blister-phase. The blister fluid is filled with virus particles. The virus is spread through direct contact with the rash or through breathing in virus particles that get mixed in the air. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or if pain persists after the rash is gone .
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What Is The Outlook For People With Recurring Shingles
Shingles usually clears up within two to six weeks.
In a small number of cases, the pain can remain once the rash has healed. This is called postherpetic neuralgia . Up to 2 percent of people who get shingles have PHN for five years or more. The risk increases with age.
Recurring shingles isnt preventable. You can reduce your risk by getting the shingles vaccine, even after youve had shingles.
A showed that people who had the shingles vaccine had 51 percent fewer cases of shingles. For people 50-59 years old, the shingles vaccine reduced the risk of shingles by 69.8 percent.
People who received the shingles vaccine generally had less severe cases of shingles. They also had
Is There A Vaccine Against Shingles
Shingix is currently the only shingles vaccine available in the United States. Its given to people over age 50.
Previously, an additional vaccine, Zostavax, was used, but it was phased out in the United States as of November 2020.
According to the CDC, two doses of Shingrix are over 90 percent effective at preventing shingles. Youll retain at least 85 percent protection for 4 years after being vaccinated.
If you get shingles after being vaccinated, your symptoms will likely be less severe. Youll also have a lower chance of developing postherpetic neuralgia a complication where pain remains even after a shingles rash goes away.
Shingles usually follows a pattern of development. It typically progresses with the following symptoms:
- First, you may notice a tingling or burning sensation in your skin.
- One to 5 days later a rash appears as small red spots.
- Fluid-filled blisters develop a few days later.
- After 7 to 10 days, the lesions crust over.
- The rash disappears over the next 2 to 4 weeks.
In some cases, pain may persist for several months or even years after the rash has disappeared. This complication, known as postherpetic neuralgia , can be severe enough to affect your quality of life.
Certain antiseizure medications can help manage the pain. Gabapentin and pregabalin are two that are commonly used.
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What Illnesses Does Varicella
Chickenpox first occurs as a blister-like skin rash and fever. It takes from 10-21 days after exposure for someone to develop chickenpox. The sores commonly occur in batches with different stages present at the same time. The blisters usually scab over in 5 days. A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs. Children with weakened immune systems may have blisters occurring for a prolonged time period. Adults can develop severe pneumonia and other serious complications.
Shingles occurs when the virus, which has been inactive for some time, becomes active again. Severe pain and numbness along nerve pathways, commonly on the trunk or on the face, are present. Clusters of blisters appear 1 to 5 days later. The blisters are usually on one side of the body and closer together than in chickenpox. Shingles does not spread as shingles from one person to another. If people who have never had chickenpox come in contact with the fluid from shingles blisters, they can develop chickenpox.
Who Is Eligible For The Vaccine
People aged 70 years of age are eligible for the vaccine.
The vaccine is also available for those previously eligible but who missed immunisation. For example, anyone in their 70s who has not yet had the vaccine.
You become eligible for the shingles vaccine as you turn 70 and remain eligible up to the age of 79.
People under 70 years of age are at lower risk of shingles but will become eligible for the vaccine when they turn 70. People aged 80 years and over are not eligible for the shingles vaccination because the vaccine becomes less effective as people get older. If you are worried about shingles speak to your GP.
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What Are The Complications Of Shingles
After the shingles rash has disappeared, you might continue to have nerve pain in that same area. Postherpetic neuralgia can last for months or years and become quite severe.
More than 10% of people who get shingles develop postherpetic neuralgia. Researchers dont know why some people get postherpetic neuralgia and others dont. It may be that nerves become more sensitive or that the virus may be invading and damaging the central nervous system.
Other complications include:
- Other types of nerve issues like numbness or itching.
- A bacterial infection of the shingles rash.
- Eye and ear inflammation if the rash is near these organs.
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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How Do You Catch Shingles
You do not “catch” shingles it comes on when there’s a reactivation of chickenpox virus that’s already in your body.
After you’ve recovered from chickenpox, the varicella-zoster virus lies dormant in your nerve cells and can reactivate at a later stage when your immune system is weakened.
Anyone who has had chickenpox can get shingles.
Shingles Vaccine Reduces Your Risk Of Getting Shingles
While there is no cure for shingles, getting the shingles vaccine can greatly reduce your risk of getting this disease.
Shingles vaccine reduces risk
The CDC recommends the shingles vaccine for healthy adults who are 50 years of age or older.
If you think you may already have shingles, treatment is important. It can reduce your pain and how long the rash lasts.
Find out how dermatologists diagnose and treat this condition at, Shingles: Diagnosis and treatment.
3 Centers for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 2019.
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ReferencesCenters for Disease Control and Prevention . Prevent Shingles: Get vaccinated. Page last reviewed July 23, 2018. Last accessed March 28, 2019.
Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.
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I’m Pregnant And Have Recently Been Exposed To Someone With Chickenpox How Will This Exposure Affect Me Or My Pregnancy
- Susceptible pregnant women are at risk for associated complications when they contract varicella. Varicella infection causes severe illness in pregnant women, and 10%-20% of those infected develop varicella pneumonia, with mortality reported as high as 40%.
- Because of these risks, pregnant women without evidence of immunity to varicella who have been exposed to the virus may be given varicella-zoster immune globulin to reduce their risk of disease complications.
- If you are pregnant and have never had chickenpox, and you get chickenpox during the:
- First half of your pregnancy, there is a very slight risk for birth defects or miscarriage.
- Second half of your pregnancy, the baby may have infection without having any symptoms and then get shingles later in life.
- Newborns whose mothers develop varicella rash from 5 days before to 2 days after delivery are at risk for neonatal varicella, associated with mortality as high as 30%. These infants should receive preventive treatment with varicella-zoster immune globulin .
Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
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Is Treating Relapse The Same
The approaches to treating shingles and any relapse are the same. In the latter case, healthcare providers may become particularly interested in isolating the cause of the weakened immunity thats causing the recurrence. That said, there is no outright cure for this disease, so treatment focuses on managing symptoms.
These approaches include:
- Antiviral medications, such as Zovirax , Famvir , and Valtrex , can help, especially if given within 72 hours of symptom onset.
- Over-the-counter drugs like Tylenol or Motrin or Advil can also help manage discomfort and pain.
- Compresses and creams are among other approaches that help relieve itching these include applying wet compresses, using calamine lotion, and taking colloidal oatmeal baths.
How Is Postherpetic Neuralgia Treated
Treatments include lotions or creams and/or other medications not specifically used for pain, such as antidepressants or drugs for epilepsy. Regular pain relievers are not usually effective for this type of pain.
If your pain doesnt lessen, you might try therapies like nerve blocks or steroid injections near the area where the nerves exit the spine. Your provider might suggest an implantable nerve stimulator device for severe, ongoing pain that hasnt responded to other treatments.
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How Long Between Shingles Attack And Recurrence
The time between an initial shingles case and its relapse can vary a great deal, and there is no established figure. However, researchers have noted most of these flare-ups arise in the four- to eight-year window following an initial attack. Recurrence within three years is much rarer.
Factors such as overall health status and the presence of other diseases can spur attacks, and there are preventative medications and approaches.
Who Should Not Be Vaccinated With Shingrix
You shouldnt receive the Shingrix vaccine if you:
- Have ever had a severe allergy to this vaccine or any ingredient in this vaccine.
- Are breastfeeding or pregnant.
- Currently have shingles.
- Are ill and have a high fever.
- Have tested negative for immunity to varicella-zoster virus .
Ask your healthcare provider if the benefits of getting the vaccine outweigh any potential risks.
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What Are The Risk Factors For Recurring Shingles
People dont know what causes recurring shingles, but certain factors increase your chances of getting shingles again.
People with weakened immune systems are more likely to get shingles again. One study determined that the rate of shingles recurrence was among people with compromised immune systems. This is about 2.4 times higher than for those who didnt have compromised immune systems.
You may have a compromised immune system if you:
- are getting chemotherapy or radiation therapy
- have organ transplants
- are taking high doses of corticosteroids like prednisone
Additional risk factors include:
- longer-lasting and more severe pain with the first case of shingles
- pain for 30 days or more with the first case of shingles
- being over the age of 50
Having one or more blood relatives with shingles may also increase your risk of getting shingles.
How To Pay For Shingrix
Commercial insurance covers about 96% of insured people for the Shingrix vaccine. Most people with private insurance will pay under $5 for each dose.
Programs like Medicaid cover Shingrix in certain states. Medicare Parts A and B do not cover the shingles vaccine. But individuals covered under Medicare prescription drug plans, or Part D, will have their vaccines covered.
For people who do not have access to insurance, there are a number of vaccine assistance programs and affordable health coverage options available. Many of these programs provide vaccines at little or no cost.
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What Should I Do About An Exposure To Varicella
If you have been in contact with someone with chickenpox or shingles, or if you have a rash-associated illness that might be chickenpox or shingles, discuss your situation with your healthcare provider. Blood tests may be done to see if you have become infected with the virus or have had the disease in the past. If you are pregnant and not immune and have been exposed to chickenpox or shingles, call your healthcare provider immediately. Your provider may choose to treat you with a medication called varicella-zoster immune globulin , but in order for this medication to be most helpful, it needs to be given as soon as possible after your exposure to varicella.