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New Shingles Vaccine

by Mary Gallagher, RN, MSN, CCRN

May 1, 2019

IN OCTOBER 2017 the FDA approved a new shingles vaccine called Shingrix. This January, the Centers for Disease Control officially recommended adults 50 and older get the new vaccine instead of the previous vaccine, Zostavax.

Shingles, or herpes zoster, is caused by the varicella zoster virus, the same virus that causes chicken pox. After a person recovers from chicken pox, the virus stays dormant in the body. For reasons not fully known, the virus can reactivate years later and cause shingles. The painful shingles rash usually develops on one side of the body, often the face or the torso, and can lead to long-term nerve pain.

About one in three people in the United States will develop shingles during their lifetime. If you’ve had chicken pox, you are at risk. Mor e than 99 percent of Americans born before 1980 had chicken pox, even if they do not remember it.

Risk factors for shingles include stress, being older than 50, having certain diseases that weaken the immune system such as HIV/AIDS and cancer, undergoing cancer treatments and taking certain medications. The risk for shingles increases with age. Some experts estimate half the people age 80 and older will have shingles. Radiation or chemotherapy can lower your resistance to disease and may trigger shingles. Drugs designed to prevent rejection of transplanted organs can increase your risk, as can prolonged use of steroids such as prednisone.

One out of 10 people who contract shingles develop nerve pain which lasts for months or years after the rash goes away. This post-herpetic neuralgia is the most common complication of shingles. The pain from shingles has been compared to childbirth or passing a kidney stone. People describe the pain as excruciating, aching, burning, stabbing and shock-like sensations. The pain may lead to depression, anxiety, difficulty concentrating and weight loss.

Shingles can interfere with daily activities like dressing, bathing, eating, cooking, shopping and travel. Other serious complications involve the eyes, including blindness. Very rarely, shingles leads to pneumonia, hearing problems, brain inflammation and death.

While shingles is not contagious in the traditional sense, shingles patients can transmit chicken pox to a person who has never had the disease or been vaccinated. While the rash is active, avoid contact with newborns, pregnant women and those with weakened immune systems.

Avoid travel when you have shingles since you will be extremely uncomfortable. International travelers should be up to date on all routine vaccinations, in addition to any recommended or required travel vaccines. Many travelers face unnecessary risk by going abroad without available protection against chicken pox or shingles. Consult your primary care provider or a travel doctor before departure to discuss necessary vaccinations.

Shingrix proves the best way to protect yourself against shingles. It is more than 90 percent effective at preventing shingles and long-term nerve pain. The CDC recommend healthy adults 50 years and older get two doses of Shingrix, two to six months apart. If you received the shingles vaccine Zostavax in the past, you still need two doses of Shingrix. You can receive it at your health care provider’s office or your pharmacy. Discuss the vaccine with your provider or pharmacist. Call your insurance provider to see if it covers the cost.

The Shingrix vaccine is available in small quantities since the demand is so high. If your health care provider or pharmacy is out of Shingrix, search an online vaccine finder (shingrix.com/shingles-vaccine-locator.html) to find a provider with Shingrix. Contact pharmacies in your area and be placed on their waiting list for Shingrix if they do not have the vaccine in stock. If it is more than six months since your first dose of the vaccine, get the second dose as soon as possible. You do not need to restart the vaccine series.

After getting the Shingrix vaccine, most people have a sore arm, with redness and swelling at the injection site. Some feel tired and experience muscle pain, a headache, shivering, stomach pain or nausea. Take an over-thecounter pain medication, such as ibuprofen or acetaminophen, to ease the discomfort. If you get side effects after the first dose of Shingrix, you still should get the second dose for full protection.

Shingrix protection stays active above 85 percent for at least the first four years after your vaccination. There is no maximum age for receiving Shingrix. If you had shingles in the past, Shingrix can prevent reoccurrence. You do not need to wait a specific length of time after having shingles before receiving Shingrix; however, make sure the shingles rash has gone away before getting vaccinated. If you received Zostavax, wait at least eight weeks before receiving Shingrix.

Studies show Shingrix is safe; it does not contain a preservative containing mercury. The vaccine helps your body create a strong defense against shingles, and side effects last only two to three days. If you have questions about Shingrix, contact your health care provider.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.


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