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Shingles prevention

October 19th, 2021

Shingles is a miserable disease, causing a rash, pain and fatigue. It can lead to chronic nerve pain and even loss of vision. Shingles affects up to 30% of the general population and about half of persons who reach age 85. A vaccine is now available in Australia to prevent this disease from 50 years of age. It is more than 90% effective and requires 2 doses 2-6 months apart.

Cause of Shingles

Shingles is caused by the chickenpox virus. This virus has the ability to “hide” in the nerves; that is, to lie dormant for many years after an attack of chickenpox in childhood. You don’t “catch” shingles in the same way as catching measles – it is always there in your body waiting for the immune system to be distracted. The symptoms are often precipitated by something that stresses your immune system (like a family tragedy, major illness such as cancer, and sometimes even travel)….those times when an attack of shingles is the last thing you need on top of everything else.

Shingles vaccines

The first shingles vaccine was a live vaccine. In Australia, this vaccine is still available free for persons over the age of 70. The original vaccine occasionally had troublesome side effects, especially in persons with a weakened immune system where it was very dangerous, but, like all technology, things improve over time.

The new shingles vaccine that has just become available in Australia is a ‘dead’ vaccine. It gives longer and better protection with fewer serious side effects. It has been registered in the world since 2006 but only came to Australia in June 2021. Over a million doses have been given in the US (not in the same league as COVID vaccine doses, of which over 6 billion have been given worldwide, but still an impressive number which means there are unlikely to be any surprises with this vaccine when it comes to side effects.)

Fast facts

The main points to be aware of with the new Shingles vaccine are:

  1. It is now recommended in persons from 50 years of age
  2. Recipients require 2 doses, between 2 and 6 months apart.
  3. Current information suggests it lasts at least 7 years – which is good since the vaccine costs about $289 per dose and you need two doses. Its upfront cost is high but it works out to be about $6.80 per month of protection.  Current data suggests it may protect people for twice as long.
  4. Side effects do occur after vaccination: 80% of recipients reported pain at the injection site, 30-40% reported swelling and redness. Additional reported side effects were fatigue, headache, muscle pain, and shivering which may last a few days in a few people. However, there are often fewer side effects as you get older.

I find that people who know a close friend or family member who have had shingles, are much more inclined to have the vaccine – they have seen firsthand how unpleasant this disease can be.

On a personal note, I have seen very nasty cases of shingles in my medical career, so I had my first dose on the day the vaccine arrived in the clinic.

 

Further information is below

CDC link to the symptoms of shingles is  here.

Pictures of shingles here and here.

National Centre for Immunisation Research and Surveillance Fact sheet is here

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