Should I Get A Vaccine
Doctors say most healthy people over 50 should get Shingrix, as well as anyone 19 or older who are immunocompromised. Itâs available at pharmacies as well as doctorsâ offices. Most people have been exposed to the chickenpox even if they didnât actually develop symptoms.
You should get the Shingrix vaccine unless:
- You are allergic to any part of the vaccine
- Had a blood test that proves you never had chicken pox
- Have shingles now
- Are breastfeeding or nursing.
How Do We Know The Vaccine Is Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The shingles vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once they’re in use, the safety of vaccines continues to be monitored by the MHRA.
What Are The Symptoms Of Shingles
Shingles typically produces a painful rash that blisters and scabs over in 7 to 10 days and clears up within 2 to 4 weeks.
One to 5 days before the rash appears, people may experience pain, itching, tingling, or numbness in the area where the rash will develop.
The rash usually erupts in a single stripe on either the left or right side of the body, or sometimes the face, along a nerve path. It could develop on the arm, thigh, head even the ear or eye. Its most common on the chest and abdomen. Symptoms of shingles may also include fever, headache, and a sense of not feeling well.
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Simultaneous Administration With Other Vaccines
RZV and LZV may be administered concomitantly with other live vaccines given by the parenteral, oral, or intranasal routes. For concomitant parenteral injections, different injection sites and separate needles and syringes should be used.
In general, inactivated vaccines including RZV may be administered concomitantly with, or at any time before or after, other inactivated vaccines or live vaccines protecting against a different disease.
LZV may be given at any time before or after live oral or intranasal vaccines. If two live parenteral vaccines are not administered concomitantly, there should be a period of at least 4 weeks before the second live parenteral vaccine is given.
Concomitant administration of pneumococcal 23-valent polysaccharide vaccine and LZV has not resulted in decreased efficacy and so the two vaccines can be given concomitantly.
For more information, refer to Timing of Vaccine Administration in Part 1.
The Biology Behind That Blistering Rash
During the initial exposure to chickenpox, some of the virus particles settle into the nerve cells around the spinal cord and brain. When the virus reactivates sometimes decades later, as a result of things like stress it travels down those nerve fibers to the skin. As the virus multiplies, the telltale rash erupts.
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Vaccination Of Immunocompromised Adults 19 Years And Older
CDC recommends two doses of RZV for the prevention of shingles and related complications in adults aged 19 years who are or will be immunodeficient or immunosuppressed because of disease or therapy. The second dose of RZV should typically be given 26 months after the first. However, for persons who are or will be immunodeficient or immunosuppressed and who would benefit from completing the series in a shorter period, the second dose can be administered 12 months after the first. For more detailed clinical guidance see .
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Why More Adults Arent Getting The Super
Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things.
First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that shingles can be incapacitating, causing severe pain that can really limit peoples functioning.
Whats more, difficulty in getting the vaccine may have discouraged those who sought it out early on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies.
Also, theres the ouch factor: not the needle, but the way the body initially responds to the vaccine itself. This is a moderately reactogenic vaccine, meaning 20 to 30 percent of people may get a fever, along with pain and swelling at the injection site, says Gregory Poland, M.D., an infectious disease expert and founder of the Mayo Clinics Vaccine Research Group. However, Poland notes, the second dose tends to cause less of a reaction, so people do better with it.
Besides, Schaffner reasons, Having your arm hurt for a day or so is a small price to pay to avoid this infection. In fact, he notes, I couldnt be more insistent and enthusiastic about any vaccine more than the shingles vaccine.
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A Look At Each Vaccine: Shingles Vaccine
View the full-size infographic. A shingles vaccine is available for adults 50 years of age and older in the United States. The vaccine prevents much of the pain and suffering caused by shingles when the virus that causes chickenpox reawakens in those with aging or compromised immune systems.
Vaccine Effectiveness And Safety
The vaccine reduces your chance of getting the virus by more than 50%, depending on your age. Vaccine effectiveness is higher among seniors between 65 and 70 years old.
No vaccine is 100% effective. If you get vaccinated, you may still develop shingles. But the infection would likely be less severe and youd be better protected from complications.
The vaccine has been licenced by Health Canada, having met all requirements under the Food and Drugs Act.
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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.
Can People Who Got The Shingles Vaccine Be Around Babies
Yes, people who had the shingles vaccine can be around babies. Unlike the previously available Zostavax vaccine, Shingrix does not contain live, weakened virus, so it does not replicate and people do not get a rash. Therefore, there is no chance of transmitting the virus to babies who are susceptible to chickenpox. Watch as Dr. Offit discusses being around babies after receiving a shingles vaccine in this short video, part of the series Talking About Vaccines with Dr. Paul Offit.
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Know The Benefits And The Side Effects
Shingrix is more than 90% effective at preventing shingles and long-term nerve pain. You may experience some short-term side effects because Shingrix causes a strong response in your immune system.
After getting Shingrix:
- Most people had a sore arm.
- Many people had redness and swelling where they got the shot .
- Many felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea.
About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities like yardwork or swimming. Side effects usually go away after 2 to 3 days. Remember that the pain from shingles can last a lifetime, and these side effects should only last a few days.
What Are The Side Effects
Shingrix can make the area where you get the shot swell or feel sore. Other effects include:
- Many people who get the vaccine have muscle aches, headaches, or feel tired.
- About 1 in 4 people have a fever or an upset stomach.
Younger people are more likely to have these side effects, and they typically last 2 or 3 days.
Itâs also possible to have an allergic reaction to an ingredient in the vaccine. If you have problems breathing, feel your face or throat swelling, or feel weak or dizzy after the shot, call 911 and get medical help right away.
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Who Should Get The Shingles Vaccine
The CDC recommends it for healthy adults over the age of 50, but the FDA has approved Shingrix for people 18 and older who are or who will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. This includes those who have already had shingles, which you can have more than once. Vaccination lowers the chances of a second round of the painful rash and of a serious outbreak and complications, Kistler says.
Thatâs why Duncan Isley, who had shingles at 45, recently got vaccinated. The outbreak he had was âfairly mildâ compared with the stories heâs heard from others. But itâs something he doesnât want to repeat.
âI had the classic torso rash and back pain. It was a very painful experience to be sure, and I still have some lingering, minor nerve sensations from time to time,â says Isley, who is now 53 and lives in Durham, NC. âI tell my close friends they should get vaccinated.â
You should also get vaccinated with Shingrix if you got an older shingles vaccine called Zostavax, which was withdrawn from the market in 2020. Zostavaxâs protection wears off with time, says Kathleen Dooling, MD, MPH, a medical officer and shingles disease expert at the CDC.
In the first year after vaccination, Zostavax prevented shingles about 60% of the time. âThat decreases in subsequent years, so that after a number of years itâs not clear that the vaccine is providing any protection,â she says.
Why Young Adults Can Develop Shingles
Shingles can develop in anyone whos had chickenpox. After you recover from chickenpox, VZV remains dormant within nerve cells in your body.
In some cases, VZV is triggered to reactivate. When this happens, the virus begins to replicate again and move along the affected nerves. When it reaches your skin, the characteristic shingles rash develops.
What causes VZV to reactivate is unknown. However, reactivation is associated with a weakened immune system.
A weakened immune system can occur due to age. But in younger adults, the immune system can be compromised by acute or chronic illness or extreme stress.
People who are immunocompromised have a higher risk of developing shingles regardless of age.
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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
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. You’re 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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What Are The Risks Of Shingles
About one in five people who get shingles will have severe pain after the rash goes away. This pain can last months or even years. This pain is known as post-herpetic neuralgia.
Rare complications of shingles include scarring, pneumonia, loss of hearing or vision, swelling of the brain and bacterial superinfections of the rash.
Main Causes Of Shingles
It is not clear what makes the varicella-zoster virus suddenly activate. Because the virus remains in the spinal nerve root after recovery from chickenpox, most researchers believe stress could trigger it.
You’re most likely to get shingles if:
- Youre above 60 years old.
- You contracted chickenpox before the age of one.
- You have a weak immune system due to underlying conditions like cancer and AIDS.
- You are under medication like chemotherapy.
- If youve gone through trauma.
- If you are stressed.
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For Patients Who Do Not Report A Prior Episode Of Varicella
When vaccinating immunocompetent adults aged 50 years and older, there is no need to screen for a history of varicella or to conduct laboratory testing for serologic evidence of prior varicella. More than 99% of adults aged 50 years and older worldwide have been exposed to varicella-zoster virus, and the Advisory Committee on Immunization Practices considers people born in the United States prior to 1980 immune to varicella. Therefore, even if a person does not recall having chickenpox, serologic testing for varicella immunity is not recommended. It is often a barrier to herpes zoster vaccination, and false negatives are common. However, if serologic evidence of varicella susceptibility becomes available to the healthcare provider, providers should follow ACIP guidelines for varicella vaccination. Shingrix has not been evaluated in persons who are seronegative to varicella, and it is not indicated for the prevention of varicella.
For adults 19 years of age and older who are or will be immunocompromised, see .
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.
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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.
First Could You Describe Briefly What Shingles Is
Shingles is a viral infection that causes a painful rash. Shingles is caused by the varicella zoster virus which is the same virus that causes chicken pox. After you have had chicken pox, the virus lies inactive in nerve tissue and years later can reactivate, causing a painful rash that looks like blisters. Most often the rash appears in a line around the right or left side of your torso, but can affect any part of the body including the face and eyes. Individuals have a 20-30% chance of getting shingles during their lifetime, and it is more likely to occur when you get older. The most common complication of shingles is post herpetic neuralgia, which causes persistent pain long after the blisters have disappeared and can last for months.
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How Funding For Vaccines Is Decided
Pharmac is responsible for deciding which vaccines are funded and what groups are eligible for free vaccines. Pharmac’s Pharmacology and Therapeutics Advisory Committee considered the cost and benefits when determining the appropriate age to offer a free shingles vaccine and recommended that free vaccination at 65 years was the best approach.
You can find further information about the funding of shingles vaccine on Pharmacs website:
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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