By Mike DuBose with Surb Guram, MD
Many people don’t realize it, but the Federal Drug Administration (FDA) has recently approved a new vaccine that is 90% effective in preventing individuals from getting shingles. This is a great improvement over the previous option, which only worked about 50% of the time! Obtaining the new two-shot vaccination does not require a prescription. You can simply walk up and request it at most pharmacies!
If you’re in your mid-twenties or older, chances are high that you had chickenpox as a child. Before the chickenpox vaccine was introduced in 1995, four million people were diagnosed with chickenpox each year, with the majority being children aged 6-10. According to Parents magazine, 95% of American adults living today had chickenpox at some point in their childhoods.
For most of us, the itchy blisters that popped up all over our bodies as a result of the illness are a distant memory. But did you know that the source of chickenpox—the varicella zoster virus—it is active in the blood for our entire lives? Although it gives us immunity from future bouts of chickenpox, the virus also increases our vulnerability to shingles, an agonizing event mostly occurring in older individuals (although shingles can strike at any age!).
What is Shingles?
Shingles is a viral infection that causes a painful, itchy rash to appear on the body, with blisters that begin to scab over after 3-5 days. Secondary symptoms include nausea, headache, fever, body aches, fatigue, chills, and sensitivity to light. Before the rash surfaces, shingles sufferers may feel itching, pain, or tingling sensations in the area where it will occur. The pain varies by person and can be very severe for many people. Rarely, an individual may experience the pain of shingles without a rash developing.
Shingles can occur anywhere, including one’s face, but tend to form stripes of blisters on one side of the body. Usually, the rash dissipates after 2-4 weeks. In some cases, however, there are lasting results. Up to one in five shingles sufferers develops post-herpetic neuralgia, consistent pain or sensitivity in the area where the blisters appeared. The Mayo Clinic explains that post-herpetic neuralgia “occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain.” More rarely, people who have had shingles may experience loss of sight, hearing loss, or eye, skin, or brain infections related to the virus.
Who Is at Risk?
The Centers for Disease Control and Prevention (CDC) estimates that a whopping one-third of people will experience shingles at some point in their lifetimes. You must have been exposed to the chickenpox virus in your past to experience shingles (although not everyone who has had chickenpox will necessarily develop shingles). Fifty percent of cases occur in patients age 60 or older. This is because, as people age, their immune system declines, and having a weakened immune system makes it more likely that the virus will resurface. According to the National Institutes of Health (NIH), “The risk of getting shingles increases as a person gets older. People who have medical conditions that keep the immune system from working properly, like cancer, leukemia, lymphoma, and human immunodeficiency virus (HIV), or people who receive drugs that suppress the immune system, such as steroids and drugs given after organ transplantation, are also at greater risk.” Being under extended, intense stress can also increase the likelihood of a shingles outbreak.
How Can I Protect Myself?
If, like most adults, you have already had chickenpox, the best way to prevent shingles is to get vaccinated against it. Until recently, the only vaccine available was called Zostavax, and it reduced the risk of shingles by 51%. But in 2017, the Food and Drug Administration (FDA) approved a new vaccine, Shingrix. According to CDC studies, Shingrix is 90% effective in preventing shingles in patients who take both doses, with an 85% effectiveness rate for at least four years after the vaccination.
The CDC now recommends that all adults over age 50 obtain the Shingrix vaccine, even if you’ve already had the older, less effective Zostavax vaccine. Shingrix comes in the form of a shot given in the upper arm, then another shot 2-6 months later. The price will vary depending on your insurance provider (many will cover it), but for most people, even the cost of obtaining the vaccine without insurance coverage ($280 for both shots) would be worth it to avoid the agony of an itchy, painful, multi-week rash! Side effects are typically mild and may include soreness at the injection site, fatigue, and headache. They usually dissipate 2-5 days after the shot.
According to the NIH, there are some who should avoid taking Shingrix, including those who:
• have ever had a severe allergic reaction to any component of the vaccine or after an initial dose of Shingrix
• tested negative for immunity to varicella zoster virus
• currently have shingles
• are pregnant or breastfeeding
You can take Shingrix even if you’ve had shingles before; just make sure the rash has gone away first. Pregnant women should wait until they have given birth or have finished breastfeeding to receive the vaccine. Excitingly, Shingrix “may eventually be approved for those with compromised immunity, who are especially susceptible to a severe case of shingles,” as noted by Jane E. Brody of the New York Times. (This is because Shingrix employs a nonliving virus particle, versus the weakened but live virus contained in Zostavax.)
For adults who have never had chicken pox, the Mayo Clinic initially recommends getting the chickenpox vaccine, called Varivax. Unlike chickenpox, shingles is not contagious (although someone may get chickenpox after coming in contact with a person who has active shingles if he or she has never had it before). However, if you experienced chickenpox, even as an adult, you may develop shingles later in life. People typically only experience one episode of shingles, but rarely, second or third instances have been reported. This is another good reason to obtain the new version of the shingles vaccination.
If you think you may have contracted shingles, call your physician right away. Unfortunately, once you are having an outbreak, it cannot be wiped out with a pill. However, there are medications that your doctor can suggest or prescribe to shorten the length of your illness and reduce the pain and itching you will endure. He or she may prescribe acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir), and may recommend over-the-counter treatments like antihistamines or calamine lotion to help with the itchiness.
The bottom line: Having shingles is a painful experience that can mostly be prevented, thanks to a new, highly effective vaccine. Particularly if you’re 50 or older, we recommend that you visit your pharmacist right away to obtain the Shingrix shots and protect your health. After all, no prescription is needed, the vaccine is often covered by your insurance or Medicare Part D, and there are few side effects! This is one time where a little bit of prevention will go a long way to avoid much pain and suffering!
About the Authors: Our corporate and personal purpose is to “create opportunities to improve lives” by sharing our knowledge, research, experiences, successes, and mistakes. You can e-mail us at [email protected].
Mike DuBose received his graduate degree from the University of South Carolina and is the author of The Art of Building a Great Business. He has been in business since 1981 and is the owner of Research Associates, The Evaluation Group, Columbia Conference Center, and DuBose Fitness Center. Visit his nonprofit website www.mikedubose.com for a free copy of his book and additional business, travel, and personal articles, as well as health articles written with Dr. Surb Guram, MD.
Dr. Surb Guram, MD is a board-certified internist and a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC and has practiced internal medicine in the Midlands for the past 30 years. See www.scinternalmedicine.com for more information on Dr. Guram and his practice.
Katie Beck serves as Director of Communications for the DuBose Family of Companies. She graduated from the USC School of Journalism and Honors College.
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