Who should receive the shingles vaccine?

Immunity decreses with age

More than 1 million cases are estimated to occur in the USA. The Elderly population is at risk because the immunity toVZV decreases with aging. More than 50% of people who reach age above 85 develop shingles at some point and 20 % of these patients develop postherptic neuralgia.

Is vaccination effective?

The shingles prevention study includeed more than 38,000 adults with median age of 69 years with a follow up for a mean of 3.13 years after receiving the vaccine. The vaccination significantly reduced the incidence of zoster by 51 %(p<.001), and the incidence of of postherptic neuralgia by 66%. The live attenuated vaccine did not result is acute shingles in vaccinated subjects. If lesions did occur, they were from the patient's own antive strain.

Is it imoportant that the vaccination decreases the incidence of postherptic neuralgia?

Yes. Antiviral therapy reduces the severity and duration of an episode of shingles but does not prevent postherptic neuralgia. Steroids also do not clearly prevent postherptic neuralgia. Steroids can only provide some pain relief during an acute episode when used with antiviral medications.

ZOSTAVAX

Manufactured by Merck and is the only vaccine available for use. It was approved by the FDA in May 2006 for prevention of herpes zoster in people age 60 and older. It must be kept frozen at all time until it is used. No booster is recommended at the present time. This vaccine is different from the Chicken Pox vaccine (Varivax) and should not be used as alternative. Zostavax is 14 times stronger than Varivax. They are both live attenuated vaccine from the same strain of the virus.