Key Points To Remember
- Shingles can be very painful.
- The Centers for Disease Control and Prevention recommends two doses of the shingles vaccine for adults ages 50 and older.
- The vaccine greatly lowers your chances of getting shingles. If you get shingles anyway, you are less likely to have the long-term pain that can occur after shingles than if you hadn’t had the vaccine.
- If you’ve already had shingles, you are not likely to get it again. But some people do.
If I Develop Shingles How Long Does It Last And Are There Any Long
Active symptoms typically last an average of 10 to 15 days, although these symptoms can linger depending on how extensive the affected area is. Some people develop blisters that leak fluid before crusting over. Patients can also experience flu-like symptoms, including body aches, fever, chills, and fatigue. It typically takes four to six weeks for all the symptoms of shingles to resolve.
Postherpetic neuralgia is the worst complication of shingles and the risk of experiencing this complication increases with age. PHN is a severe nerve pain that can last from days or weeks to months or even years in extreme cases. Anyone whose rash occurs on the scalp, neck and shoulder area may be at an increased risk of experiencing PHN. While the majority of individuals who get shingles will not have PHN, it can be debilitating for those who do experience it.
Know Your Shingles Risk
You can get shingles at any age if youve had chickenpox.
But older adults and those who are immunocompromised get it most often. Two-thirds of shingles cases in Canada happen to people over 50 years old. The severity of shingles and its complications also increase with age.
Age is the most important risk factor.
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If I Have Shingles Now Can I Get Vaccinated
The shingles vaccine is used to prevent shingles and it will not help if you already have shingles. If you have shingles, it is recommended that you wait at least 1 year before getting the shingles vaccine. You can get shingles more than once in your life, so even if you have had shingles before, the shingles vaccine may help to prevent another shingles episode.
Is What My Internist Said Correct Should I Get The Shingles Vaccine And If So How Long Is The Vaccine Good For
No, you still need the vaccine, especially if they didnt prove it was shingles. Most people have no side effects from the shot, so unless you have another medical condition that compromises your immune system or have had a bad reaction in the past, there is no reason the side effects should scare you off. You should get the vaccine, definitely, if you are over 60.
Since the shingles vaccine is relatively new, how long the vaccine lasts is a question that’s still being studied. At this point we know the vaccine provides 5 years of protection at the very least, but it’s possible that you would only need to get it once in your life . By the time you would need a follow-up shot, the research will be much further along!
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How Do I Protect Myself From Shingles
The best protection from shingles is vaccination. People can still get shingles after receiving the varicella vaccine but they are 4 to 12 times less likely to do so than if they haven’t been immunized. The vaccine is recommended for most people 60 and older.
Some people should not receive the vaccine for example, those with certain allergies or who are taking certain medications. A health professional can advise who should not be vaccinated due to contraindications to the vaccine.
People between 50 and 59 years can request the vaccine from their health professional.
Side Effects And Counseling For Reactogenicity
In eight 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. Also, 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.
Healthcare providers should counsel patients about expected reactogenicity before administering Shingrix.
What to tell patients about the side effects of Shingrix:
Most people have a sore arm after they get Shingrix. Many people have redness and swelling on their arm spanning several inches where they got the shot. Many people also felt tired or experienced muscle pain, a headache, shivering, fever, stomach pain, or nausea. About 1 out of 6 people had symptoms severe enough to prevent them from doing regular activities. You should plan to avoid strenuous activities, such as yardwork or swimming, for a few days after vaccination. Remember that the pain from shingles can last a lifetime, and these side effects should only last 2 to 3 days.
The impact of prophylactic analgesics in conjunction with Shingrix has not been studied. However, you may suggest patients take over-the-counter ibuprofen or acetaminophen to ease discomfort from side effects.
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Why More Adults Arent Getting The Super
Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things. First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that singles can be incapacitating, causing severe pain that can really limit peoples functioning.
Whats more, difficulty in getting the vaccine may have discouraged those who sought out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.
Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.
Who Should Not Get The Shingles Vaccine
If you are getting Shingrix®, speak with your health care provider if you have had a life-threatening reaction to a previous dose of the vaccine or to any part of the vaccine.
If you are getting Zostavax® II, speak with a health care provider if you:
- Have had a life-threatening reaction to any part of the vaccine including gelatin or neomycin
- Have an immune system weakened by disease or medical treatment
- Have active, untreated tuberculosis
- Are pregnant or planning to become pregnant. Women should avoid becoming pregnant for 3 months after getting Zostavax® II
There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns, speak with your health care provider.
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Shingrix Dosage And Schedule
Shingrix should be administered to adults age 50 years and older as a two-dose series , 2 to 6 months apart .
If more than 6 months have elapsed since the first dose of Shingrix, you should administer the second dose as soon as possible. However, you do not need to restart the vaccine series.
If the second dose is given less than 4 weeks after the first dose, the second dose should be considered invalid. A valid second dose should be administered 2 months after the invalid dose .
Shingrix Vaccine Efficacy And Duration Of Protection
The efficacy of two doses of Shingrix for the prevention of herpes zoster was high among all age groups. In a clinical trial of more than 30,000 participants, vaccine efficacy was 96.6% in adults age 50 to 59 years, 97.4% in adults age 60 to 69 years, and 91.3% in adults age 70 years and older. Vaccine efficacy remained high in adults age 70 years and older, at or above 84.7% in all four years after vaccination.
The efficacy of two doses of Shingrix for the prevention of postherpetic neuralgia was high: 91.2% in adults age 50 years and older, and 88.8% in adults age 70 years and older.
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Mild Side Effects Of Shingles Vaccine:
- Redness, soreness, swelling, or itching at the site of the injection .
- Headache .
It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. There is no documentation of a person getting chickenpox from someone who has received the shingles vaccine .
Some people who get the shingles vaccine will develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.
Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems by CDC and FDA.
Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination. If you have a severe allergic reaction or other emergency that cant wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.
Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
The shingles vaccine does not contain thimerosal .
This information was taken directly from the Shingles Vaccine Information Statement dated 10/06/2009.
How Can I Get The Shingles Vaccine
You can buy the shingles vaccine at most pharmacies and travel clinics. Shingrix® is given as a series of 2 doses, 2 to 6 months apart, and costs about $150/dose. Zostavax® II is given as 1 dose and costs about $200. Some health insurance plans may cover the cost of the vaccine check with your provider.
If you buy the vaccine at a travel clinic, a doctor or nurse on site will be able to immunize you. Most pharmacists in B.C. are also able to immunize.
If you want to be immunized by your doctor, find out if they have a supply of the shingles vaccine.
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Where In The Body The Vaccination Is Given And How Many You Will Need
Like most vaccinations, the vaccine will be given in your upper arm. You will only have the vaccination once.
If you have the Zostavax vaccine, you will just need one injection. If you are not eligible for the live vaccine, you will need 2 doses of the Shingrix vaccine 2 months apart to give you the best protection. Once your course is completed, you will not need any more shingles vaccines.
Does The Vaccine Work
In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England . This showed that the shingles vaccine was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia in this period. Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period.
In the early 2000s researchers carried out a very large study of Zostavax, the shingles vaccine used in the UK, involving over 38,000 adults aged 60 or older. The results showed that:
- In adults aged between 60 and 70, the vaccine reduced the number of cases of shingles by 51.3%
- In adults aged over 70, the vaccine reduced the number of cases of shingles by 38%
- The vaccine reduced the incidence of post-herpetic neuralgia by over 66% in all age groups
- For those who did get shingles, the vaccine reduced the severity of the disease.
Read the abstract of this study , published in 2005 by Oxman et al.
Adults aged 80 or over are not offered the shingles vaccine. This is because the effectiveness of the vaccine declines with age in older age groups.
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People Who Shouldnt Have The Vaccination
There are 2 shingles vaccines available. One contains a weakened version of the live shingles virus.
The live vaccine is the one that is routinely used in the UK but people who have weakened immune systems, for example due to cancer treatment, should not have it. They should have the inactivated shingles vaccine. Your doctor will advise whether this applies to you. Further information is available on the Shingrix vaccine.
If youve had a severe reaction to any of the substances that go into the vaccine, you shouldnt have it. Again, your GP will advise you.
The live shingles vaccine used in the UK contains porcine gelatine. Some people may not want this vaccine but it is the recommended vaccine unless you cannot have it because you have a weakened immune system.
If you have the Zostavax vaccine, you will just need one injection. If you are not eligible for the live vaccine, you will need 2 doses of the Shingrix vaccine 2 months apart to give you the best protection. Once your course is completed, you will not need any more shingles vaccines.
Can A Person Who Is Living In The Same Household As Someone Who Is Immunosuppressed Or Pregnant Receive Shingles Vaccine
Yes, shingles vaccine can be given to adults in close contact with babies and children, pregnant women or people with weakened immune systems. There is an extremely small risk of a vaccine-related rash and the low possibility of wildtype varicella-zoster virus transmission. Discuss your concerns with your doctor.
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If You Were Never Vaccinated For Chicken Pox And Have Never Had Chicken Pox Can I Get Shingles Should I Be Vaccinated For Chicken Pox And Shingles
If youve never had chicken pox, no. If you did not get chicken pox as a child, dont get either vaccinations, it is likely that you are immune to the disease. Its very rare to give an adult the vaccine for chicken pox. Adults do not do well with childhood vaccinations because they can end up with complications.
Who Is At Risk For Shingles
Anyone who had chickenpox can develop shingles. As you age, the antibodies you developed to the chickenpox virus begin to fade. By the time you reach your 60s, you have few antibodies left to protect you. Any major health event can then lead to a reactivation of the virus.
Shingles is most likely to develop in someone whose immune system is compromised. This includes those suffering from such conditions as COPD, asthma, inflammatory bowel disease, kidney disease, rheumatoid arthritis, or another chronic condition. Medication that suppresses the immune system, such as radiation, chemotherapy or steroids, also puts individuals at increased risk. For some, age itself is the greatest risk factor. After the age of 50, the lifetime risk of developing shingles is 30 percent.
Shingles should be treated like any active viral infection. If you are experiencing active symptoms, its especially important to stay away from those with weakened immune systems and those who have never had chickenpox.
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How Do You Get Immunised Against Shingles
You can only get the shingles vaccine on its own, not as a combination vaccine. It is given as a needle.
Shingles vaccines include:
Note the Zostavax vaccine contains a small amount of the live virus. Some people may not be able to receive a live vaccine for medical reasons, please discuss with your doctor or immunisation provider for further information.
Dose Route Of Administration And Schedule
Live attenuated zoster vaccine
Dose
Each dose is 0.65 mL .
Route of administration
Each dose is 0.5 mL .
Route of administration
Intramuscular, into the deltoid region of the upper arm.
Administration of the RZV as a subcutaneous injection is a vaccine administration error and should be avoided. However, if Shingrix is inadvertently administered subcutaneously, that dose will be considered as valid in the vaccine series. The second dose will be given as per vaccine schedule.
For more information, refer to Vaccine Administration Practices in Part 1.
Schedule
2 doses, 2 to 6 months apart. A 0,12 months schedule may be considered for improved adherence to the 2nd dose .
Providers should consider different strategies to promote adherence to the two dose schedule for RZV .
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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.
If I’ve Had Shingles Already Can I Still Have The Shingles Vaccine
If you have had shingles before, you can still have the shingles vaccine. Your natural immunity is boosted by having shingles, but it is uncertain how long your immunity will last. If you have had shingles within the past year, your chances of getting shingles again soon is reduced, so it’s recommended that you wait at least 1 year before getting the shingles vaccine.
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