1. What is shingles?
Shingles, also known as zoster, is caused by varicella zoster virus, the same virus that causes chickenpox. Shingles is a painful rash that usually develops on one side of the body, often the face or upper body. The rash forms blisters that usually scab over in 7 to 10 days and clears up within 2 to 4 weeks. For some people the pain can last for months or even years after the rash goes away. This long-lasting pain is called post-herpetic neuralgia (PHN), and it is the most common complication of shingles.
The good news is that you can reduce your risk of shingles, which affects nearly 1 in 3 Americans in their lifetime, through vaccination.
2. Who should get the shingles shot?
Adults 60 years or older should receive the shingles vaccines known as ZOSTAVAX. The vaccine is also approved by the US Food and Drug Administration (FDA) for adults aged 50 to 59 years as it offers protection to this younger adult group.
However, the US Centers for Disease Control (CDC) does not currently have a recommendation for routine use of the shingles vaccine in this younger adult age group.
You should not get the shingles vaccine if you have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine.
The inactive ingredients in ZOSTAVAX are hydrolyzed porcine gelatin, sodium chloride, monosodium L-glutamate, sodium phosphate dibasic, potassium phosphate monobasic, potassium chloride and trace quantities of neomycin and bovine calf serum. The product contains no preservatives. Egg products are not listed by the manufacturer in the list of ingredients for ZOSTAVAX. Tell your health care provider if you have any severe allergies.
3. Can I get shingles under the age of 50 years?
Yes. Even though it is more common in older people, shingles can develop at an earlier age. Your risk of developing shingles can be higher if you have a weaker immune system because of illness or taking a medication that might suppress your immune system.
4. Can you get shingles after – or from – the shingles shot?
You cannot get shingles from the shingles vaccine. And according to the CDC, there’s no documentation of a person getting chickenpox from someone who has received the shingles vaccine.
The shingles vaccine doesn’t eliminate all cases of shingles. Studies show that the vaccine cuts the risk of shingles by about half in people over age 60. The cases of shingles that do occur in vaccinated people tend to be milder.
People can, however, develop shingles a second time. If it’s possible to get shingles more than once, why does a vaccine work at all? Merck’s medical director for adult vaccines, says that unlike most vaccines, which prime a person’s immune system to ward off a virus the first time it invades, “ZOSTAVAX boosts the immune system’s ability to keep the preexisting herpes infection in check, even though it never fully disappears.”
5. I’ve gotten the shingles shot already. Can and should I get it a second time?
A second or booster shot of the shingles vaccine is not currently recommended by CDC or the U.S. Advisory Committee on Immunization Practices (AICP).
However, the AICP notes that “the protection offered by the herpes zoster vaccine wanes within the first 5 years after vaccination, and duration of protection beyond 5 years is uncertain, it is unknown to what extent persons vaccinated before age 60 years will be protected as they age and their risk for herpes zoster and its complications increases.” This is something to discuss with your health care provider.
6. I’ve never had chickenpox. Should I get the vaccine?
Anyone 60 years of age or older should get the shingles vaccine, whether or not they remember having had chickenpox or not. Studies show that more than 99% of Americans ages 40 and older have had chickenpox, even if they don’t remember getting the disease.
7. Who should not get the shingles shot?
In addition to those who suffer from allergies noted above, the shingles vaccine should not be given to people with a history of primary or acquired immunodeficiency state, including leukemia, lymphoma, or other malignant neoplasm affecting the bone marrow or lymphatic system, or with acquired immunodeficiency syndrome or other clinical manifestation of infection with human immunodeficiency viruses; receiving immunosuppressive therapy, including high-dose corticosteroids; or who are or may be pregnant. I recommend you talk this over with your physician.
8. Do I need a doctor’s prescription in order to get a shingles shot at Walgreens or can I just walk in? When is a prescription needed?
It depends on state laws. In most states, pharmacists can give vaccines to patients through entering into practice agreements with physicians and by undergoing additional training leading to certification. These are known as collaborative drug therapy agreements and while laws and regulations vary state-to-state, this is a fairly common practice that expands access to many types of immunizations – including the shingles vaccine – without having to go to the doctor’s office.
You should check with your local pharmacy to find out if they offer the shingles vaccine.
9. Will my insurance or pharmacy plan cover the shot?
Medicare Part D covers the cost of the shingles vaccine. Check your plan benefits before getting the vaccine, since Medicare Part D rules vary. Your insurance company could also cover some or all of the cost, and some public health departments offer the shot at a reduced price.
Most private insurance plans cover the shingles vaccine – called Zostavax – for people over 60 years of age. The company that makes the shingles vaccine has a website with useful information on insurance coverage: merckvaccines.com/Products/Zostavax/Pages/reimbursement.
10. I’ve had shingles already. Should I get a shingles shot or not? Will the shot make my symptoms go away?
According to the US CDC: “even if you have had shingles, you can still receive the shingles vaccine to help prevent future occurrences of the disease. There is no specific time that you must wait after having shingles before receiving the shingles vaccine. The decision on when to get vaccinated should be made with your health care provider. Generally, a person should make sure that the shingles rash has disappeared before getting vaccinated. CDC recommends Zostavax for use in people 60 years old and older to prevent shingles.”
This is a one-time vaccination. There is no maximum age for getting the shingles vaccine.
If you currently have shingles, the shot will not make your symptoms go away. The vaccine can, however, help you avoid getting it again – but check with your healthcare professional on the timing of a shingles shot if you do have shingles now. If you have shingles, your doctor may want you to start treatment with antiviral medicines. Caught early enough, oral antiviral medications can shorten the course of the infection and reduce the chances of possible long-term complications.
Some useful information on how to reduce the pain of shingles can be found here:
webmd.com/skin-problems-and-treatments/shingles/shingles-home-treatment.
To summarize this WebMD article on how to take good care of skin sores:
- Avoid picking at and scratching blisters. If left alone, blisters will crust over and fall off naturally.
- Use cool, moist compresses if they help ease discomfort. Lotions, such as calamine, may be applied after wet compresses.
- Apply cornstarch or baking soda to help dry the sores so that they heal more quickly.
- Soak crusted sores with tap water or Burow’s solution to help clean away crusts, decrease oozing, and dry and soothe the skin.
- Ask your doctor about using topical creams to help relieve the inflammation caused by shingles.
- If your skin becomes infected, ask your doctor about prescription antibiotic creams or ointments. Check with your doctor.
Be well, stay well~
Pharmacist Andy
Andy Stergachis, Ph.D., R.Ph. is the Director of the Global Medicines Program at the University of Washington in Seattle and a subject expert on public health and pharmacy-related topics.
