Most people have heard of shingles, a painful rash caused by the chickenpox virus. Some have seen a commercial on tv or more likely know a friend or family member who has had shingles. After initial chicken pox infection as a child, the virus sits “dormant” or inactive in the spinal cord. If we all live until our mid 80s, then about half of us will get shingles. Typically, shingles is on one side of the body, usually the trunk. It starts as small spots that turn into “vesicles,” or raised bumps filled with clear liquid. It is very painful and lasts a few weeks. It can involve your eye or ear, sometimes causing visual or hearing loss. We usually treat the pain with acetaminophen or ibuprofen and in some cases even need narcotics. In an unlucky 10% of people, the pain stays in that spot for months, due to a “frying” of the nerve. This is called postherpetic neuralgia and is very difficult to treat with standard pain medications. It is often severe, requiring powerful narcotics and other neurological medications which have a side effect of heavy sedation.
Because of the high incidence of shingles and the painful nature of it, it is recommended that adults get the shingles vaccine. We have had a vaccine for shingles, called Zostavax, since 2006, but it is only 50% effective.
Fortunately, we now have a better shingles vaccine available. This new vaccine, Shingrix, is FDA approved for adults over 50. It was tested on over 30,000 people for over 3 years and found to be much more effective. For example, the effectiveness for the younger 50-59 year age range is over 90%. This wanes a little bit in older adults but still superior to Zostavax.
If you already got Zostavax, it is advised that you wait TWO MONTHS before you get your first dose of Shingrix. Unlike Zostavax, it’s not a live vaccine. The vaccine is 2 doses 2-6 months apart. There are more local side effects but they are self limited, lasting a few days at most, and are not severe (like redness, swelling, achiness).
Ask about Shingrix. For commercial insurers, this should be available and covered at your doctor’s office. For Medicare, it is often cheaper to get this at the pharmacy. It’s no secret that primary care providers value preventative medicine. We are lucky to add another effective vaccine to keep our patients healthy and help them avoid disease.