How Should You Treat Shingles
Antiviral medicines like acyclovir, valacyclovir, and famciclovir have been developed to reduce the length and severity of the illness. They are most effective when started soon after the shingles rash appears. Consequently, you should call your health care provider to explore treatment options as soon as you contract or believe you have contracted shingles.
Topical or oral pain medicines may help reduce the pain caused by shingles. Wet compresses, calamine lotion, and colloidal oatmeal baths may also help relieve itching.
Is There Anyone Who Should Not Have The Shingles Vaccination
There are 2 shingles vaccines available in the UK:
- Zostavax, a live vaccine given as 1 dose
- Shingrix, a non-live vaccine given as 2 doses
If Zostavax is not suitable for you, a GP or practice nurse will decide whether to offer you Shingrix instead.
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
Allergic Reaction To Shingles Vaccination
There is a very small chance of a severe allergic reaction to the shingles vaccine, as there is with other vaccines.
Anaphylaxis is very serious and potentially life-threatening, but it can be treated. All healthcare staff that deliver vaccinations are trained in this. With prompt treatment, people fully recover from anaphylaxis.
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Why You Shouldn’t Get The Shingles Vaccine
- Medical Reviewer: Dany Paul Baby, MD
Medically Reviewed on 5/24/2022
Shingles is a disease that usually presents with a painful rash that affects one in three people in their lifetime. It is caused by the same virus that causes chickenpox the herpes virus varicella-zoster. More than 99% of people born before 1980 have had chickenpox and have this virus dormant in the brain or spinal cord.
Shingles activates when your immunity is low, usually with advancing age. The currently used recombinant zoster vaccine is safe and effective. But not everyone who is a candidate for the shingles vaccine should take it. Like all vaccines, the shingles vaccine has benefits and harms. You should know about both and make an informed decision about taking it.
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What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
Should You Get A Covid
Some experts recommend that it can be a good idea for people with autoimmune diseases to get the COVID-19 vaccine. This is because people who have autoimmune diseases may have weakened immune systems due to taking immunosuppressant medications to treat their conditions.
People with weakened immune systems may be more likely to get severe COVID-19, according to the . Experts say that the vaccine may be effective against the illness severity. Speak with your doctor to learn more about the COVID-19 vaccine to see if its right for you.
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What Vaccines Can Help Prevent Shingles
There is currently one vaccine available in the U.S. to prevent shingles. Shingrix was approved in 2017 and it is more than 90% effective in preventing shingles. With Shingrix, you get two shots between 2 and 6 months apart and protection lasts an estimated 4-5 years. Doctors recommend it for healthy people over 50 as well as those 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy..
An earlier vaccine called Zostavax was removed from the market in 2020. That vaccine used a weak form of the chickenpox virus to send your bodyâs immune system into action to fight the disease. Shingrix does not. If you received the Zostavax vaccine, it is recommended that you also receive Shingrix.
How Is Shingles Spread
You do not “catch” shingles it comes on when there’s a reawakening of chickenpox virus that’s already in your body. The virus can be reactivated because of a range of issues, including advancing age, medicine, illness or stress.
Anyone who has had chickenpox can get shingles. It’s estimated that around 1 in 5 people who have had chickenpox go on to develop shingles.
Read more about the causes of shingles.
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.
Hsv Pathogenesis And Replication
Replication is a multi-step process. Post-infection, HSV glycoproteins interact with and attach to the cell. The viral envelope then fuses with the cell membrane, releasing its contents into the cell. DNA is uncoated and transported into the nucleus when nucleocapsid fuses with the viral envelope . Here, immediate-early genes are transcribed . Primary herpes infection involves replication within epithelial cells, with an incubation period of 46 days. Mature virions are then transported to the cell membrane, where they are released, causing cell lysis and local inflammation. Replication continues until host immune responses contain the initial infection .
Herpesvirus ascends peripheral sensory nerves to spread to the trigeminal ganglion, where latent infection develops. Latent virus can be induced to reactivate. Reactivation has been associated with various stimuli including stress, infections, and UV light exposure. However, from a molecular standpoint, reactivation is a phenomenon that continues to be studied and is not clearly understood. Clinical manifestations of reactivation vary widely in terms of presentation and severity .
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Cvs Pharmacy Now Offering New Shingles Vaccine At Locations Nationwide
More than 9,800 CVS Pharmacy locations have the Shingrix vaccine in stock for patients
WOONSOCKET, R.I., March 16, 2018 /PRNewswire/ — CVS Pharmacy, the retail division of CVS Health , announced today that all of its more than 9,800 pharmacies have the new Shingrix vaccine available for patients.1 The new vaccine was licensed by the U.S. Food and Drug Administration in 2017 and is now recommended by the Centers for Disease Control and Prevention .
Healthy adults age 50 and older are recommended to get two doses of Shingrix, two to six months apart, to prevent shingles and reduce the course and severity of the disease. The Shingrix vaccine is considered more than 90 percent effective at preventing shingles and protection stays above 85 percent for at least the first four years after a patient is vaccinated.
Ninety-nine percent of people ages 50 and older are at risk of getting shingles, a painful rash that is also known as herpes zoster, in their lifetime. There are an estimated one million cases of shingles each year in the U.S. It is recommended that patients who have had shingles, have previously received the Zostavax vaccine,2 or who are unsure if they have had chickenpox, receive the Shingrix vaccine. Anyone who has recovered from chickenpox may develop shingles, including children, although the risk of shingles increases as people age.
Recombinant Subunit Zoster Vaccine
There is a new herpes zoster recombinant subunit adjuvanted vaccine . It is not a live vaccine and requires a two-dose schedule with approximately 26 months between doses. The vaccine was registered in Australia in 2017 for people aged 50 years and above. However, it is not yet available for use. There is reportedly a limited global supply.
In 2018, an application by the manufacturer to include the HZ/su vaccine on the National Immunisation Program was unsuccessful due to uncertainty regarding cost-effectiveness. This vaccine is registered and used in some other countries, including the USA where the Centres for Disease Control and Prevention recommend it in preference to the live attenuated vaccine.33
The recombinant vaccine is more efficacious and more reactogenic than the live vaccine. In clinical trials, it provided 97% protection against herpes zoster for 5059 year olds and 91% for those aged over 70 years.34,35 Similar levels of protection were observed against postherpetic neuralgia over more than three years. Overall in those aged over 70 years, more people vaccinated with the recombinant vaccine than with placebo reported adverse events that prevented normal everyday activity in the week following vaccination .34 Monitoring during the first eight months of its use in the USA has found the vaccines safety profile to be consistent with pre-licensure trials.36
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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.
Where The Fda And Cdc Stand
According to the CDC, people ages 50 and up and immunocompromised adults ages 19 and older should get two doses of Shingrix to prevent shingles, PHN, and other possible complications. Shingrix is effective and safe for most people, including people with autoimmune disorders.
The CDC currently recommends that people with chronic medical conditions, such as RA, get the shingles vaccine. Additional CDC guidelines for people with autoimmune conditions are as follows:
- Shingrix is usually delivered in two doses, two to six months apart. If you are immunocompromised, your healthcare provider may suggest that you get your second Shingrix dose after just one to two months instead.
- Its usually best to wait until your symptoms are well-controlled to get Shingrix. If youre currently having a severe RA flare-up, you should typically wait until you feel better to get the shingles vaccine.
- If youre taking immunosuppressants to manage RA symptoms, talk to your healthcare provider about the vaccine schedule that works best for you.
The Food and Drug Administration approved the use of Shingrix in 2017 for people ages 50 and older. In 2019, the FDA approved Shingrix for immunocompromised adults ages 18 and older. The FDA hasnt yet issued any specific guidelines about Shingrix and RA.
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How Can I Get A Shingles Vaccine
While most people get their shingles shots at a pharmacy, some receive it at their doctors office. At one time, some states required a prescription to get the shingles vaccine at a pharmacy, but those states have recently changed their rules. Now you dont need a prescription to get the shingles vaccine.
At a pharmacy. Pharmacists in all states can administer vaccines included on the CDC-recommended adult immunization schedule, including the shingles vaccine. Make sure your pharmacy is in your Part D plans network so it can bill your plan directly. Check with your pharmacy and insurance plan for details.
At a doctors office. Its a good idea to confirm your doctor can bill Medicare Part D before you plan to get the vaccine there. Otherwise, you may need to pay for the vaccine and submit a claim for reimbursement to your Part D plan. Ask the doctors office and your plan about the rules.
Keep in mind
If you have trouble affording Part D prescription drug coverage, you may qualify for the Extra Help program, a government program that helps people with limited income and assets pay premiums and out-of-pocket costs for Part D drug coverage. Starting in 2024, the Inflation Reduction Act also expands the level of income eligibility for the Extra Help program.
Update October 11, 2022
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report AEFIs through local public health officials and to follow AEFI reporting requirements that are specific to their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For LZV the following AEFIs are also of particular interest and should be reported:
- Suspected transmission of vaccine-strain virus to a close household or occupational contact. This phenomenon has been documented following varicella vaccine but it is rare, and transmission has not been documented with LZV.
- Recurrent HZ following immunization of individuals with a history of HZ prior to immunization, noting the area of recurrence.
- Recurrent HZO following immunization of a person who has had a previous episode of HZO. If available, a vitreous fluid specimen should be sent to a laboratory with a request to determine whether the virus is the vaccine strain or wild type virus.
For definitions of serious and unexpected adverse events, refer to Adverse Events Following Immunization in Part 2.
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Im Pregnant And Have Had A Blood Test For Chickenpox What Do The Results Of This Test Show
The blood test can show that you:
- Are immune and have no sign of recent infection. You have nothing further to be concerned about.
- Are not immune and have not yet been infected. You should avoid anyone with chickenpox during your pregnancy.
- Have or recently had an infection. You should discuss what the risks are for your stage of pregnancy with your healthcare provider.
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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How Does The Shingles Vaccine Work
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
What Does Shingles Look Like
The shingles rash can look like a distinctive cluster of fluid-filled blisters, similar to chickenpox, but the rash is usually centrally located around the torso. Another common location is on one side of the forehead or around one eye, but shingles blisters have been known to occur anywhere on the body.
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A Closer Look At The Safety Data
Both Shingrix and Zostavax shingles vaccines have been shown to be safe and well tolerated. Common side effects, such as soreness and redness at the injection site, are usually mild to moderate in intensity and resolve quickly on their own.
In 8 clinical trials of more than 10,000 participants:
- Grade 3 reactions were common after patients received Shingrix.
- About 1 out of 10 adults who received Shingrix reported grade 3 injection-site symptoms such as pain, redness, and swelling.
- About 1 out of 10 reported grade 3 systemic reactions such as myalgia , fatigue , headache, shivering, fever, and gastrointestinal illness.
- Most people who got Shingrix reported at least some pain at the injection site.
- A 2013 study showed that patients with a history of a previous shingles rash had the same side effects after Zostavax as those with no history of shingles. See Safety of zoster vaccine in elderly adults following documented herpes zoster.
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