Betty Chaffee/ January 9, 2020/ immunization, Self management, vaccines/ 5 comments

The new Shingles vaccine, Shingrix, has been in short supply for the past year. It's starting to become more widely available, and the supply is expected to meet demand during 2020. If you're 50 years of age or older and you haven't been able to complete the two-shot series yet, or if you haven't even thought about getting vaccinated, now's the time to put it on your to-do list!

What is Shingles?

image of shingles rash on back and chestShingles is an infection caused by the same virus, varicella zoster, that causes chickenpox. Chickenpox tends to be an infection of children, though adolescents and adults can get it, too. But after chickenpox resolves, the virus may stay in the body. It hides away in nerve tissue, totally unnoticed, often for decades. Then the virus can reactivate by traveling down the nerve fibers and coming out as a painful skin rash. Typically it shows up in just one area of the body. Outbreaks are common along the torso and back on one side of the body, but they can happen along any group of nerve fibers, including the eye.

The first sign that many people experience is tingling or itching, sometimes with mild to severe pain. Then a rash may appear, which typically turns into water-filled blisters. The blisters dry up and crust over in a few days. Sometimes that's the end of trouble; other times pain along the affected nerve fibers continues for weeks to months, or longer. 

photo of shingles rash on chest

Shingles rash on chest

photo of ophthalmic shingles

Shingles rash on eyelid

It's estimated that about a third of people who have had chickenpox will develop shingles during their lifetime. The risk goes up after the age of 50, possibly due to weaker immune systems as people age. And though chickenpox infections can only happen once, shingles can happen again even to those who have already had it. Interestingly, if you're 50 years of age or older, even if you don't remember having had chickenpox as a child, you're at risk of getting shingles. Why? Because back then, children were so widely exposed to the chickenpox virus that it's unlikely we weren't infected, even if we didn't have symptoms. Experts believe that even those who think they never had chickenpox probably had a mild case, and are at risk of developing shingles over time.

The good news is that shingles can be prevented effectively with a vaccine.

Two shingles vaccines are currently available.

Zostavax was the first shingles vaccine, approved in 2006 for use in those over 60 years of age. Studies showed that it was about 50% effective in preventing shingles. More than that, it was about 67% effective in preventing the continued pain syndrome many suffer after the acute infection. When it was introduced, that level of protection was a huge step forward in preventing shingles and its long-lasting symptoms.

Shingrix, the new shingles vaccine, was approved in 2017 for use in people 50 years and older. It's been shown to be much more effective than Zostavax - upwards of 90% - in preventing both shingles outbreaks and the continued pain syndrome afterward. The improved efficacy makes it the preferred vaccine for most people. It's approved for use even in those who've already had Zostavax.

When Shingrix was first marketed in 2017, demand was immediate and high. So supplies ran short almost immediately. Over the past year many people found Shingrix to be unavailable at their usual pharmacy and gave up trying to find it. But the shortage appears to be over now, or will be very soon. 

If you're 50 years of age or older, plan to get your shingles vaccination in 2020

Shingrix is quite safe, with few side effects. Shingrix contains an ingredient (an "adjuvant") that boosts the efficacy of the vaccine, so pain at the injection site is a common side effect. It can be pretty uncomfortable for some, but typically resolves in a day or two. Because of the adjuvant, some people experience mild fever and body aches after the vaccination, but this side effect also resolves pretty quickly.

Two injections are required to provide adequate immunity, with the second injection due two to six months after the first. Some pharmacies will send you a reminder for that second injection, but mark it on your calendar to be sure. Call your pharmacy first to make sure they have it in stock and can give it to you without a prescription. Also check on your insurance coverage - most insurances cover this preventative vaccine, many without a copay, but it's best to know ahead of time. 

For more information about shingles, download a handout from the National Institute on Aging to read and share with others. 

As always, post your comments and questions below! Or contact us at BetterMyMeds for more information about Shingrix and other vaccinations.

 

 

Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
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5 Comments

  1. The article mentions that if you’ve had chicken pox as a child, the virus may stay in the body. Is there a simple test to know if that virus exists in the body?

    1. Tony,
      That’s a great question. Unfortunately, the answer is “no”. In researching shingles and chickenpox, I didn’t even see a mention of research in that area. Maybe because the virus lives in the nerves and any kind of testing would be too invasive? That’s just a wild guess. It sure would be nice if we could do a better job of predicting who’s at risk for shingles, but right now we’re stuck with just assuming everyone is at risk.

      1. Ugh. That’s what I was afraid of. I had a rash on my side that I thought may have been shingles but it really wasn’t that bothersome. Since we cannot find this virus and then get rid of it, I think I’ll take my chances with what may only be (in my case) its minor symptoms.

        1. Wellllllllll,….. you kind of can get “rid” of it, in the sense that you can make your body recognize it and defend itself if it comes back out again. That’s what the vaccine will do for you. It’s hard to say what your chances are of getting shingles again, but a second occurrence could still cause significant pain or other damage. Think about it, anyway. I had shingles years ago, too, but I’m still getting the vaccine. The episode I had wasn’t all that uncomfortable but it happened around the ophthalmic nerve so there was concern for my eye health.

          1. Good point. The areas around the eye, where singles can show up, is a scary thought. Thanks for this post.

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