Vaccine expert and pediatrician, Paul Offit, says the new shingles vaccine for adults is a godsend:

What’s remarkable about Shingrix is that it dramatically eases the pain and nervous system damage associated with shingles but seems to enhance the immune systems of the elderly.

Shingles occurs when chickenpox virus, which thrives silently in the nervous system after the initial infection, reawakens after hibernation and travels down a nerve root. The result is a rash that appears as a long, thin strip along the side of the body. Sometimes shingles causes a rash on the face; when it involves the eye, shingles can cause blindness. Every year in the United States about 1 million people develop shingles. During their lifetimes, 1 of every 3 people will suffer this disease, most after they are 60 years old.


“Shingles isn’t so bad,” said no sane person, ever:

In addition to weakened muscles, graying hair, and thinning skin, the human immune system also gets weaker and more vulnerable with age. That makes shingles especially painful and terrible for the elderly. The trademark rash, which usually resolves in about two weeks, isn’t even the worst symptom of shingles. About 90% of the time, the rash is preceded by a sharp, unrelenting, burning pain. Sometimes the pain lasts well after the rash has disappeared, for weeks and even months. This particular type of pain is called post-herpetic neuralgia, or PHN. Between 15% and 20% of people with shingles suffer PHN. Along with corneal abrasions, lower back pain, kidney stones, and labor and delivery, PHN is ranked the worst pains in medicine—so bad that it can lead to suicide.


As we learned in yesterday’s post, the new recombinant varicella zoster (shingles) vaccine, Shingrix, is preferred over the older live, attenuated Zostavax. Only about half (51%) of people 60 and older who receive Zostavax will be protected against shingles, and the protection diminishes as people age. By the age of 80 years old, Zostavax is only 18% effective in preventing shingles. Shingrix, says Dr. Offit, is so much better with age:

Shingrix’s protection rates are unprecedented in the world of immunizations—especially among the elderly. For those 50 to 59 years of age, 96.8% are protected; for those 60 to 69 years of age, it’s 97.4%, for those older than 70 to 79 years of age, it’s 97.9%; and for those older than 80 years of age, it’s 97.6%. From a medical perspective, it’s hard to find a medical product that works this well in people this age.


Like all vaccines, there are potential side effects:

That doesn’t mean Shingrix is a perfect vaccine. It comes with a host of side effects: local pain, redness, achiness, fatigue, fever, and swelling occur in the two days after the vaccine shot. Ninety-five percent of people who experienced these side effects, though, reported it didn’t interfere with their quality of life.


Most of these side effects are mild — certainly milder than any case of shingles.


*** On January 22, 2018, Pediatric Alliance and some of our pediatric colleagues from around the United States began participating in an 8-week AAP-sponsored immunization advocacy campaign on social media. Please follow all our social media posts during this project on Facebook and Twitter.


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