Outcome Definitions And Follow
Our primary outcome was community HZ, defined by a claim in the OP or PB setting with an International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code for HZ in any position with a claim for HZ-specific antiviral , identified using NDCs, within 7 days of diagnosis. As a sensitivity analysis, we used this same clinical definition without requiring a prescription for antivirals. As secondary outcomes, we evaluated community ophthalmic zoster and PHN. We defined community OZ by a claim in the institutional OP or PB setting with an ICD-10 diagnosis code for OZ in any position , combined with a claim for a prescription for HZ-specific antivirals within 7 days of diagnosis. We defined PHN in the 90180 days after HZ onset using a modified version of the PHN algorithms from Klompas et al and Klein .
Follow-up continued until occurrence of any of the following: a subsequent claim for a third dose of RZV death termination of Medicare Parts A/B or D coverage or enrollment into Part C admission to a nursing home, skilled nursing facility or hospice occurrence of either HZ, OZ, or PHN or end of the study period.
Should You Get Shingrix If You Had The Zostavax Shingles Vaccine
It is recommended that you get two doses of Shingrix even if you got a different shingles vaccine in the past. Before Shingrix was approved, the Zostavax shingles vaccine was available. It was discontinued in November 2020 as Shingrix is much more effective. If you had the Zostavax vaccine, talk to your healthcare provider about getting 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.
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Data Sources And Study Design
The primary data sources were Medicare claims and enrollment databases. We derived demographic and death information from the enrollment databases and information on vaccinations, health covariates, preventive services, and outcomes from Medicare Part A , Part B , and Part D claims. Supplemental data on health-seeking attitudes and frailty conditions were captured from the Medicare Current Beneficiary Survey . We used a prospective cohort design with a study period from 1 November 2017 to 20 October 2019 .
When Should I Get The Second Dose
The CDC recommends that adults ages 50 and older get a second dose of Shingrix two to six months after their first dose. If youve waited longer than six months since your first dose of Shingrix, its safe to get a second dose right away. Most people dont need to repeat the first dose.
Some immunocompromised adults may need a second dose within one to two months. If you have a disease or are taking medication that affects your immune system, talk to your healthcare provider about the best timeline for your two doses of the shingles vaccine.
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Why Does Shingles Develop Under The Breast
Shingles can develop under the breast because of reactivation of the chicken pox virus from nerves around this area. Typically, the rash will appear on the torso and wrap around the body in a ribbon-like way. In some cases, the rash can be on the breasts and affect the areola, the area around the nipples.
Who’s Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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How To Know If You Have Shingles
SHINGLES. also known as herpes zoster, is a viral infection. 14. Shingles is the reactivation of the varicella zoster virus, the same virus that causes chickenpox. After a person gets chickenpox or is exposed to the varicella zoster virus, the virus stays asleep inside the body for life, usually not causing any problems or symptoms.
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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Contraindications And Precautions For Herpes Zoster Vaccination
Shingrix should not be administered to:
- A person with a history of severe allergic reaction, such as anaphylaxis, to any component of a vaccine or after a previous dose of Shingrix
- A person who is known to be seronegative for varicella
- It is not necessary to screen for a history of varicella. However, if a person is known to be varicella-negative via serologic testing, providers should follow ACIP guidelines for varicella vaccination.
Shingrix has not been studied in pregnant women or women who are breastfeeding. Providers should consider delaying Shingrix vaccination for these women.Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.To learn more, see Contraindications and Precautions, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices .
Who Should Not Get The Shingles Vaccine
Some people shouldnt get the shingles vaccine. These people include those:
- Who currently have shingles.
- Who have had a severe allergic reaction to the shingles vaccine in the past.
- Who have tested negative for immunity to the varicella-zoster virus, meaning youve never had chickenpox. If youve never had chickenpox, you should get the chickenpox vaccine.
- Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
- Who are pregnant or breastfeeding.
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Who Needs A Shingles Vaccine
Shingrix is recommended for adults aged 50 or older. You should still get the vaccine even if youve had shingles in the past, as it is possible to get it again.
You can also get Shingrix if you received Zostavax in the past. This is important because studies have shown that the efficacy of Zostavax over time.
Fever And Feelings Of Malaise
Fever is one of the most common side effects of many vaccines, including Shingrix. This symptom often accompanies other feelings of malaise, such as muscle pains, chills, and headaches. A fever indicates that the bodys immune system is doing its job of responding to the vaccine.
Ibuprofen, acetaminophen, and other OTC fever reducers can help keep a fever and many accompanying symptoms at bay. However, if you develop a high-grade fever of 103°F or higher, reach out to your doctor immediately.
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How Well Does Zostavax Work
Zostavax®, the shingles vaccine, reduced the risk of shingles by 51% and the risk of post-herpetic neuralgia by 67% based on a large study of more than 38,000 adults aged 60 years or older. Protection from shingles vaccine lasts about 5 years.
While the vaccine was most effective in people 60 through 69 years old, it also provides some protection for people 70 years old and older.
Adults vaccinated before age 60 years might not be protected later in life when the risk for shingles and its complications are greatest.
Study Population And Inclusion Criteria
To be included in the study, beneficiaries met the following criteria: alive and aged 65 years on the index date continuously enrolled in Medicare Part D for at least 12 months prior to the index date continuously enrolled in Medicare Parts A and B and not Part C for at least 15 months prior to the index date not in a nursing home, skilled nursing facility, or hospice on the index date and did not have a HZ diagnosis in the inpatient, institutional outpatient , or professional settings in the 1 year prior to the index date. To address concerns regarding potential confounding because of differences in prevention and healthy lifestyle, we further duplicated all analyses restricted to beneficiaries who had received an influenza vaccine between the start of the 20162017 influenza season and the index date.
Beneficiaries were classified into an autoimmune population if they consulted for any of the selected autoimmune conditions included at least twice in the 1 year prior to the index date. We adapted our autoimmune conditions definition from Cooper et al. 2009 , along with supporting literature .
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How Effective Is The Shingles Vaccine In Preventing Shingles
The shingles vaccine can provide strong protection against shingles and postherpetic neuralgia , the most commonly occurring shingles complication.
The shingles vaccine is 97% effective in preventing shingles in people ages 50 to 69 years old. Its 91% effective in people ages 70 years and older.
In addition, the shingles vaccine is 91% effective in preventing PHN in people ages 50 to 69 years old. Its 89% effective in people ages 70 years and older.
Tips For Managing Shingles Shot Side Effects
As mentioned earlier, most side effects go away in a couple days without any treatment.
Plan to take it easy for a couple days after each vaccine dose. Avoid unnecessary physical activity, including exercise, housework, and yard work. You may be advised to take an over-the-counter pain reliever, like acetaminophen or ibuprofen , to help with arm pain.
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What Does Shingles Under The Breast Look Like
A shingles rash under the breast appears as a long, broad strip around the torso. In the early stages, the rash may look flat or like raised blotches on the skin that are pink and red. When it is fully developed, the rash will:
- Be red but could be darker or the same color as the skin on people with dark skin tones
- Has fluid-filled blisters that form scabs
- Be painful, with pain often starting before the rash appears
- Have itchiness or tingling in the area before the rash develops
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Side Effects Requiring Immediate Medical Attention
Along with its needed effects, zoster vaccine, inactivated may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking zoster vaccine, inactivated:
Rare
- Ankle, knee, or great toe joint pain
- blindness
- fever greater than 39 degree Celsius
- joint stiffness or swelling
- lower back or side pain
- swollen, painful, or tender lymph glands in the neck, armpit, or groin
Incidence not known
- Hives, welts, or itching
- inability to move the arms and legs
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- redness of the skin
- sudden numbness and weakness in the arms and legs
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How Does The Shingles Vaccine Work
Shingrix is a recombinant vaccine: It is made in the lab using a protein found in the outer shell of the varicella-zoster virus. The vaccine prompts the body to produce an immune response against the virus protein. This way, the immune system will recognize and fight the virus when it reactivates in the body, preventing shingles. It does not contain a weakened form of the virus, like many vaccines do.
The largest clinical trial of the vaccine, which was done in 18 countries, found that it was 97.2% effective at preventing shingles in adults aged 50 years and older. In a later trial, completed at the same locations, vaccine efficacy was 89.8% in people 70 years of age and older.
In addition to preventing shingles from developing, the vaccine offers other benefits. The small percentage of people who got shingles after receiving the vaccine in clinical trials reported less pain than did those who got the disease and were not vaccinated. Additionally, the vaccine prevented shingles-related complications in all but one person.
You might have heard about a different shingles vaccine called Zostavax that was approved in 2006. But it is no longer available as of November 2020. Fortunately, Shingrix has higher efficacy than Zostavax.
Itchy Skin Near The Injection Site
Itchy skin, also called pruritus, can potentially occur near the injection site after receiving Shingrix. Itching, swelling, and redness arent usually a huge cause for concern, as they often occur together as a localized reaction.
Applying Benadryl gel or hydrocortisone cream around the injection area can help reduce itchy, swollen, or red skin. If the itching worsens or spreads away from the injection site, get in touch with your doctor.
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Who Should Not Get Zostavax
Some people should not get shingles vaccine :
The Shingles Prevention Study involved individuals age 60 years and older and found that Zostavax significantly reduced disease in this age group. The vaccine is currently recommended for persons 60 years of age and older.
- A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine. Tell your doctor if you have any severe allergies.
- A person who has a weakened immune system because of:
- HIV/AIDS or another disease that affects the immune system,
- treatment with drugs that affect the immune system, such as steroids,
- cancer treatment such as radiation or chemotherapy, or
- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
This information was taken from the Shingles Vaccine Information Statement dated 10/06/2009.
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.
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What Questions Should I Ask My Healthcare Provider
Its normal to have questions before you get a vaccine. Some common questions you may want to discuss with your healthcare provider include:
- When should I get the shingles vaccine?
- What side effects should I expect?
- How does the shingles vaccine work?
- When should I schedule each dose of the shingles vaccine?
- How effective is the shingles vaccine?
- Is there any reason I shouldnt get the shingles vaccine?
- What could happen if I dont get the shingles vaccine?
New Shingles Vaccine: What You Need To Know
Nov. 13, 2019 — Unlike some vaccines, thereâs been so much demand for the new shingles vaccineShingrix that itâs not always easy to find. It was approved in 2017, and the CDC recommends the vaccine for adults 50 and older to prevent this painful, blistering illness. It is being used in place of the previous vaccine, Zostavax.
More than a year later, doctors say they are learning more about how it works, its safety risks, and how it compares to Zostavax.
How effective is Shingrix?
âIt’s just remarkable,” says Wilbur Chen, MD, an associate professor of medicine at the Center for Vaccine Development and Global Health, University of Maryland School of Medicine. “It has performed better than I expected.”
In studies, Shingrix was more than 97% effective at preventing shingles in people 50 and older. It works just as well in older adults, who are at greater risk for a painful shingles complication called postherpetic neuralgia . “When 70- and 80-year-olds get shingles, it can be extremely debilitating,” Chen says.
By contrast, Zostavax cuts the risk of shingles by only 51% and PHN by 67%. It’s only about 38% effective in people over age 70.
How safe is Shingrix?
“So far so good,” Schaffner says. The main side effect is soreness in the arm where you get the shot.
Other side effects are mild and usually last for 2 to 3 days, including:
- Redness
- Stomach pain
- Nausea
Who shouldn’t get Shingrix?
Can I get the Shingrix vaccine now?
How do I pay for Shingrix?
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