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Health & Medicine

2008-03-01 09:38:00

What is shingles and is there a vaccine?

Answer: Let me start by explaining what the shingles virus is. Shingles are caused by the same virus that causes chickenpox. The chickenpox virus stays inactive in certain nerves and can become active again, usually later in life causing the shingles virus to appear. Shingles are not contagious and it isn’t clear how or why the same virus that causes chickenpox can come back as shingles after being hidden in the nervous system for many years. There is a shingles vaccine that has been available for about a year now and yet very few people have received the shot. This vaccine is currently recommended for patients over the age of sixty that have never had an outbreak of shingles. That is a very large population of patients but for various reasons this shot has not been utilized in the way we thought it would. Shingles is a very serious disorder and is characterized by a skin rash, pain with burning or itching in the area of the rash. Many patients will present with pain and or itching first and then have the full blown outbreak of shingles in a few days. This disorder tends to follow the lines of nerves and thus we see evidence of the rash located on the chest, face and neck area generally in a linear fashion following the path of nerve distribution. Shingles cause a great deal of pain and discomfort at the time of outbreak and in many patients this discomfort will last forever. About one third of the patients who contract shingles will have persistent pain in the nerve distribution that can last for months and even years. This is known as Postherpetic Neuralgia, (PHN), a serious complication resulting from shingles. PHN can cause disability and a great deal of suffering in patients who develop this complication. Shingles may also involve the eye and even cause nerve damage about the face that can be devastating. Loss of vision is certainly another potential complication of shingles. Most people have either heard of shingles or know someone who has had the virus. The shingles vaccine that is currently available has a low incidence of complications and about an eighty percent success rate in preventing even a single episode of shingles. The vaccine is not covered by Medicare or many insurances at this time and costs a patient approximately $200.00. This is certainly a barrier for some patients and can hinder the widespread distribution of the vaccine. Furthermore, people continue to be worried about vaccines in general and specifically about a new vaccine that could cause harm to them. Even in patients that have received the vaccine, if an outbreak of shingles occurs, the vaccine seems to diminish the chance of getting Postherpetic Neuralgia. There are about one million new cases of shingles each year in the United States and half of those occur in patients over the age of sixty. I believe this vaccine makes a great deal of sense given these numbers. Furthermore, a significant number of people younger than sixty understand this preventive approach and are opting to pay to receive the shingles vaccine knowing that the benefits are twofold. First, the vaccine can potentially keep them from contracting shingles and second, if they do contract shingles, the vaccine can lessen the full blown complications of this virus. I recommend that if you have had an episode of chickenpox in the past or feel you are at risk for having shingles, you should talk to your doctor about having this vaccine. The cost of the vaccination is significant but pales in contrast to an episode of shingles.