The Most Agonizing Pain – Part II

More than 30% of Americans will be diagnosed with shingles…

The pain from shingles can last for years. And your risk of getting it increases as you age.

So it’s no wonder that our issue on shingles brought in dozens of questions and comments from our readers. This topic clearly resonated with you all and we appreciate the feedback.

Educating yourself is crucial. That’s why we’re dedicating this week’s Q&A to more questions about both shingles and its vaccine.

What topics are you most concerned about right now? Sending your suggestions and concerns to [email protected].

Q: Do you recommend a shingles vaccine even if one has had chickenpox as a youth? – P.F.

A: Yes. If you had chickenpox, you still have the virus in your body. That virus also causes shingles. So if you had chickenpox, you’re at risk for shingles.

The vaccine cuts your risk of shingles by about half, and also reduces the chance of developing nerve pain known as postherpetic neuralgia.

Q: If you never had chickenpox, how can you be sure that you do not have the virus? Can you get the shot without the virus? – R.L.

A: If you are unsure whether or not you had chickenpox or the chickenpox vaccine, talk to your doctor. He should recommend a viral test to see if you have antibodies to the chickenpox virus.

If you had chickenpox or received the vaccine, your body will have these chickenpox-specific antibodies. If you were never exposed, you won’t have any antibodies.

If you don’t have these antibodies, be very careful around children with chickenpox and around open blisters on shingles patients – you can contract chickenpox through both these forms.

And getting chickenpox as an adult is much worse than for children. Side effects like pneumonia complicate the disease in adults and recovery isn’t as fast. In fact, adults are 25% more likely to die from chickenpox. The good news is that about 90% of adults over the age of 40 today did have chickenpox, even they don’t remember it. If you want to be sure, ask for a viral test.

Q: I keep asking this question to a few different doctors and I don’t get a straight answer. I had a mild case of shingles in my late 40s. I’m now 55 years old. Can a person get shingles more than once? – J.M.

A: Often people think that shingles only strikes once in a lifetime, but several studies (including this one) show it can appear more than once. The chance of recurrence is about 6%.

However, your risk increases over time. The older you are, the more likely you are to develop shingles. Also, if you have a compromised immune system, you’re more at risk for shingles.

Q: I was wondering how long a shingles vaccine is good for? – C.H.

A: The full protection of the vaccine usually lasts about five years. After that, the effectiveness wears off as you age. If you had your shot five or more years ago, talk to your doctor about whether or not you should get a second one.

Q: I appreciated your write-up on shingles. Have you found a shingles vaccine that can be used for patients who are taking Humira, Enbrel, or other such biologics that suppress the immune system? I understand that the current shingles vaccine is a “live vaccine” and therefore unsuitable for such patients (as opposed to the flu vaccine which is not live).

I believe Merck is doing a trial on a new shingles vaccine that is also “not live” and can be administered to these folks… Is this or other such “non live” vaccines near to receiving FDA approval? If not, any further suggestions for those who cannot take the current vaccine? – M.N.

A: I love when readers teach us something. Yes, the live vaccine currently offered (Zostavax) is not safe for anyone on immunosuppressant drugs. That includes Humira, Enbrel, or chemotherapy drugs. A live vaccine means you get a living sample of the virus to allow your body’s immune system to build up resistance to it.

We read up on the new trials M.N. mentioned and found that GlaxoSmithKline is currently testing an inactivated vaccine on immunosuppressed patients. An inactivated vaccine means that they’ve taken the virus and killed it. Scientists then use parts of the virus – like its proteins – to build the vaccine.

Live virus vaccines carry with them the chance that the introduced virus could trigger a full-blown version of the disease (one of the reasons you may get shingles right after getting the vaccine). Inactivated viruses carry little risk of that happening because the virus in the vaccine is dead. However, the dead virus will elicit a weaker immune response, so you may not build full resistance with a single dose.

If it’s successful, their new vaccine could be available to folks who can’t get the live version. We’ll keep an eye on this story as it unfolds.

What We’re Reading…

  • Have any more questions about shingles or other medical topics? Send them to us right here.