Shingles is a painful condition that usually causes a rash and blisters on the skin. It occurs when the herpes zoster virus reactivates in a nerve. This only occurs in those who have had chickenpox.
Chickenpox most commonly occurs in children and is caused by the varicella-zoster virus. The body creates antibodies that destroy the virus. Some viral bodies survive and move into the nerves, where they lie dormant. In some cases, the virus reactivates causing herpes zoster, or shingles. Postherpetic neuralgia is pain in the affected area that may last for months or years.
Herpes Zoster and the Shingles Vaccine
Shingles may be prevented with a vaccine. Zostavax® was tested "in a clinical trial involving more than 38,000 adults 60 years of age or older," according to the Centers for Disease Control (CDC). "The vaccine reduced the overall incidence of shingles by 51% and the incidence of [post-herpetic neuralgia] by 67%." Reddening of the skin, pain and tenderness, swelling, and itching are the side effects that were most likely to develop at the injection site.
The herpes zoster vaccine is a live virus that is injected beneath the skin. Unlike the hidden, dormant virus in the nerves, the injected virus can be more easily found by the immune system so that it can make antibodies.
Varicella Zoster and Immunity to Herpes Zoster
The CDC recommends that everyone who is at risk for shingles get vaccinated because recurrent episodes of shingles can and do happen; however, the U.S. Food and Drug Administration (FDA) reports, "An episode of shingles boosts immunity to the virus so it is unlikely that persons who have had shingles will suffer from them again. The effectiveness of Zostavax in preventing repeated episodes of shingles has not been demonstrated in clinical studies."
The CDC advises health care providers to administer the herpes zoster vaccine to anyone who is not sure whether they have had chickenpox because there is no recommendation against vaccinating those with no varicella-zoster history. The CDC does specify, however, that physicians should administer the varicella vaccine against chickenpox if a patient tests negative for varicella antibodies. A negative test for varicella antibodies proves that the patient either has not had chickenpox or has not had it bad enough to produce antibodies.
Contraindications for the Shingles Vaccine
The FDA advises against administering Zostavox to individuals who are allergic to gelatin, the antibiotic neomycin, or to any other component of the vaccine. Those who take immunosuppressing drugs, have immunocompromising diseases such as HIV, or who are otherwise immunocompromised should not use Zostavox.
The herpes zoster vaccine has been shown to decrease the incidence of shingles by 51% in those who have not had a prior case of herpes zoster. The vaccine has not been studied in those with previous episodes of shingles, so the effectiveness of the vaccine is unknown for repeated occurrences.
Related Articles
- Herpes Zoster (Shingles) Symptoms and Treatment
- How Chickenpox Causes Shingles (Herpes Zoster)
- The Non-Life of a Virus
Sources:
- "Herpes Zoster - Vaccine Q&As for Providers (Shingles)," Department of Health and Human Services Centers for Disease Control and Prevention (Accessed June 23, 2010)
- "Zostavax (Herpes Zoster Vaccine) Questions and Answers," U.S. Food and Drug Administration (Accessed June 23, 2010)
Diane Ursu - Diane Ursu joined Suite101 as a contributing writer in August 2009 and became a Feature Writer in January 2010. She is a freelance writer ...
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