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What Can Cause A Shingles Outbreak

Is There A Vaccine For Shingles

Shingles: What you need to know about causes, symptoms, and prevention.

There are two shingles vaccines currently available, Shingrix and Zostavax. Shingrix vaccine, a newer vaccine, is preferred over Zostavax for the prevention of shingles and its complications. Two doses of Shingrix given 2 to 6 months apart are recommended for healthy adults 50 years of age and older. Shingrix is also recommended for adults who have previously received Zostavax. A single dose of Zostavax may still be used to prevent shingles in certain cases for healthy adults 60 years and older.

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 Is The Best Way To Prevent Shingles

Your best chance at preventing shingles is to get vaccinated. There is one vaccine, Shingrix, which is very effective in preventing shingles and complications, including postherpetic neuralgia.

  • Shingrix is a recommended vaccine for all adults age 50 years and older whether or not they have had shingles or previously received varicella vaccine. The vaccine is a series of two doses. The administration of the second dose is given 2 to 6 months after the first dose.

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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 .

What Makes Shingles So Painful

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The most common complication of shingles is a condition called postherpetic neuralgia . People diagnosed with PHN have severe pain for at least 90 days after the shingles rash has cleared up. The pain can lead to a lower quality of life for many people. As people get older, they are more likely to develop PHN, and the pain is more likely to be severe.

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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.

Is The Shingles Vaccine Safe

The FDA have approved the use of both shingles vaccines in healthy adults over the age of 50.

However, there are some instances in which a person should not get either vaccine â if they are pregnant or breastfeeding, allergic to any ingredient in the vaccine, or have a weakened immune system, for example.

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What Can You Do To Prevent Shingles

While you may not be able to control certain factors that might trigger shingles, there are strategies you can use to prevent shingles. The most important is vaccination. Research shows that the shingles vaccine Shingrix is 90% effective in preventing an outbreak of shingles. Even if you do get shingles after being vaccinated, Shingrix greatly reduces your risk of developing persistent pain in the affected area, known as post-herpetic neuralgia.

In addition to getting vaccinated, its always a good idea to take steps to keep your body healthy, such as choosing healthy foods, staying active, and getting sufficient sleep. Its not clear if healthy lifestyle habits like these can prevent shingles, but even if they dont, theyre worthwhile because they will benefit your body in many other ways.

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Do You Need To Stay Away From Children People Who Are Pregnant Have Cancer Or Anyone With A Weak Immune System After You Get The Zostavax Vaccine

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According to the CDC, its safe to be around babies and young children, pregnant women or anyone with a weakened immune system after you get the Zostavax vaccine. Even though the Zostavax vaccine contains a weakened live varicella-zoster virus, the CDC says theres no documented case of a person getting chickenpox from someone who has received the Zostavax vaccine. And remember: You cant get shingles unless youve already had chickenpox.

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Long Term Side Effects

In rare cases, the live shingles vaccine, Zostavax, can cause a skin rash or shingles.

The rash that occurs with shingles can affect any area of the body, but it often appears as a line of blisters that wraps around the torso.

Within a few days the blisters cluster, and they continue to form for several more days. The blisters can take 2â3 weeks to heal, according to the American Academy of Dermatology.

Other common symptoms of shingles include:

two shingles vaccines for adults: the recombinant zoster vaccine and the zoster virus vaccine .

Who Should Be Vaccinated With Shingrix

The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.

You should get the Shingrix vaccine even if:

  • Youve had shingles already.
  • Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
  • You dont know for sure if youve ever had chickenpox.

Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.

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Where Can I Find More Information About Research On Shingles

In addition to the NINDS, several other NIH organizations support research relevant to understanding, treating, or preventing shingles and its complications, including the National Institute of Allergy and Infectious Diseases and the National Institute on Aging .

  • NIH RePORTER is a searchable database of current and previously funded research supported by NIH and some other federal agencies. RePORTER also includes links to research results such as patents and publications citing support from these projects.
  • PubMed allows users to search millions of journal article abstracts in biomedical research fields. The full text of many articles describing research funded by NIH and other sources is also freely available through PubMedCentral

What Triggers Shingles In Some People And Not Others

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Experts dont fully understand this. One theory is that shingles occurs when your immune system loses its ability to keep the virus in check.

After you get chickenpox, your immune system is able to recognize the varicella-zoster virus thanks to specialized immune system cells, called B and T cells, that are able to remember the virus and quickly marshal an attack on it. Factors that weaken the immune system increase your risk of developing shingles. These include

  • certain illnesses, such as HIV , cancer, or autoimmune conditions.
  • medicines that suppress your immune system, such as cancer drugs, steroids, medications to treat autoimmune conditions, and drugs given to patients who undergo an organ transplant to keep their bodies from rejecting it.
  • age-related changes: shingles can occur in people of any age, including children, but is most common in people over age 60. Your immune system may become weaker as you get older. While its not totally clear why this happens, it may be due to a decline in T cells. Some experts also think that as you age, the bone marrow produces fewer stem cells, the progenitors of T cells and B cells. With fewer of these white cell soldiers in the army, the immune system might not be able to mount as powerful a response to invaders as it once did.
  • certain genetic factors: past studies have indicated that an increased susceptibility to shingles can run in families, according to the National Institutes of Health.

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Is Shingles Contagious

Someone with shingles cant spread shingles to another person, but they can spread chickenpox. The varicella-zoster virus is spread through direct skin-to-skin contact with the fluid that oozes from the blisters. Shingles is rarely spread by breathing in the varicella-zoster virus the way airborne viruses are spread. If your rash is in the blister phase, stay away from those who havent had chickenpox or the chickenpox vaccine and keep your rash covered.

What Are The Symptoms

The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.

One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.

Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.

In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.

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How Is Shingles Treated

Specific treatment for shingles will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history
  • How long the shingles have been present
  • Extent of the condition
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:

  • Creams or lotions to help relieve itching
  • Cool compresses applied to affected skin areas
  • Antiviral medicines
  • Anticonvulsants

Can Shingles Be Harmful During Pregnancy

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Still, pregnant women who develop chicken pox can experience complications, including varicella pneumonia, a condition that can be fatal.

If a pregnant woman develops a varicella rash from five days before to two days after delivery, the newborn will be at risk for neonatal varicella.

Pregnant women who have been exposed to the virus may be given a varicella-zoster immune globulin injection to reduce the risk of complications to both mother and baby.

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What The Research Says

What we do know is that when your immune system is compromised or distracted fighting off another virus, it tends to give the herpes zoster virus a chance to reactivate.

Past research has established that immune-suppressing medications like chemotherapy and corticosteroids as well as health conditions that attack your immune system like Crohns disease, HIV, and lupus increase your risk for a shingles outbreak.

Researchers are currently trying to understand whether COVID-19 may do the same thing.

Preliminary data suggests that this could be the case, but we do not know yet.

A small 2021 study involving 491 vaccinated people in Israel showed that six participants experienced shingles for the first time after getting their first dose of COVID-19 vaccine. All six individuals had pre-existing conditions that lowered their natural immune response, and all six fully recovered after developing shingles.

This study prompted researchers to advocate for more studies on COVID-19 vaccines as possible triggers for the shingles virus.

Data gathered in Brazil also showed an increase of 10.7 cases of shingles per million inhabitants during the time of the pandemic.

Its impossible to know exactly how and to what extent the effect of increased stress of the pandemic and other factors played into these numbers increasing during that span of time. Stress has long been suspected to be a possible factor in developing shingles.

How Can I Take Care Of Myself

  • Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
  • Put cool, moist washcloths on the rash.
  • Rest in bed during the early stages if you have fever and other symptoms.
  • Try not to let clothing or bed linens rub against the rash and irritate it.
  • You develop worsening pain or fever.
  • You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
  • The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
  • The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
  • You have trouble walking.

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What Can Be Done To Prevent The Spread Of Shingles

A vaccine for chickenpox is available and it is hoped that individuals immunized against chickenpox will be less likely to develop shingles in later life.

The risk of spreading the virus that causes shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of shingles. Once the rash has developed crusts, the person is no longer contagious.

If You Get The Shingles Vaccine Does This Mean Youre 100% Protected From Getting Shingles

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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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Shingles Chickenpox And Pregnancy

An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.

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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Who Gets Shingles

Anyone who has recovered from chickenpox may develop shingles, including children. However, shingles most commonly occurs in people 50 years old or older. The risk of getting shingles increases as a person gets older. People who have medical conditions that keep the immune system from working properly, like cancer, leukemia, lymphoma, and human immunodeficiency virus infections, or people who receive drugs that weaken the immune system, such as steroids and drugs given after organ transplantation, are also at greater risk to get shingles.

How Is It Treated

New treatment for the pain of shingles

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
  • corticosteroids

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Why Does Shingles Appear Mostly On One Side Or In One Area Of Your Body

The virus travels in specific nerves, so you will often see shingles occur in a band on one side of your body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area. It doesnt spread over your whole body. Your torso is a common area, as is your face.

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