Vaccine prevents shingles in older adults

(Republished with permission from the St. Louis Post-Dispatch. This article originally ran in the Suburban Journals on Wednesday, July 5, 2006.)

Julie Randle
Of the Suburban Journals

If you’re at risk of shingles – and anyone who has ever had chicken pox is – there’s a new vaccine that can stop the virus before it ever appears.

The only catch is that the vaccine is only for those who are 60 or older, and it’s a bit pricey.

The U.S. Food and Drug Administration approved May 25 the use of Zostavax, a vaccine manufactured by Merck. The shot of vaccine can be given to healthy people ages 60 and older who have never had shingles.

“It’s given to prevent shingles,” said Dr. Lawrence Gelb, professor of medicine at Washington University School of Medicine. “It’s not a therapeutic vaccine; it’s a preventative vaccine.”

Zostavax is a live weakened virus that works by simulating an attack of shingles, minus the pain or blisters. This in turn boosts the body’s immune system against the virus, often preventing the natural outbreak of shingles, Gelb said.

“Only time will tell if it will be beneficial. It’s a significant advance in geriatrics because it will prevent half of the cases of shingles in this population and two-thirds of the lingering cases of pain,” he said.

Though the vaccine is available for use now, it hasn’t become a hot commodity. However, Gelb expects the use of the vaccine to drastically increase once the Advisory Committee on Influenza Practices (ACIP) establishes the recommendations for the use of Zostavax in the fall. ACIP is part of The Centers for Disease Control and Prevention, which provides suggestions for the use of influenza vaccine and antiviral agents.

In the U.S. more than 1 million cases of shingles occur each year, of which about 600,000 happen in individuals age 60 and older, Gelb said.

Shingles is a painful eruption of blisters localized on a patch of skin. In addition a rash may also appear. Shingles most commonly appears on the trunk of the body, followed next by the face, but it can occur anywhere on the body, he said.

The first sign of the condition may include burning or tingling pain in or under the skin. Other symptoms include chills, upset stomach, headaches or fever. Usually, the lesions heal in three to four weeks, but the pain can remain for weeks, months, years, even decades, Gelb said.

When shingles is in the acute stage it is treated with antivirals and as the lesions heal, narcotics, anticonvulsants and tricyclic antidepressants may be used to treat the pain.

Though shingles can strike at any age, it becomes more common as people age. The shingles virus is always present in the body, but as people stay healthy their immune system keeps it in check; therefore, it doesn’t effect most people until their immune system begins to break down.

According to The National Institute of Neurological Disorders and Stroke Web site, shingles originates from the same virus that causes chickenpox, the varicella-zoster virus. For an individual to develop shingles, they must have had chickenpox first.

If people are curious about the vaccine and want to know more about it, they should talk to their doctor, Gelb said.

“My thought is that there is no down side to taking it except the cost — $150,” he said.

Copyright 2006 St. Louis Post-Dispatch, Inc.