ASK THE DOCTOR - Shingles Vaccination

Question: “Two doctors have told me not to have the new shingles vaccination because I have already had shingles (about 4 years ago).  I've looked it up on the internet and this is never addressed.  Dr. Donohue (whose column is in the Riverside Press Enterprise) did say anyone over the age of 60 should have it, but didn't mention if people had already had shingles whether they should.”

Answer: The shingles is caused by the varicella-zoster virus, which is the same virus that causes the chickenpox. Once you have been infected with this virus, it can lie dormant in your body along the nerves for decades. During times of stress or weakness in the immune system, the virus can re-activate. When this happens, a series of small blisters develop along the path of the affected nerve. The blisters then eventually crust over, similar to the chickenpox, and ultimately the rash resolves.

Some people develop a severe burning pain with the shingles known as post herpetic neuralgia which may persist for months or years. Because 90% of adults have had the chickenpox, they are at risk of developing the shingles. The risk increases with age and one of every two people who reach the age of 85 will develop the shingles. Although there are treatments if the rash is caught early, they may fail to prevent the development of post herpetic neuralgia.

The Centers for Disease Control came out with a recommendation in May of this year that all adults over the age of 60, including those who have already had the shingles, should receive the vaccine. The ZOSTAVAX vaccine is not 100% effective at preventing the shingles but has been shown to reduce the risk of the shingles by over 50% and can also reduce the risk of post herpetic neuralgia by over 65%. ZOSTAVAX should not be withheld just because you have had the shingles; but individuals who are allergic to gelatin or neomycin should not receive this vaccine. It is also not recommended for patients with certain cancers or those taking chemotherapy.

ZOSTAVAX costs around $150 per dose; but may be covered in part by some insurance plans. Please check with your doctor for more information.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.