The Centers for Disease Control and Prevention (CDC) has recommended the herpes zoster vaccine for nearly everyone aged 60 and older, for the prevention of shingles.
But even though the vaccine was approved back in May 2006; and even through trials show it reduces shingles outbreaks by 50 percent and its most common complication (post-herpetic neuralgia) by two-thirds — this useful vaccine is still underused.
Shingles most often begins with an unexplained throbbing or burning pain in a localized area on one side of the chest or lower back. After a few days to weeks, a painful rash appears and evolves into pus-filled blisters. The rash is not contagious, but a bacterial infection can get a foothold inside the blisters.
Shingles affects about 1 million Americans every year, and between 10 percent and 20 percent of us will develop shingles during our lifetime. The incidence of shingles increases with age and is more frequent in people whose immune systems are weakened due to HIV infection, immunosuppressant treatment following an organ transplant, chemotherapy, and disorders like leukemia or lymphoma. People with a compromised immune system should not get this vaccine.
Shingles, caused by the same virus that causes chicken pox, can attack any of the 95 percent of adult Americans who have had the childhood illness. Though the pain and rash of shingles usually clear spontaneously within several weeks, the viral infection can damage nerves and lead to post-herpetic neuralgia, pain that persists for a month or longer after the disappearance of the rash. Post-herpetic neuralgia affects about 15 percent of people with shingles and is more common in older individuals.
The most serious complication, which affects almost 2 percent of people with shingles, is an infection of the nerve that supplies sensation to the eyes. This infection can lead to permanent loss of vision in the affected eye and to facial scarring.
The zoster vaccine (Zostavax®) is given as a single injection. Most insurance plans cover at least part of the $150 cost. Unfortunately, Medicare offers coverage under Part D rather than Part B, which means a higher cost for the vaccine.
