Benefits and Side Effects of the Shingles Vaccine

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How does the new shingles vaccine compare to the previous one?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Adult vaccination can be thought of as a cornerstone of successful aging, but a major issue hampering the uptake of shingles vaccination is the lack of awareness of the disease. Shingles is caused by a reactivation of the chicken pox virus later in life. After your body beats back chicken pox, the virus hides in waiting in your spinal cord, waiting for an opportunity to strike back. When it does, the virus can surge forth, traveling along the path of a nerve branching off the spinal cord, wrapping around one side of the body to the front, producing skin blisters along the way in a characteristic belt-like pattern that does not cross the midline in front. (Both shingles and the name of the virus, zoster, are from the Latin and Greek, respectively, for “belt”).

The blistering rash can be intensely painful and leave scarring or discoloration behind but usually disappears in a few weeks on its own. However, approximately 30 to 50 percent of people suffer “postherpetic neuralgia,” persistent pain that can last for a year or more, that sometimes can be debilitating. Usually, it affects nerves around your trunk, but in 10 to 25 percent of cases, it can erupt across your face, which can lead to permanent facial muscle weakness, hearing loss, or blindness. As if that’s all not bad enough, having shingles as much as quintuples your odds of having a stroke over the subsequent few weeks, a risk that gradually declines over the following six to twelve months.

It’s surprising more people don’t know about it, since the lifetime risk of shingles is 30 percent––meaning nearly one in three will get it sometime in their lives. Young adults only have about a one in 1,000 chance of getting it every year, whereas in older adults that climbs to closer to one in 100 each year. That comes out to a million cases of shingles every year in the United States. Thankfully, there is a shingles vaccine.

The first became available in 2006, using a live weakened strain of the virus. The efficacy was only about 50 percent, and couldn’t be used in immunocompromised individuals, such as those with HIV or on immunosuppressive drugs, such as many on chemotherapy. Thankfully, in 2017, a recombinant shingles vaccine was approved, with a 90 to 97 percent efficacy for preventing an outbreak. It requires two separate injections 2 to 6 months apart and is expensive ($280), but covered by Medicare and most private insurance plans. It also can cause transient systemic symptoms, such as muscle aches, fatigue, headaches, or fever and chills serious enough to interfere with everyday activities about 10 percent of the time. But the new vaccine is considered so much more effective that it’s recommended for everyone starting at age 50, even if you were previously immunized with the old one. Given that the new vaccine is only about five years old, longer-term safety and efficacy data are still coming in, but, so far so good. As soon as I turned 50, I lined up for mine.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Adult vaccination can be thought of as a cornerstone of successful aging, but a major issue hampering the uptake of shingles vaccination is the lack of awareness of the disease. Shingles is caused by a reactivation of the chicken pox virus later in life. After your body beats back chicken pox, the virus hides in waiting in your spinal cord, waiting for an opportunity to strike back. When it does, the virus can surge forth, traveling along the path of a nerve branching off the spinal cord, wrapping around one side of the body to the front, producing skin blisters along the way in a characteristic belt-like pattern that does not cross the midline in front. (Both shingles and the name of the virus, zoster, are from the Latin and Greek, respectively, for “belt”).

The blistering rash can be intensely painful and leave scarring or discoloration behind but usually disappears in a few weeks on its own. However, approximately 30 to 50 percent of people suffer “postherpetic neuralgia,” persistent pain that can last for a year or more, that sometimes can be debilitating. Usually, it affects nerves around your trunk, but in 10 to 25 percent of cases, it can erupt across your face, which can lead to permanent facial muscle weakness, hearing loss, or blindness. As if that’s all not bad enough, having shingles as much as quintuples your odds of having a stroke over the subsequent few weeks, a risk that gradually declines over the following six to twelve months.

It’s surprising more people don’t know about it, since the lifetime risk of shingles is 30 percent––meaning nearly one in three will get it sometime in their lives. Young adults only have about a one in 1,000 chance of getting it every year, whereas in older adults that climbs to closer to one in 100 each year. That comes out to a million cases of shingles every year in the United States. Thankfully, there is a shingles vaccine.

The first became available in 2006, using a live weakened strain of the virus. The efficacy was only about 50 percent, and couldn’t be used in immunocompromised individuals, such as those with HIV or on immunosuppressive drugs, such as many on chemotherapy. Thankfully, in 2017, a recombinant shingles vaccine was approved, with a 90 to 97 percent efficacy for preventing an outbreak. It requires two separate injections 2 to 6 months apart and is expensive ($280), but covered by Medicare and most private insurance plans. It also can cause transient systemic symptoms, such as muscle aches, fatigue, headaches, or fever and chills serious enough to interfere with everyday activities about 10 percent of the time. But the new vaccine is considered so much more effective that it’s recommended for everyone starting at age 50, even if you were previously immunized with the old one. Given that the new vaccine is only about five years old, longer-term safety and efficacy data are still coming in, but, so far so good. As soon as I turned 50, I lined up for mine.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the last video in my series on vaccines. Be sure to watch the other two on the flu and pneumonia vaccines.

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