Should I Get the Zoster Vaccine

Should I Get the Zoster Vaccine


Herpes Zoster Vaccine is called Zostavax. It contains live attenuated (weakened) varicella virus 14x greater than regular varicella vaccines.  It is FDA-approved for patients ≥50years old though recommended for those ≥60years. 

A 2005 study at Harvard published in the New England Journal of Medicine showed the following: 
The Vaccinated group vs the Placebo Group (no vaccine given) had the following:
1. 51% fewer episodes of Zoster
2. Less severe outbreaks
3. 66% Less Post Herpetic Neuralgia



`
Herpes zoster, or Shingles, is the reactivation of hidden Chickenpox virus varicella–zoster virus (VZV) hiding in your nerve ganglia (senosry). The risks of getting Shingles increases with age. Increased age also increases the risk of a bad case as well. The incidence and severity of herpes zoster increase with advancing age; more than half of all persons in whom herpes zoster develops are older than 60 years. Complications occur in almost 50 percent of older persons with herpes zoster.3


The most frequent horribly debilitating complication is postherpetic neuralgia (PHN), a nerve-type of pain syndrome that persists or develops after the dermatomal rash has healed. The frequency and severity of postherpetic neuralgia also gets worse with increasing age. The pain and discomfort associated with herpes zoster can be prolonged and disabling, diminishing the patient’s quality of life and ability to function to a degree comparable to that in diseases such as congestive heart failure, myocardial infarction, diabetes mellitus type 2, and major depression. Antiviral therapy reduces the severity and duration of herpes zoster but does not prevent the development of postherpetic neuralgia. Postherpetic neuralgia may persist for years and in some patients, there is no relief. It can drive a patient to deep sadness, depression, and anxiety. 


Thus the vaccine is a good idea for most patients. I have had friends who have had Shingles in their 40’s and it was truly difficult on themselves and their family. You cannot get Shingles if you never had Chickenpox. There is a rare report of someone getting Shingles after the Chickenpox vaccine years later. 


References:

 2005 Jun 2;352(22):2271-84.

A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

Oxman MN1, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD, Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, Zhang JH, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA, Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE, Marques AR, Keay SK, Goodman RP, Cotton DJ, Gnann JW Jr, Loutit J, Holodniy M, Keitel WA, Crawford GE, Yeh SS, Lobo Z, Toney JF, Greenberg RN, Keller PM, Harbecke R, Hayward AR, Irwin MR, Kyriakides TC, Chan CY, Chan IS, Wang WW, Annunziato PW, Silber JL; Shingles Prevention Study Group.

Abstract

BACKGROUND:

The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella-zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults.

METHODS:

We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine (“zoster vaccine”). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia.

RESULTS:

More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild.

CONCLUSIONS:

The zoster vaccine markedly reduced morbidity from herpes zoster and postherpetic neuralgia among older adults.

Shopping Cart