Shingles Vaccine

December 11, 2017
Miriam Brandon, MD
Miriam Brandon, MD

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Shingles has been in the news recently after a new vaccine approval was announced. So what is shingles and why should we try to prevent it?

Shingles is a painful rash caused by the virus that causes chicken pox, varicella zoster. After an infection with chicken pox, the virus stays in the cells of the nervous system. The virus can reactivate causing this painful shingles rash in one area of your body associated with the nerves. 1 in 5 people will develop shingles in their lives. It can occur in healthy adults, but becomes more common after the age of 50. Shingles happens only when you had a previous chicken pox infection, but at times, that infection can be so mild it does not produce symptoms. This may lead some to believe they are not at risk for shingles when they actually are.

A shingles infection starts typically with itching, burning, or tingling in a certain area of the skin. This is usually on one side of the body. The blistery rash follows these symptoms after a couple of days and is in a band like pattern on the skin. The rash is almost always painful with sharp, stabbing, or burning pain. The pain often interferes with daily activities and sleep. For many people, the rash resolves in about a week and the pain subsides after a few weeks. Unfortunately, some will continue to have pain in the area of the rash even after the rash resolves. We call this postherpetic neuralgia. This pain can last much longer. Shingles can also cause complications of vision loss if the rash is on the face. While the rash is present, you can infect others with the varicella zoster virus to those who have immune system problems or never had chicken pox.

There are antiviral medicines to treat shingles which decrease the length of time the rash persists and can decrease the occurrence of postherpetic neuralgia. The pain can be treated with typical pain medications or medicines specific to this type of nerve pain.

Vaccines are available to decrease the likelihood you will get shingles. Zostavax is a weakened live virus that prevents about half of shingles cases. There is a new vaccine that should soon be available called Shingrix. This vaccine prevents about 90% of cases. It also appears more effective in the age group most at risk of shingles and related complications, people over the age of 60. It should be available next year.