Submitted by Kerr Drug

Q: My wife recently had an outbreak of shingles. It was very painful for her, and now I am wondering if I should get the vaccination recommended for people 60 and over.

A: The Centers for Disease Control and Prevention (CDC) estimates that about one in three people will develop shingles in their lifetime—and that number increases if a person is over the age of 50.¹

Shingles affects each person differently. Some people will get a mild rash with tolerable pain that fades in a few weeks. Others may experience a rash with burning and unbearable pain; even after the rash is gone the pain may last for months.

The virus that causes chickenpox stays in the body and can re-emerge when the immune system is weakened, which results in the shingles. During an episode of shingles, a painful rash with blisters will usually develop on one side of the body. A person can also have fever, headache, and pain, which can be severe. After the rash disappears, about one in five people will have lingering pain. This pain can last months or even years.

If shingles is caught early, certain drugs can be used to shorten the length of illness. However, treatment for the residual pain can be hard and may not fully ease the pain. It is possible for people to have more than one episode of shingles.

Fortunately, a vaccine called Zostavax^® can help decrease your chances of getting shingles. This vaccine decreases a person’s chances of getting shingles by 50% and decreases the likelihood of having pain by 67%.² If someone does get shingles after receiving the vaccine, then the case can be less severe. Zostavax is not for treating a current outbreak of shingles or the pain after the rash is gone.

The shingles vaccine is given subcutaneously (an under-the-skin injection) in the back of the upper arm and has side effects that are similar to other vaccines. The most common side effects are redness and swelling at the injection site. Some patients may get a mild headache that can be treated with over-the-counter pain medications.

The shingles vaccine is called a “live” vaccine and should not be given to patients who have a fever. However, people who have a mild cold can still receive the vaccine. Although it is called a “live” vaccine, you cannot get the shingles from it. If you have the shingles, you cannot spread the shingles to another person. However, someone who has never had chickenpox could get chickenpox from someone with shingles.

Currently, the CDC recommends that adults over the age of 60 get the vaccine once in their lifetime, even if they have already had a case of shingles. In July of 2011, the Food and Drug Administration (FDA) approved the shingles vaccine for adults as young as 50 years of age. The shingles vaccine is not for everyone; people whose immune systems are weakened due to certain medications, cancer treatments, or disease states such as HIV/AIDS may not be eligible for the vaccine immediately. People who have severe reactions to gelatin or neomycin should not get the vaccine. Talk to a doctor about whether or not the shingles vaccine is right for you.

In North Carolina, the shingles vaccine can be given at participating pharmacies and requires a prescription from a doctor. The vaccine is kept frozen and requires special storage conditions. Once it is mixed, it is only good for 30 minutes, which is one reason most doctors’ offices may not carry it. Most Medicare Part D and private insurance plans will cover part of the vaccine cost. Despite the vaccine being available since 2006, many people who are eligible for the shingles vaccine have not received it. Ask your doctor or pharmacist for more information about the shingles vaccine.

 

References:

Shingles (herpes zoster) overview. cdc.gov/shingles/about/overview.html. Accessed December 2, 2011.

Centers for Disease Control and Prevention. Vaccine information sheet: shingles. U.S. Department of Health and Human Services. 10/6/09.

 

This month’s Ask the Pharmacist column was written by Karen Soong, PharmD Candidate, Abisoye Abisogun, PharmD, and Natasha Michaels, PharmD—Kerr Drug, 1106 Environ Way, Chapel Hill, NC.