Wednesday, June 5, 2013

Shingles Vaccine and Shingles (Herpes Zoster)

Shingles is caused by the same virus that causes chickenpox, varicella-zoster virus. After the symptoms of chickenpox have disappeared, the virus remains in a dormant state in the nerve tissues. When the immune system of a person who had chickenpox is compromised, then there is a potential of an outbreak of shingles.
I have not found a definitive explanation of what a compromised immune system is. Stress appears to be a factor but lots of people have stress yet not everyone has an outbreak of shingles. Earlier this week, I was diagnosed with shingles. My doctor asked me if I was having a lot of stress. Considering that my daughter had just received her MD and in a week my son will be hooded for his PhD, I didn't see that stress was a factor in my case.
I was given the shingles vaccine about 5 years ago. As friends and family learn that I have shingles, I heard many comments. The most common is "I thought the vaccine was supposed to prevent shingles."
Well, I am testimony that it does not. In fact having shingles does not prevent you from another outbreak. So what does the vaccine do?
  • Can help prevent an outbreak of shingles if you have had chickenpox.
  • Can help prevent a recurrence of shingles if you have had a previous outbreak of it.
  • Shorten the duration of the outbreak.
  • Affect the degree of pain during an outbreak.
  • Affect the incident of post-outbreak pain.
The articles that I read concerning shingles use the phrase "can prevent" not "will prevent." Apparently, the vaccine reduces the risk of developing shingles by 50%. That might not seem like a lot, but shingles is very painful and can pose some serious long term issues.
Before the shingles vaccine was introduced, I knew a few friends and relatives who had shingles. They all talked about the excruciating pain and how long it took to be pain free. The duration of pain and the severity of it seem to be what the vaccine helps. My doctor told me that it was most beneficial in preventing the pain that lasted after the blisters and scabs disappeared.
The vaccine is primarily available to people 50 or older because the incidence of shingles is much higher as you age. Apparently the number of people who had a bout of shingles in which the pain lasted months or even years increased markedly in the older population. This pain is called postherpetic neuralgia; meaning pain due to nerve damage from the herpes virus.
I couldn't tell from the articles I read what percentage of people who have an outbreak of shingles suffered postherpetic neuralgia. However, according to WebMD, over 50% of the cases of postherpetic neuralgia occur in people over 60.

Last weekend, I was having some strange pain in one spot on my right side but could find no evidence of a bruise, irritation, or sore. The next day, the pain near my armpit was worse and an area of pain appeared near my shoulder blade. When the pain turned from an ache to a tingling sensation, I suspected shingles.

I made an appointment with my doctor. A rash was just beginning to appear when she examined me. That turns out to be significant because the anti-viral drug is more effective if started within 72 hours of the appearance of the rash.

Although I am not a "happy camper," the pain and discomfort I am feeling is not unbearable. This is largely due to the fact I did have the shingles vaccine in combination with the medications that were prescribed for  me.

For more information regarding shingles, chickenpox, the vaccine and treatment for shingles, visit the CDC and WebMD web sites. Both sites have information regarding who should not receive the vaccine.

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