You get shingles when the virus that may have given you chickenpox when you were young becomes active again. Doctors don’t know why this happens. Show
When the virus wakes up, it causes itching and tingling feelings in your skin that can last up to 5 days. Then blisters appear on your body or face, often in a strip on one side of your body. You also may have a fever, an upset stomach, headaches, and chills. The rashes tend to go away within a month, but shingles can lead to long-term nerve damage and pain, especially in people over 50 or are immunocompromised. About 1 in 3 people in the US will get shingles in their lifetime, or about 1 million people a year. It can happen at any age, but you’re more likely to have it as you get older. That’s why doctors recommend a shingles vaccine for most people over 50. What vaccines can help prevent shingles?There is currently one vaccine available in the U.S. to prevent shingles. Shingrix (RZV) was approved in 2017 and it is more than 90% effective in preventing shingles. With Shingrix, you get two shots between 2 and 6 months apart and protection lasts an estimated 4-5 years. Doctors recommend it for healthy people over 50 as well as those 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy.. An earlier vaccine called Zostavax was removed from the market in 2020. That vaccine used a weak form of the chickenpox virus to send your body’s immune system into action to fight the disease. Shingrix does not. If you received the Zostavax vaccine, it is recommended that you also receive Shingrix. Should I get a vaccine?Doctors say most healthy people over 50 should get Shingrix, as well as anyone 19 or older who are immunocompromised. It’s available at pharmacies as well as doctors’ offices. Most people have been exposed to the chickenpox even if they didn’t actually develop symptoms. You should get the Shingrix vaccine unless:
Shingrix can make the area where you get the shot swell or feel sore. Other effects include: Younger people are more likely to have these side effects, and they typically last 2 or 3 days. It’s also possible to have an allergic reaction to an ingredient in the vaccine. If you have problems breathing, feel your face or throat swelling, or feel weak or dizzy after the shot, call 911 and get medical help right away. Can I get a shingles vaccine if I’m younger than 50?Yes. While Shingrix is approved generally for people 50 and older, the FDA has also approved its use for those aged 19 years and older who are or will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. Will Medicare or my health insurance pay for a shingles vaccine?Medicare Part D covers the cost of a shingles vaccine. If you have private health insurance, check your plan. Some insurers will pay for it after age 50 and others at 60. SOURCES: Shingles,” “Recombinant Shingles VIS,” “Shingles Vaccination,” “What Everyone Should Know about Zostavax.” American Family Physician: “Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.” U.S. Food and Drug Administration: “Approval letter for Shingrix,” “Patient Information about Zostavax.” Nov. 13, 2019 -- Unlike some vaccines, there’s been so much demand for the new shingles vaccine Shingrix that it’s not always easy to find. It was approved in 2017, and the CDC recommends the vaccine for adults 50 and older to prevent this painful, blistering illness. It is being used in place of the previous vaccine, Zostavax. More than a year later, doctors say they are learning more about how it works, its safety risks, and how it compares to Zostavax. How effective is Shingrix? “It's just remarkable," says Wilbur Chen, MD, an associate professor of medicine at the Center for Vaccine Development and Global Health, University of Maryland School of Medicine. "It has performed better than I expected." [Chen has a grant from GlaxoSmithKline, the company that makes Shingrix, but it's not related to the vaccine.] In studies, Shingrix was more than 97% effective at preventing shingles in people 50 and older. It works just as well in older adults, who are at greater risk for a painful shingles complication called postherpetic neuralgia (PHN). "When 70- and 80-year-olds get shingles, it can be extremely debilitating," Chen says. By contrast, Zostavax cuts the risk of shingles by only 51% and PHN by 67%. It's only about 38% effective in people over age 70. The effects of Shingrix last longer, too. Protection stays above 85% for 4 years after you get the vaccine. "At 4 years, there was very little to any [reduction] in the measure we use for protection," says William Schaffner, MD, an infectious disease specialist and professor of preventive medicine and infectious diseases at Vanderbilt University. "That was very different from the first vaccine, Zostavax because by that time, [protection] was already diminishing." How safe is Shingrix? "So far so good," Schaffner says. The main side effect is soreness in the arm where you get the shot. Other side effects are mild and usually last for 2 to 3 days, including:
"There have been no serious events associated with the vaccine that are specifically attributable to the vaccine," Schaffner says. But doctors will know more about the effects of Shingrix as time goes on. "The CDC is continuing to do, as they do with all new vaccines, a safety review." Who shouldn't get Shingrix? The vaccine is safe for healthy adults ages 50 and over. "That's a huge segment of the population," Schaffner says. The only people who should definitely not get this vaccine are pregnant women and anyone who has ever had a severe allergic reaction to Shingrix or any of its ingredients. The CDC's Advisory Committee on Immunization Practices (ACIP) hasn't confirmed whether the vaccine is safe for people who have a weakened immune system because of a disease or medicine. "The big concern among certain groups of doctors is that they don't want to evoke a reaction that might, for example, in a transplant patient result in a rejection of the transplant," Schaffner says. "They want to make absolutely sure the vaccine is safe." Another worry is that taking drugs that weaken the immune system might make the shingles vaccine less effective. ACIP is discussing how to give the vaccine to people with a weakened immune system. It's important for this group to be protected because they're at higher risk for shingles and its complications. Can I get the Shingrix vaccine now? You might have to wait. Due to higher-than-expected demand, Shingrix has been in short supply. GlaxoSmithKline has ramped up its production of the vaccine, and the company says it plans to significantly increase the number of available doses in 2019. "My sense is it's coming in, and so those folks who have waited or have been frustrated because it wasn't available should try again," Schaffner says. To help you find Shingrix in your area, GSK offers a shingles vaccine locator on its website. If Shingrix isn't available at your pharmacy, ask your doctor about getting the older Zostavax vaccine in the meantime. Just wait at least 8 weeks after getting Zostavax to have the Shingrix vaccine. What do doctors still need to learn about Shingrix? Future research will show how effective this vaccine is in special groups of people, like those with a weakened immune system. Also still unclear is how long Shingrix's protection will last. "We don't know if a person gets vaccinated at the age of 50, if we should give them a booster every 10 years, or every 15 to 20 years, or if no boosters are necessary," Chen says. How do I pay for Shingrix? Shingrix costs $280 for both shots. Under the Affordable Care Act, all Health Insurance Marketplace plans and most private health insurance plans will cover Shingrix with no deductibles or copayments -- as long as you get the vaccine from an in-network provider. Medicare covers the shingles vaccine under Part D, its prescription drug plan. But not everyone on Medicare has Part D, and some of these plans have copays and deductibles. GSK says the average out-of-pocket cost for people on Medicare Part D is about $50 per dose. Should you get Shingrix if you've already had shingles? Yes. Shingles can come back after you've had it. "There's a somewhat increased risk that you could get a second episode, so go ahead and get the vaccine," Schaffner says. Just wait until your rash and other symptoms have cleared. CDC: "About the Vaccine," "Shingrix Recommendations," "What Everyone Should Know About Shingles Vaccination (Shingrix)," "What Everyone Should Know About Zostavax." Michael Hogue, PharmD, professor of pharmacy, Samford University College of Health Sciences. William Schaffner, MD, infectious diseases specialist, Vanderbilt University. Kenneth Schmader, MD, professor of medicine; chief, division of geriatrics, Duke University Medical Center. Morbidity and Mortality Weekly Report: "Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines." |
How many shingles shots do you need
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