Shingles (Herpes Zoster) is a painful skin rash with blisters. One in five people develop chronic pain after the rash clears up. The shingles vaccine Zostavax contains a live virus and it sometimes causes shingles, chickenpox, or death in people with a weak immune system.
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Table of Contents for Shingles
How do you get shingles?
How many people get shingles every year?
What are the symptoms of shingles?
How soon do symptoms appear?
What are complications of shingles?
How is shingles treated?
How effective is the shingles vaccine?
What is the immunization schedule for shingles?
What are shingles vaccine names?
Shingles (Herpes Zoster) is a painful skin rash, often with blisters, that can cause chronic pain. Shingles is caused by the same virus that causes chickenpox, varicella zoster virus (VZV).
This virus stays inactive in the body for many years after a person recovers from chickenpox. Shingles occurs when the virus re-activates for unknown reasons. Instead of causing chickenpox, it causes shingles in adults.
Anyone can get shingles if they have had chickenpox or Zostavax®, a vaccine against shingles that contains a live varicella zoster virus. People with an active shingles rash can spread the virus through skin-to-skin contact and cause chickenpox in people who are not immune.
It is estimated that 1 million people develop shingles in the United States ever year. Approximately 30% of people will develop shingles if they are infected with the varicella zoster virus, either as a result of having chickenpox or a shingles vaccine with a live virus. People who get the vaccine tend to have a much less serious case of shingles.
Shingles starts with a painful skin rash and sometimes blisters that scab over in 3-5 days. The rash is usually on one side of the body, in a strip of skin, or clustered on one side of the face. The rash clears up in 2-4 weeks. Itching or tingling may occur before the rash develops.
The symptoms of shingles include:
- Itching or tingling
- Skin rash
- Blisters and scabs
- Body chills
- Upset stomach
It usually takes decades for symptoms of shingles to appear after a person has a natural chickenpox infection, but it can occur sooner in people who get the shingles vaccine Zostavax. Most case of shingles occur in people over the age of 60, but it can occur in children.
Shingles sometimes causes severe complications like pneumonia (lung infection), hearing loss (deafness), blindness, scarring, brain inflammation (encephalitis), Guillain-Barré Syndrome, Acute Disseminated Encephalomyelitis (ADEM), meningitis, stroke, or death.
About 20% of people who get shingles develop Post-Herpetic Neuralgia (PHN) after the rash clears up. PHN is nerve damage in the skin that causes persistent pain for months or years. The pain may extend beyond the borders of the rash. It can be excruciating, sharp, throbbing, and disabling. Older adults are more likely to develop PHN from shingles.
Antiviral medications can reduce the severity of a shingles skin rash if they are given within 24 to 72 hours of the appearance of the rash. Patients may also need pain medications.
Zostavax® is a shingles (Zoster) vaccine that was approved in May 2006 and developed by Merck & Co. It is a live attenuated vaccine, which means it contains a live virus that has been weakened. It is not safe for people with compromised immune systems because the live virus can cause a severe infection or death if the body can’t fight it off.
Zostavax reduces the risk of shingles by 51% in adults over 60 years old. In real numbers, that means 1.7% of patients who got Zostavax still got shingles vs. 3.3% of unvaccinated patients. Protection lasts for about 5 years. Zostavax is less effective in adults over 70 years old.
Zostvax was 41% effective in adults between 70-79 years old, and 18% effective in adults over 80. It also reduced the rate of Post-Herpetic Neuralgia in adults over 70 years old who developed shingles despite getting the vaccine.
The CDC recommends that adults over 60 years old should get a shingles vaccine, whether or not they remember having chickenpox.
- Zostavax® (Merck & Co.)
The vaccine reduces the risk of getting shingles by 50% and helps prevent painful nerve complications. However, the vaccine can also cause severe side effects, especially in people who are very sick.
The most commonly reported side effects of Zostavax were redness (36%), pain or tenderness (35%), swelling (26%), and itchiness (7%) where the shot was injected. Some people also develop a headache or a chickenpox-like rash near the place where they were vaccinated. This rash is contagious and it should be covered until it disappears.
Zostavax is a live vaccine and it should not be given to people who have a weak immune system or pregnant women.
Zostavax can potentially cause shingles, the exact same disease it is supposed to prevent. It is usually a less-serious illness, but there are reports of people who died of infections caused by the live virus in the Zostavax vaccine.
In August 2014, the FDA required Merck to add shingles and chickenpox to the list of Zostavax side effects. The FDA strengthened warnings about “infections and infestations” with the virus in the vaccine.