Question on Shingles

Dear Dr. Spence,
Would you please provide some information regarding the new vaccine for shingles?
Signed,
Imma Rash

Dear Imma,
I appreciate the question – this is a good opportunity to discuss several new vaccines that hit the market recently. First is the zostavax vaccine to prevent herpes zoster, or shingles. Herpes zoster is essentially a reactivated chicken pox virus. Nearly 99% of the population will test positive for antibodies to the chicken pox regardless of whether they had it or not. The virus remains dormant in the body for years then reappears along the course of a peripheral nerve. Shingles is an extremely painful condition associated with burning superficial skin pain and a horrible blistering rash. Many patients may develop a post-herpetic neuralgia, a chronic, often debilitating pain syndrome that remains long after the rash disappears. Zostavax is used in adults over the age of 60 to help prevent shingles. It contains a weakened chicken pox virus that can decrease your risk of developing shingles by an estimated 51%. Further, should a patient still develop shingles, the vaccine will help decrease the likelihood of developing post-herpetic neuralgia by 66% as well. One frequently asked question is whether the vaccine can be given to patients younger than 60 years of age or in those who have previously had shingles. Studies have not been performed to formally address these questions, but it is suspected that the vaccine may be effective in any age group (of course, insurance companies may not reimburse them). Secondly, the risk of getting shingles a second time is only 5%. Though not inherently harmful, the question that remains is whether $250 is worth dropping the risk of recurrence from 5% to 4%. The only side effects from vaccination are localized skin reactions (redness, pain, swelling, bruising) or headache. The second vaccine recently approved is gardasil, a vaccine geared towards girls and young women ages 9 through 26 to help prevent cervical cancer, precancerous lesions and genital warts. Again, though not studied, it appears to be both safe and effective for women older than 26. It may soon be approved for men as well to help prevent the spread of HPV (human papilloma virus), the virus believed responsible for causing cervical cancer. It is not known if the vaccine confers life-long protection or not. Preliminary data suggests that a booster may not be necessary. Time will tell.

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.