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Shingles vaccine gets mixed reviews

August 11, 2009 12:00:00 AM PDT
Shingles is a condition that sends one million Americans to the doctor every year. The painful rash can lead to permanent nerve pain in the skin. The FDA recently approved a vaccine for the condition, but some doctors think its too early to add it to the yearly check-up.Fresh out of dental school, Dr. Mark Offenback thought it was just stress when a rash appeared on his side.

"We realized it was shingles when the blisters stopped at my sternum and stopped at my spine on the other side," said Dr. Offenback.

Bill Jones, 82, is still suffering from some side-effects of a case of shingles he contracted last November.

"There is still a lot of sensitivity," said Jones.

About one million people develop shingles every year, and half of those cases occur in people over 60.

The CDC recently issued a recommendation that all patients over 60 receive the newly-developed shingles vaccine. In a study, it reduced the risk of shingles by about half and the risk of lingering nerve pain by 67-percent.

"If the shingles vaccine was used to its full potential, it would prevent half of all shingles disease altogether," said Florida State University professor Dr. Michael Muszynski.

But insurance coverage of the vaccine is far from universal, and although research suggests it lasts up to six years, doctors don't yet know if a booster dose is needed.

"We don't know after four years, what happens," said Dr. Archana Shah from Winter Park Memorial Hospital.

Dr. Shah only recommends the shingles vaccine for her patients if they've had the condition at least once and have a healthy immune system. She says because the vaccine is new, many questions remain unanswered.

"We need more trials. We need more time," said Dr. Shah.

"I think the shingles vaccine has been underutilized. The risk-benefit ratio of the shingles vaccine is overwhelmingly in favor of giving the vaccine," said Dr. Muszynski.

Until everyone is onboard, a conversation with your doctor is the best place to start.

The vaccine was FDA approved in 2006 and is covered by some insurance companies for those over 60, but not for younger patients. It costs about $150 to $300 per patient.

Web Extra Information: Shingles Vaccine Debate

BACKGROUND:

Shingles, or herpes zoster, is a painful skin rash caused by the same virus that leads to chickenpox. The condition occurs when the virus -- already present in your system -- reactivates. The rash often appears on the trunk of the body such as a band of blisters around the back and chest. Blisters often accompany the rash, and they usually persist for about seven to 10 days. Besides pain, symptoms include fever, headache, chills and upset stomach. Very rarely, the condition can lead to pneumonia, hearing problems, blindness, brain inflammation or death. According to the Centers for Disease Control (CDC), about one out of every five people with shingles continues to experience pain after the rash clears up. This condition is called post-herpetic neuralgia.

TREATMENT:

Shingles is often treated with antiviral medication to reduce the severity and duration of the symptoms. They work best if started within the first three days of the rash. Doctors also sometimes recommend steroids to reduce pain, swelling and the risk of developing post-herpetic neuralgia.

PREVENTION:

If you have had chickenpox, you can't catch shingles from someone infected with it. However, you can catch chickenpox from someone with shingles if you come in direct contact with the blisters. Last year, the CDC made an official recommendation that adults 60 and older receive the vaccine against shingles. The CDC does not recommend the vaccine if you:

  • Have ever had a life-threatening allergic reaction to gelatin or the antibiotic neomycin
  • Have a weakened immune system because of HIV/AIDS or any other disease that affects the immune system; treatment with immuno-compromising drugs like steroids; cancer treatment like radiation or chemotherapy; or a history of cancer affecting the bone marrow or lymphatic system
  • Have active, untreated tuberculosis
  • Are pregnant, might be pregnant, or plan to become pregnant within three months after getting the vaccine
  • Are moderately or severely ill or have a temperature of 101.3 degrees Fahrenheit or higher
Although the CDC says the risk of the shingles vaccine causing serious harm is extremely small, about one in three people experience redness, soreness, swelling or itching at the injection site. In addition, about one in 70 people experience a headache after receiving the vaccine. People who have had shingles can receive the vaccine to prevent future occurrences of the condition.

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