Should I Get The Shingles Vaccine And If So When
A vaccine for shingles was approved by the FDA in 2006.The vaccine is currently approved for adults over the age of 50 but the American College of Physicians recommends waiting to vaccinate until the age of 60 to ensure that the vaccine is most effective when the complications from shingles can be more severe. As you age, your odds of developing a more serious case of shingles, as well as postherpetic neuralgia, increase.
After the age of 60, the shingles vaccine is 51 percent effective in preventing shingles and 67 percent effective in preventing postherpetic neuralgia. The protective effects of the vaccine diminish after five years, so the later you receive the vaccine the better chance you will have of protecting yourself. Those who still develop shingles after receiving the vaccine should experience less severe symptoms.
Approximately 4 percent of patients who develop shingles will experience a recurrence of the disease. If you have already experienced shingles, getting vaccinated may help you prevent a recurrence and should reduce the duration and severity of new symptoms should the disease recur.
Who Is At Risk For Shingles
Anyone who had chickenpox can develop shingles. As you age, the antibodies you developed to the chickenpox virus begin to fade. By the time you reach your 60s, you have few antibodies left to protect you. Any major health event can then lead to a reactivation of the virus.
Shingles is most likely to develop in someone whose immune system is compromised. This includes those suffering from such conditions as COPD, asthma, inflammatory bowel disease, kidney disease, rheumatoid arthritis, or another chronic condition. Medication that suppresses the immune system, such as radiation, chemotherapy or steroids, also puts individuals at increased risk. For some, age itself is the greatest risk factor. After the age of 50, the lifetime risk of developing shingles is 30 percent.
Shingles should be treated like any active viral infection. If you are experiencing active symptoms, its especially important to stay away from those with weakened immune systems and those who have never had chickenpox.
If You Were Never Vaccinated For Chicken Pox And Have Never Had Chicken Pox Can I Get Shingles Should I Be Vaccinated For Chicken Pox And Shingles
If youve never had chicken pox, no. If you did not get chicken pox as a child, dont get either vaccinations, it is likely that you are immune to the disease. Its very rare to give an adult the vaccine for chicken pox. Adults do not do well with childhood vaccinations because they can end up with complications.
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How Does The Shingles Vaccine Work
People with a weakened immune system cannot have live vaccines. They will be offered a non-live vaccine called Shingrix. It activates the immune system but also contains an ingredient called an adjuvant, which helps to boost the response to the vaccine.
Very occasionally, people develop chickenpox following shingles vaccination . Talk to a GP if this happens to you.
What Is Herpes Simplex Virus
HSV is a virus that can cause painful ulcers in your mouth or on your genitals. There are two main herpes simplex viruses HSV-1 and HSV-2. HSV-1 infections most commonly affect your mouth, but they may also result in sores on your genitals. HSV-2, on the other hand, primarily affects your genitals. In the U.S., over 50% of adults have HSV-1, and 15% of sexually active people have HSV-2.
Once youve been infected with HSV, the virus stays in your body long term, causing sores or blisters to appear periodically . In rare cases, it can cause life-threatening infections like meningitis and encephalitis.
When you think of herpesviruses, HSV is likely what comes to mind. But both types of HSV are actually part of a larger family of herpesviruses, including:
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Very Common And Common Adverse Events
Very common adverse events occur in 10% or more of vaccinees. Common adverse events occur in 1% to less than 10% of vaccinees.
Injection site reactions are very commonly reported for both LZV and RZV. For LZV recipients the frequency is slightly higher in adults aged < 60 years. For all ages, the majority of these events were rated mild or moderate in intensity and lasted less than 2 days.
Due to the adjuvant in RZV, which induces a high cellular immune response and helps address the natural age-related decline in immunity, RZV is more reactogenic than LZV.
Injection site AEs are very commonly reported by recipients of RZV. Approximately 80% report injection-site pain and approximately 30% report redness at the site of injection.
Systemic adverse events, primarily fatigue and myalgia are common in LZV recipients and very common in RZV recipients . For RZV, they include headache .
Local and systemic reactions that were severe enough to interfere with normal activities have been more frequently reported following the receipt of RZV than LZV. However, these reactions have been temporary . Patient education on the short-term reactogenicity of the RZV is recommended prior to vaccine administration to promote adherence to the second dose.
Who’s Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
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Herpes Zoster Vaccine: Canadian Immunization Guide
For health professionals
Last complete revision:
July 2018 This chapter was revised to reflect NACI’s Updated Recommendations on the Use of Herpes Zoster Vaccines. Most sections were revised to include information and practice recommendations for the new recombinant zoster vaccine which is now available in Canada. Changes include:
- Recommendations for use in different populations.
- Contraindications and precautions.
- Administration of the HZ vaccines: Table 1 was added to summarize key information.
- Considerations on the efficacy, effectiveness and immunogenicity of HZ vaccines: Table 2 was added to summarize key information.
- Vaccine safety and adverse events.
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report AEFIs through local public health officials and to follow AEFI reporting requirements that are specific to their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For LZV the following AEFIs are also of particular interest and should be reported:
- Suspected transmission of vaccine-strain virus to a close household or occupational contact. This phenomenon has been documented following varicella vaccine but it is rare, and transmission has not been documented with LZV.
- Recurrent HZ following immunization of individuals with a history of HZ prior to immunization, noting the area of recurrence.
- Recurrent HZO following immunization of a person who has had a previous episode of HZO. If available, a vitreous fluid specimen should be sent to a laboratory with a request to determine whether the virus is the vaccine strain or wild type virus.
For definitions of serious and unexpected adverse events, refer to Vaccine Safety in Part 2.
For more information refer to Reporting Adverse Events Following Immunization in Canada.
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What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects may affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
The shingles vaccine does not contain thimerosal .
Progesterone Hormonal Contraception And Herpes Infection In Women
A number of studies have shown that multiple aspects of immunity in the female genital tract are controlled by sex hormones, and hormones influence susceptibility to several sexually transmitted diseases, including HSV infection.
Evidence from animal studies has shown that treatment with female sex hormones had a significant impact on rates of HSV-2 transmission. Treatment with estradiol was found to confer some protection against vaginal HSV-2 infection in a mouse model, whereas progesterone was found to exacerbateviral infection and contributed to extensive inflammation.146-148 This may be because progesterone induces a diestrus-like state, during which mice are most susceptible to HSV-2 infection.149
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Why People Are Talking About Covid And Herpes
First, let’s talk about how the COVID vaccine became linked to herpes in the first place.
A recent study published in Rheumatologylooked at the effect of mRNA-based vaccines on patients with autoimmune inflammatory rheumatic diseases – a group of diseases that cause your immune system to attack your joints, muscles, bones, and organs, such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, and polymyositis.
The study reported that out of 491 patients with AIIRD, six adult women developed herpes zoster infections, aka shingles, within three to 14 days after receiving the Pfizer vaccine – five developed symptoms after their first dose and one after receiving the second dose. The researchers noted that these six women accounted for only 1.2 percent of the 491 patients with AIIRD involved in the study. Meanwhile, zero patients in the control group experienced a herpes zoster infection after vaccination.
The information was then published on April 20 in the New York Post, where it began making the rounds online. And though the study’s lead author, Victoria Furer, M.D., did tell the Jerusalem Postthat there’s no causal link between the two , she mentioned that the vaccine could be a “trigger” to patients with similar pre-existing conditions. And this was enough to create a little internet frenzy particularly among those who are already skeptical of getting the vaccine in the first place.
People Who Shouldnt Have The Vaccination
People who have weakened immune systems, for example due to cancer treatment, should not have the vaccine. Your doctor will advise whether this applies to you. Also, if youve had a severe reaction to any of the substances that go into the vaccine, you shouldnt have it. Again, your GP will advise you.
The shingles vaccine in use in the UK contains porcine gelatine. Some people may not want this vaccine but this is the only one available currently in the UK.
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About Dr Alpana Goswami
Dr. Alpana Goswami received her medical degree from Maulana Azad Medical College in New Delhi, India. She completed residencies at The Johns Hopkins Hospital and Greater Baltimore Medical Center. She is board certified in internal medicine and has a special focus on diabetes, hypertension, hyperlidemia, heart disease, obesity and fitness. Dr. Goswami previously served as the chair of internal medicine at Suburban Hospital.
When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people may have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
Shingrix causes a strong response in your immune system, so it may produce short-term side effects more intense than you are used to from other vaccines. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days.
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Shots May Help Prevent Genital Herpes Transmission
Three-shot regimen seems to control lesions as effectively as daily pills, but wider trials needed
Researchers tested the experimental vaccine in 310 people with herpes from 17 centers around the United States. The three shots, administered three weeks apart, appeared to reduce patients’ genital lesions and the process of “viral shedding” in which they can spread the disease through sexual contact.
Infectious disease experts hailed the vaccine as a promising development in the treatment of genital herpes. The incurable disease affects about one in every six people ages 14 to 49 in the United States, according to the U.S. Centers for Disease Control and Prevention.
“In general terms, people receiving have greater than 50 percent fewer days in which virus is present in their genital tracts, which in theory may reduce transmission,” said study author Jessica Baker Flechtner. She’s chief scientific officer at Genocea Biosciences, the Cambridge, Mass., manufacturer of the vaccine.
“However, this would need to be proven in a well-powered clinical trial,” she added. “Our trials have included both men and women, and to date, we have not seen a difference in the vaccine impact between genders.”
Patients were randomly split into seven dosing groups, including a placebo group.
Who Should Not Get Vaccinated
According to the CDC, some people should not be given the shingles vaccine, including those who:
- Have had allergic reactions to the vaccine
- Tested negative for varicella-zoster virus immunity
- Currently have shingles
- Have a severe or moderate illness that is considered acute, such as a respiratory infection
- Have a temperature of 101.3 degrees F or higher
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What Everyone Should Know About The Shingles Vaccine
Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix , separated by 2 to 6 months, to prevent shingles and the complications from the disease. Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.
Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated.
Who Should Not Get Shingrix
You should not get Shingrix if you:
- have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix
- tested negative for immunity to varicella zoster virus. If you test negative, you should get chickenpox vaccine.
- currently have shingles
- currently are pregnant or breastfeeding. Women who are pregnant or breastfeeding should wait to get Shingrix.
If you have a minor acute illness, such as a cold, you may get Shingrix. But if you have a moderate or severe acute illness, you should usually wait until you recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
The side effects of the Shingrix are temporary, and usually last 2 to 3 days. While you may experience pain for a few days after getting Shingrix, the pain will be less severe than having shingles and the complications from the disease.
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Who Is Eligible For The Vaccine
People aged 70 years of age are eligible for the vaccine.
The vaccine is also available for those previously eligible but who missed immunisation. For example, anyone in their 70s who has not yet had the vaccine.
You become eligible for the shingles vaccine as you turn 70 and remain eligible up to the age of 79.
People under 70 are at lower risk of shingles but will become eligible for the vaccine when they turn 70. People aged 80 years and over are not eligible for the shingles vaccination because the vaccine becomes less effective as people get older. If you are worried about shingles speak to your GP.
Dose Route Of Administration And Schedule
Live attenuated zoster vaccine
Each dose is 0.65 mL .
Route of administration
Each dose is 0.5 mL .
Route of administration
Intramuscular, into the deltoid region of the upper arm.
Administration of the RZV as a subcutaneous injection is a vaccine administration error and should be avoided. However, if Shingrix is inadvertently administered subcutaneously, that dose will be considered as valid in the vaccine series. The second dose will be given as per vaccine schedule.
For more information, refer to Vaccine Administration Practices in Part 1.
2 doses, 2 to 6 months apart. A 0,12 months schedule may be considered for improved adherence to the 2nd dose .
Providers should consider different strategies to promote adherence to the two dose schedule for RZV .
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