People aged 60 years and older are often urged to receive a vaccination for the shingles virus; however, with other vaccine policies in place, confusing instructions, and significant side effects, consumers are left unsure what is required.
For example, adults are urged to receive an annual flu shot, to receive the pneumococcal pneumonia vaccine at age 65, and to receive a tetanus booster shot once a decade, according to Harvard Health Publications, Harvard Medical School. Meanwhile, the Advisory Committee on Immunization Practices, the group that sets vaccine policy for Americans, issued its official recommendation for the shingles vaccine in 2008, which states that all Americans who are 60 years of age and older should be vaccinated, even if they have had the shingles (herpes zoster) previously.
This recommendation differs from the U.S. Food and Drug Administration- (FDA) approved instructions found in the package insert for the shingles vaccine, which does not offer advice either way. The Committee’s recommendation also conflicts with a question-and-answer sheet that was posted on the agency’s Web site when the vaccine was approved suggesting that the shingles vaccine is not necessary after an individual has had shingles previously because “it’s unlikely that people who have had shingles will suffer from them again.” Some research disagrees.
Meanwhile, physicians may be more inclined to urge their patients to receive the vaccine; however, insurance policies may not cover the shot in all circumstance. For example, according to Harvard Health Publications, Medicare Part B, which does cover flu shots and the pneumococcal vaccine, does not cover the shingles vaccine. Also, costs vary; however, with physician fees, the injection may cost patients several hundred dollars.
Shingles is caused by the varicella-zoster virus, the virus that causes chickenpox. Following a case of chickenpox, the varicella-zoster virus may lie dormant in the nerves that carry sensory signals, such as touch and pain to the spinal cord and brain. When the virus re-emerges, becoming active, nerves, skin, and other tissues become inflamed and serious damage to nerve tissue may occur, leading to long-lasting postherpetic neuralgia pain. The active virus may also cause pain and sensitivity with no rash, but with weakness in the arms and legs; inflammation of parts of the eyes; and, in some cases, Bell’s palsy.
Based on the Shingles Prevention Study involving 39,000 individuals—research which provided the FDA with the basis for its approval—revealed that the vaccine did not protect people from shingles in about half the cases, but did better prevent postherpetic neuralgia, which is a type of prolonged pain that develops and continues after the typical shingles rash disappears in about 10 to 15 percent of people diagnosed with shingles. In some cases, the shingles vaccine, which is made with a weakened shingles virus, has led to “live attenuated” vaccines that lead to shingles in rare cases.
According to Harvard Health Publications, there is a 50-50 likelihood that the shingles vaccine will prevent shingles and a 66 percent likelihood that the vaccine will prevent postherpetic neuralgia, which may be debilitating, lasting for months, even years. Some research suggests immunity from the vaccine wanes, so there may be recommendations for booster shots in the future. Today, adults receive one shot in the upper arm.
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The shingles vaccine is manufactured by Merck and sold under the brand name Zostavax. Zostavax and is manufactured with the same strain of the varicella-zoster virus (the Oka/Merck strain) as the chickenpox vaccine that children receive, but is no less than 14 times stronger, according to Harvard Health Publications.