Persons With Chronic Diseases
Although definitive data are lacking, individuals with autoimmune disease not being treated with immunosuppressive drugs are not considered significantly immunocompromised. Individuals 50 years of age without contraindications should receive RZV.
For more information, refer to Immunization of Immunocompromised Persons, and Immunization of Persons with Chronic Diseases in Part 3.
Who Should Not Get The Shingles Vaccine
The shingle vaccine is a live vaccine. This means that it can cause an infection in people with very weakened immune systems and should not be used in people with leukaemia, lymphoma, other conditions affecting your bone marrow, tuberculosis or in people having immunosuppressive therapy such as chemotherapy. It should also not be given to children and pregnant women.
How Long Does Shingles Last
Most cases of shingles last three to five weeks. Shingles follows a pattern:
- The first sign is often burning or tingling pain sometimes, it includes numbness or itching on one side of the body.
- Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
- A few days later, the rash will turn into fluid-filled blisters.
- About a week to 10 days after that, the blisters dry up and crust over.
- A couple of weeks later, the scabs clear up.
Most people get shingles only one time. But, it is possible to have it more than once.
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How Effective Is The Shingles Vaccine
Having the shingles vaccine reduces your risk of getting shingles and post-herpetic neuralgia, but the effect of the vaccine differs by age and time since vaccination. Age at which you get vaccinatedThe shingles vaccine is most effective at preventing shingles in people aged 5059 years and becomes less effective as you get older. It is effective in about 5 in 10 people aged 6569 years and about 4 in 10 people aged 80 years or older. Times since vaccinationProtection from the shingles vaccine wears off over time. The highest protection against shingles is during the first year after receiving the vaccine. By 6 years after being vaccinated, protection is very low. Booster dosesThere is no information about whether a booster dose of the shingles vaccine provides any benefit. Although there are no recommendations, adults who have previously received the shingles vaccine can receive a second dose after 1 year. There are no safety concerns about receiving a second dose.
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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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.
Can It Cause Side Effects
Like every vaccine, Shingrix has the potential for side effects, although so far, none seem particularly worrisome. The new shingles vaccine does appear to be more likely to cause pain during injection and at the site of injection for up to three days afterward than Zostavax does.
In clinical trials, the side effects also included injection site redness and swelling, muscle pain, and immune system responses such as headache, shivering, fever, and upset stomach. Most, according to GlaxoSmithKline, its manufacturer, lasted less than three days.
Though Shingrix was tested on some 16,600 adults in clinical trials, its real-world use has been limited. The company will be conducting additional safety and efficacy studies over the next few years, and the CDC will be monitoring any adverse events that are reported.
As with any drug thats approved on the basis of studies in only thousands, in contrast to millions after approval, strict post-marketing surveillance studies have to be agreed upon, with severe penalties for irregularities, says CRs Lipman.
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Connection Between Stress Shingles And Sleep
While stress isnt itself considered a risk factor for shingles, research published in the journal Innovations in Clinical Neuroscience suggests that stress, stressful life events, and depression often precede outbreaks of shingles. One reason may be because stress lowers the bodys natural immune defenses and provides an opening for the dormant herpes virus to reactivate and surface.
Stress can adversely impact sleep and cause insomnia. But poor sleep can also add to your stress, leaving you suffering from excessive daytime sleepiness and making you prone to accidents, injury, and illness.
Ways to reduce stress include:
- Exercise regularly, but not too close to bedtime as doing so can make falling asleep more difficult.
- Meditate, take a yoga class, or practice relaxation exercises.
- Eat a healthy, balanced diet.
- Talk with a therapist.
- Take supplements, such as melatonin, which may improve your sleep.
- Do something creative, such as paint or journal.
Should I Get The Shingles Vaccine And If So When
A vaccine for shingles was approved by the FDA in 2006.The vaccine is currently approved for adults over the age of 50 but the American College of Physicians recommends waiting to vaccinate until the age of 60 to ensure that the vaccine is most effective when the complications from shingles can be more severe. As you age, your odds of developing a more serious case of shingles, as well as postherpetic neuralgia, increase.
After the age of 60, the shingles vaccine is 51 percent effective in preventing shingles and 67 percent effective in preventing postherpetic neuralgia. The protective effects of the vaccine diminish after five years, so the later you receive the vaccine the better chance you will have of protecting yourself. Those who still develop shingles after receiving the vaccine should experience less severe symptoms.
Approximately 4 percent of patients who develop shingles will experience a recurrence of the disease. If you have already experienced shingles, getting vaccinated may help you prevent a recurrence and should reduce the duration and severity of new symptoms should the disease recur.
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Who Should Get The Shingles Vaccine
The CDC recommends healthy people who are 50 or older get two doses of Shingrix, which is more than 90 percent effective in preventing shingles, also known as herpes zoster. The excruciating rash is caused by the same virus that causes chickenpox and anyone who has ever had chickenpox may develop shingles. There are a million cases of it each year in the U.S. and the risk rises with age.
You can’t develop shingles if you’ve never had chickenpox, but most adults have had the disease. Studies show 99 percent of Americans who are over 40 have had chickenpox, even if they don’t remember it, the CDC noted. The dormant virus may get reactivated when the immune system is weaker during infections or times of stress, for example.
People should get Shingrix even if they’ve received the Zostavax vaccine in the past or have already had shingles, the agency advises.
You should receive the second dose of Shingrix two to six months after you get the first shot and that may mean another round of side-effects. How you reacted to the first dose doesnt necessarily predict how youll react to the second, Dooling said.
Early CDC data shows more than 70 percent of patients are getting that second dose within the recommended six month window.
What Is Shingrix The New Shingles Vaccine
Shingrix, approved by the U.S. Food and Drug Administration in late 2017, is more likely to cause short-term side effects than either Zostavax or other vaccines for adults, said Dr. Kathleen Dooling, a medical officer in the division of viral diseases at the Centers for Disease Control and Prevention.
One of the important things is to go into this vaccination knowing that youll probably have some side effects after and be prepared for those, Dooling told TODAY.
The advice weve been giving people is that if you plan to get the vaccine, in the day or two afterwards, dont plan any big, strenuous activities. For example, dont plan a big gardening project… dont plan your big golf game for that period.
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Treatment If The Condition Gets Worse
In some cases, shingles causes long-term complications. Treatment depends on the specific complication.
- is persistent pain that lasts months or even years after the shingles rash heals. Certain medicines, such as anticonvulsants, antidepressants, and opioids, can relieve pain. Most cases of PHN resolve within a year.
- Disseminated zoster is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment may include both antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
- Herpes zoster ophthalmicus is a rash on the forehead, cheek, nose, and around one eye, which could threaten your sight. You should seek prompt treatment from an for this condition. Treatment may include rest, cool compresses, and antiviral medicines.
- If the shingles virus affects the nerves originating in the brain , serious complications involving the face, eyes, nose, and brain can occur. Treatment depends on the nature and location of the complication.
Who Should Not Get Vaccinated
According to the CDC, some people should not be given the shingles vaccine, including those who:
- Have had allergic reactions to the vaccine
- Tested negative for varicella-zoster virus immunity
- Currently have shingles
- Have a severe or moderate illness that is considered acute, such as a respiratory infection
- Have a temperature of 101.3 degrees F or higher
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Why Is Vaccination Against Shingles Recommended
About one third of people will develop shingles in their lifetime and 50% of people will develop shingles by the time they reach age 85 years. While shingles can get better on its own, the most common complication occurring in up to 3 in every 10 people with shingles is pain that goes on after the shingles rash has cleared. This is called post-herpetic neuralgia .
- Post-herpetic neuralgia is usually described as a burning or shooting pain, with itch, numbness, tingling or sensitivity to touch or temperature.
- The risk and severity of both shingles and post-herpetic neuralgia increases with age.
- Post-herpetic neuralgia can go on for months to years.
Having the shingles vaccine can help prevent shingles and reduce the risk of post-herpetic neuralgia. Read more about post-herpetic neuralgia.
How Is Shingles Treated
Because the shingles virus is a herpes virus, the mainstay of treatment involves antiviral therapy for a minimum of one to two weeks. Its extremely important to complete the course of therapy even if you are feeling better. It usually takes about 48 to 72 hours to see the impact of the antiviral medication. When initiated quickly after the onset of symptoms, antiviral medication may shorten the severity and duration of the illness and decrease the chance of developing PHN.
Pain is most often treated with non-steroidal anti-inflammatory medications, although sometimes the pain is so severe that narcotic medication is required. If the patient cannot tolerate narcotics, we can also prescribe anticonvulsant drugs.
Itching can be treated with over-the-counter medications such as cortisone, calamine lotion and Benadryl cream. The goal is not to scratch the blisters, which could cause the area to become infected. Topical medications can also be used to protect the skin from infection.
It is possible to get shingles more than once. Patients who suspect they may be experiencing a recurrence of shingles should begin treatment as soon as they observe the new symptoms, since early treatment may prevent these patients from getting the full-blown rash.
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Shingrix Shingles Vaccine: Side Effects Shortages Age And More
Americans seem to have a love-hate relationship with the new shingles vaccine.
Love, because Shingrix which offers much better protection against the painful rash than its predecessor Zostavax is so popular that there are shortages of the vaccine.
Hate, because people are also complaining the shot is painful and comes with unpleasant side effects.
My arm feels like Mike Tyson punched it 9 times, one man tweeted last month after getting the new vaccine.
Today, I got the shingles vaccination. Now my left arm hurts so much, a woman tweeted this week.
The Shingles vaccine is 97% effective, which is awesome. The side effects are killing me, which sucks . Still better than getting Shingles by a
Others complained of fever, muscle aches, feeling lousy & virusy and suffering like Ive been hit by a Mack truck.
Its not their imagination.
How You Get Shingles
You dont catch shingles. Chickenpox virus caught earlier in your life reactivates later to cause shingles. You cant catch shingles from someone who has chickenpox.
However, if you have shingles blisters, the virus in the fluid can infect someone who has not had chickenpox and they may develop chickenpox.
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Why A New Shingles Vaccine
Did we need a new shingles vaccine? To answer that question, it helps to have a bit of background on this infection.
Shingles, which is also called herpes zoster, occurs when the chickenpox virus , which is dormant in those whove had the illness, reawakens later in life. Almost all adults older than 40 carry the chickenpox virusand the older we get, the more the risk of getting shingles climbs. According to the CDC, the infection strikes about 1 million people in the U.S. each year and nearly one in three adults will experience a bout of shingles in their lifetime.
The two to four weeks of shingles, marked by symptoms such as a blistery and painful rash on one side of the body, can be difficult enough. But about one in five people with shingles go on to develop postherpetic neuralgia, or PHN, which is nerve pain that can linger for months or even years.
Since 2006, weve had Zostavaxapproved for those between 50 and 59 but recommended by the CDC for adults 60 and olderas the sole bulwark against shingles. Zostavax offers 70 percent protection against shingles for people between 50 and 59 but only 18 percent in people 80 and older, according to the Pink Sheet, which reports on the pharmaceutical industry.
When all ages are taken into consideration, Zostavax cuts the chance of shingles by only 51 percent and the risk of PHN by 67 percent.
Shingles is a big problem with immunocompromised people, Schaffner says.
Treatment Of Pain After Shingles
Treatment for people with PHN may include:
- Nerve blocks: Local anesthetic or alcohol injected directly into the nerve affected
- Thoracic epidural injections: Local injection in the space around the spinal cord
- Antidepressant medications: Such as amitriptyline
- Membrane stabilizers: Such as gabapentin
- Capsaicinapplication: Topical cream applied to the affected area
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Side Effects Of Getting The Vaccine
Like all vaccines, the shingles vaccines can cause side effects, but they’re generally mild and do not last long.
Common side effects that occur in at least one in 10 people are:
- redness, pain, swelling, itching at the injection site
If the side effects continue for more than a few days, contact your GP or practice nurse.
Tell your GP if you develop a rash after having the shingles vaccination.
Complications Following Shingles Vaccine Are Serious In About 3% Of Cases: Cdc
Have A Potential Case Reviewed By An Attorney
Amid continuing concerns about reports of problems with the single-dose Zostavax shingles vaccine, a new report reviewed adverse reactions to the newer, double-dose Shingrix vaccine, indicating that about three percent of those reactions resulted in serious injuries or complications.
GlaxoSmithKlines Shingrix vaccine is believed to be safer and more effective for prevention of shingles among older adults, and has largely replaced the older live-virus Zostavax vaccine, which has been linked to reports of more severe and persistent shingles outbreaks and auto-immune complications in recent years.
In the latest issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report , health officials indicate that at least 4,381 reports of adverse events have been received involving shingles inoculation with Shingrix, about 130 of them are classified as serious, including seven deaths. However, it is unclear whether the deaths were tied directly to the vaccine.
Shingrix was introduced in October 2017, and has been approved for prevention of shingles among adults age 50 and older. It was the second shingles vaccine approved in the U.S., and has been widely viewed as a superior replacement for Mercks Zostavax , which has been linked to complications as a result of an under-attenuated live virus contained in the vaccine.
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Who Should Get Vaccinated
The Centers for Disease Control and Prevention reports that people who should receive the shingles vaccine include:
- Adults who are healthy, aged 50 and older
- People who have not had shingles
- Those who are unsure if they have had chickenpox. Studies show that over 99% of Americans over age 40 have had chickenpox, this includes those who cant remember having the disease.
- People who have had shingles . Studies have shown that some people can get shingles twice, or even three times and the risk of getting shingles again is about the same as the chances of getting them in the first place.
- Those who received Zostavax .