Article written by Weston Malek
Almost 1 in 3 Americans will suffer from a severely painful condition as a result of a vaccine-preventable disease at some point in their lifetime. About 1 million cases occur in the United States each year, the majority in people over 60 years old. The disease with these alarming rates: shingles.
Shingles (also referred to as herpes zoster) is a painful, itchy, blistering rash that often develops in a stripe on one side of the body or face. Even though this rash typically clears up within a few weeks, the burning or stabbing pain can last for weeks to months after. This is called post-herpetic neuralgia (PHN) and the risk of developing PHN increases with age, especially in people over 60 years old. PHN alone can be debilitating, but shingles can also have other complications leading to vision problems or blindness.
The virus that causes shingles, varicella zoster virus (VZV), is the same virus that causes chickenpox. Most adults – and almost everyone born in the U.S. before 1980 – have been exposed to the virus, even if they do not remember ever having chickenpox. Shingles results from a reactivation of the virus later in life due to a weakening of the immune system with age, due to medical conditions that compromise the immune system (such as leukemia or HIV), or due to medications that suppress the immune system (such as steroids and other drugs used in rheumatologic disorders or after organ transplantation). People who had chickenpox younger than 18 months of age or who were exposed before birth are also at a higher risk of developing shingles.
Even though those at risk of shingles have already been infected with the virus, the best method of reducing shingles and PHN in adults is through vaccination. Since 2006, Zostavax® has been recommended for adults 60 years and older as a single-dose, live virus vaccine for shingles prevention. Zostavax reduces the risk of developing shingles by 51% and PHN by 67%. Unfortunately, people with weakened immune systems from medical conditions who are at the highest risk of developing shingles should not receive Zostavax because of the potential risk for complications from receiving a live virus vaccine. Additionally, shingles protection from Zostavax typically only lasts about 5 years, meaning that older adults will be at high risk again when immunity wanes.
On October 25, 2017, the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) endorsed use of a new vaccine, Shingrix®, as the preferred vaccine to prevent shingles. Our next blog will discuss the advantages of Shingrix and why everyone over 50 years old should consider getting vaccinated.
1. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C. Public Health Foundation, 2015.
2. GlaxoSmithKline. CDC’s Advisory Committee on Immunization Practices recommends Shingrix as the preferred vaccine for the prevention of shingles for adults aged 50 and up [press release] (2017 Oct 25) [cited 2017 Nov 29]. Available from: https://www.gsk.com/en-gb/media/press-releases/cdc-s-advisory-committee-on-immunization-practices-recommends-shingrix-as-the-preferred-vaccine-for-the-prevention-of-shingles-for-adults-aged-50-and-up/