When I was in medical school I had a healthy 86-year-old patient whom I adored. She was hilarious and always came to clinic with more energy than the students. In my 4th year, she developed shingles and later, severe post-shingles pain (called post herpetic neuralgia).
In a few months she went from being an active, engaged member of the community to being bed-ridden on sedatives.
Unfortunately, she never recovered from the pain and died just before I graduated. Had it not been for the shingles, I’m sure she would still be going, keeping up with the latest class of med students.
Today there is a vaccine for shingles and the Center for Disease Control and Prevention recommends that everyone aged 60 years or older be vaccinated.
Herpes zoster (which is commonly called shingles) is reactivation of a chicken pox infection. Once you have chicken pox (or get the chicken pox vaccine) the virus lives dormant in your nerves for your entire life.
Instead of being an itchy blistering rash like chicken pox, shingles is a painful rash that forms along the tract of a nerve. It is almost always unilateral (affects only one side) and limited to a small area.
The rash lasts for a couple of weeks, but the pain, burning, or numbness can last years and can be incapacitating. Immediate treatment with oral antiviral drugs such as acyclovir or valacyclovir can stop the outbreak and minimize the pain and suffering. However, patients often wait several days to see a doctor or are misdiagnosed initially. In these cases, a full blown zoster outbreak might develop, and it is often too late to prevent post herpetic neuralgia pain.
The shingles (zoster) vaccine is a live virus vaccine, just like the chicken pox vaccine. It has been shown in studies to prevent or minimize the outbreak of shingles in adults. It’s also effective in reducing the severity and duration of the pain from shingles. It’s recommended for adults aged 60 or over, even if they have had shingles before (unlike chicken pox, it’s possible to get shingles multiple times). The vaccine does not treat an active outbreak nor does it treat post herpetic neuralgia; it only works to prevent complications.
Some people might have medical conditions that make them unable to get the vaccine; check with your physician to see if you are eligible.
If you read this post and are not sure if you should get vaccinated because you’re afraid the shot will be too painful, then trust me, you should be the first in line to get yours. The needle stick will be nothing compared to prolonged pain from shingles.
Post written by Jeffrey Benabio, MD. You might also like:
Photo credit: zmxncbv, Flickr.com