By Larry LaBenne, PharmD, CDE, Pharmacist, Penn Highlands Community Pharmacy
Shingles, or herpes zoster, is a painful rash that’s caused by reactivation of varicella zoster virus infection from a prior chickenpox infection.
After one gets chickenpox – usually as a child – the virus lies inactive in the nervous system and will reactivate years later as shingles.
Anyone with a prior history of chickenpox is at risk of developing shingles. However, the risk of developing shingles increases with age; the majority of shingles cases occur in those aged 60 or greater.
Although shingles can occur anywhere on the body, it most often occurs as a single patch or strip of blisters on the left or right side of the torso.
While shingles is not considered a life-threatening condition, it can be very painful and complications can arise. In some cases, shingles pain continues long after the rash disappears due to the virus causing damage to nerve fibers.
This condition is known as postherpetic neuralgia. Also, vision loss can result from shingles blisters occurring in or near the eye.
Two shingles vaccines are currently available: Zostavax and Shingrix. Zostavax has been available since 2006, and Shingrix since 2017.
Prior to the availability of Shingrix, many people received a dose of Zostavax and were told that one vaccination would offer lifetime protection.
However, Zostavax was later found to be only 51 percent effective at preventing shingles within the first year post-vaccination with the effectiveness level later declining to around 35 percent.
In contrast, Shingrix is considered to be at least 97 percent effective at preventing shingles and its complications, and so far, appears to retain most of its effectiveness in the years post-vaccination. Based on the apparent greater effectiveness of Shingrix, it is uniformly recommended for those at risk of shingles.
The Centers for Disease Control now recommends that adults aged 50 or older receive two doses of Shingrix with the second dose given two to six months after the first dose.
It is important to note that the two-dose series of Shingrix is also recommended for anyone who previously received a dose of Zostavax.
Shingrix is administered via the intramuscular route in the muscle just below the shoulder. By virtue of it being an intramuscular injection, tenderness at and around the injection site is often expected for a few days after vaccination.
Many people do report that the injection site tenderness with Shingrix is more pronounced versus other intramuscular injections.
Also noteworthy is about 10-20 percent of people also report mild and transient flu like symptoms lasting one to two days post-vaccination.
Regardless, all seem to agree that a few days of a localized ache or a couple days of mild flu symptoms is trivial compared to the pain that results from a shingles infection.
If you are interested, Shingrix is now available locally. For a while, Shingrix production wasn’t meeting demand. But it is back on local shelves.
The Penn Highlands Community Pharmacy in the DuBois Community Medical Building, South Main Street, DuBois, and McCabe Drug, Main Street, Reynoldsville, both offer the vaccine to those 50 and older, and most insurances cover the cost.