Vaccine Smarts
By Dr. Richard Rupp and Bridget Hawkins, Ph.D.

Dear Vaccine Smarts,

I recently turned 60. I told my doctor that I wanted to go ahead and get the shingles vaccine.

She wouldn’t give me the vaccine because I didn’t know if I ever had the chickenpox.

My mother is in her 90s and she is unlikely to remember which of her children had the chickenpox. What should I do?

Sandra,
Dickinson

Dear Sandra,
 

The varicella virus causes both chickenpox and the shingles. The symptoms of chickenpox include fever, headache, body aches and an itchy rash that last up to two weeks.

The rash consists of blisters in the mouth and on the skin that scab over. Nearly everyone caught chickenpox during childhood or young adulthood before the introduction of the chickenpox vaccine.

It is generally assumed that everyone born before 1980 had chickenpox.

After the chickenpox goes away, the varicella virus remains in the nerve roots for the rest of our lives.

Our immune system controls the virus and, for the most part, it remains quiet and doesn’t cause any problems.

If the immune system fails, the virus moves down the nerve from the root to infect the skin, causing blisters.

The medical term for the rash is herpes zoster, but it is better known as shingles.

Shingles can be a serious problem. Blindness can occur if the blisters form on the eye and cause scarring.

More commonly the nerve that the virus traveled down may become damaged and cause severe pain that lasts for months or even years.

The term for this type of pain is called neuralgia. People who think they may have shingles need to contact their physician. There are medications that can help treat shingles.

About a third of people who did not get the chickenpox vaccine will get shingles during their lifetime.

Sometimes it occurs in young people but most cases are in people older than 60 and those with weak immune systems from things like chemotherapy.

People who received the chickenpox vaccine are less likely to get shingles during their lifetime.

They may still get shingles, though, especially if they caught the natural or “wild type” varicella virus at some time during their lifetime.

People are most likely to have caught the wild type virus before they were vaccinated.

The shingles vaccine also is known as the zoster vaccine. The vaccine helps boost the immune system and keeps the virus in check.

It is a live virus vaccine, so people with certain immune system problems should not receive the vaccine.

We really aren’t sure why your physician asked you the question and didn’t give you the vaccine.

The recommendation from the Centers for Disease Control is that all adults 60 and older should receive a dose of the vaccine unless otherwise advised by their physician.

You should take the subject up with your doctor again. If you do not have an immune system problem, it is safe to get the vaccine regardless of whether you had the chickenpox.

Dr. Richard Rupp is a pediatrician and member of UTMB’s Sealy Center for Vaccine Development. Bridget Hawkins, Ph.D. is the assistant director of the SCVD. This column is supported by a UTMB President’s Cabinet Award to provide information about vaccines. Visit www.utmb.edu/scvd/vaccinesmarts or like us on Facebook.