Vaccine Smarts
By Dr. Richard Rupp and Bridget Hawkins, Ph.D.
Dear VaccineSmarts,
My neighbor received the shingles vaccine in the past. She is currently suffering from a bad case of the shingles. Was there something wrong with the vaccine?
Larry
Hitchcock
Dear Larry,
Shingles is not like most other vaccine-preventable diseases. Most vaccines prevent illness by stopping germs from invading the body. In the case of shingles, the virus is already inside of us. The virus that causes shingles is the same one that causes chickenpox. After having had chickenpox, the virus remains in some of the nerve roots. If a person’s immunity to chickenpox begins to decline, the virus comes down the nerves and infects the overlying skin causing the blistering rash known as shingles. The vaccine works by boosting the immune system.
Shingles does not spread from person to person, although an individual with shingles can transmit the virus to an uninfected person. That person will develop chickenpox and be at risk for shingles later in life.
Shingles can occur just about anywhere on the body. Usually it occurs on the trunk but can occur on the face or eye as well. The rash on the eye can lead to blindness. Stabbing or burning pain can precede the rash by a few days. The rash usually heals within four weeks. Some people develop chronic inflammation or damage of the nerves, resulting in pain that may last from months to years.
There are about a million cases of the shingles in the United States each year. Studies using blood tests show that essentially all adults have had chickenpox and harbor the virus. Age is the biggest risk factor for developing shingles. Over half the cases occur in adults over 60. Studies indicate that about half of all people who reach 85 will have had shingles. That’s probably a result of our immune system weakening as we age.
The shingles vaccine is licensed for people over 50 and recommended for routine use for people over 60. Individuals who are immunosuppressed should not get the vaccine.
So, what happened in the case of your neighbor? The vaccine reduces the chance of developing shingles by about half in people over 50. In those vaccinated who still develop shingles, the vaccine cuts the chance of developing chronic pain by nearly 40 percent. It is very important that individuals, who think they may have shingles, vaccinated or not, contact their medical provider right away. If it is shingles, their provider should prescribe medication to limit the rash and decrease the chance of developing chronic pain.
Maybe someday we will have a better vaccine. It seems to us that cutting the chance of getting shingles in half and further decreasing the chance of post-shingles pain makes the vaccine worthwhile.
Vaccine Smarts is a UTMB column from the Sealy Center for Vaccine Development dedicated to answering questions about vaccines. The column is published in the Galveston Daily News.
For more information, email vaccine.smarts@utmb.edu or check out the VaccineSmarts Facebook page or follow us on Twitter @VaccineSmarts.
Dr. Richard Rupp is a pediatrician and member of UTMB’s Sealy Center for Vaccine Development. Bridget Hawkins, Ph.D., is an associate profesor of anesthesiology and a member of the Sealy Center for Vaccine Development. This column is supported by a UTMB President’s Cabinet Award to provide information about vaccines. Visit www.utmb.edu/scvd/vaccinesmarts.