A new shingles vaccine promises to prevent 90 percent of cases in people 50 and older. The vaccine called Shingrix was just licensed by the Food and Drug Administration last month and is already being recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices as the go-to vaccination for the prevention of the debilitating condition.
“This is good news for seniors,” said Dr. Violeta Mihailescu, a geriatrician with Novant Health Senior Care . “The new vaccine offers better protections for people older than 70. Not only did it reduce the incidence of shingles by 90 percent, it also decreased the severe pain associated with shingles by 89 percent.”
Shingles, also known as the herpes zoster virus, will affect nearly 1 in 3 Americans, the CDC says. Each year, an estimated 1 million people will get shingles and about half the cases occur in people 60 or older.
The virus that causes the chickenpox also causes shingles. Years after a person recovers from the common and highly contagious childhood ailment of chickenpox, the dormant virus can reactivate in a person’s body and trigger a shingles outbreak causing blistering rash that may cause chronic pain. And for some people, the pain can last for months, even years.
“Even after the blistering rash subsides, patients may have persistent pain and itchiness,” Mihailescu said. “Ideally, if we can treat the rash within the first 48 hours with an antiviral, we can prevent further complications.”
Since 2006, the CDC has recommended a vaccine called Zostavax to prevent shingles in people 50 and older. Overall, that vaccine is 51 percent effective in the prevention of shingles and 67 percent effective in reducing nerve pain in people older than 70 years of age. However, it also appears to lose its effectiveness in time. An analysis of patients 60 years old in a large health system revealed the effectiveness of Zostavax vaccine decreased from 68 percent in the first year to 4 percent in the eighth year.
The new Shingrix vaccine, on the other hand, provides better protection and is more than 90 percent effective for people in middle age and beyond. The CDC advisory panel is recommending the vaccine for Americans 50 and older to prevent shingles. Adults who had previously been vaccinated with Zostavax should receive the new vaccine too.
“Zostavax’s efficacy wanes after eight years which is one reason some providers preferred to postpone administering the shot to people in their 60s since it is a once-in-a-lifetime immunization,” Mihailescu said. She added that we don’t know whether the effectiveness of the new vaccine will wane after four years because it is too new.
Once the CDC director approves the panel’s recommendation it will become official policy.
The side effects of both vaccines are similar and mild in nature, although Zostavax, the older vaccine, occasionally may have more serious complications as it is a live attenuated vaccine. “Most patients described mild pain and temporary swelling at the injection site. Some complained of fatigue,” she said.
Even patients who have already had shingles would benefit from the new vaccine and should speak to their provider about getting the immunization when it becomes available.
One problem experts foresee with Shingrix is getting eligible adults to get the required number of shots. The vaccine requires two doses administered two months apart. Even with the current vaccine which requires only one shot, barely 31 percent of adults 60 and older have gotten vaccinated.
Another issue may be cost. Zostavax is an expensive vaccine and Shringrix will likely cost even more. For people that have medical insurance through work, call your insurance provider to check on the coverage and co-pays. For individuals on Medicare, Shingrix will probably be covered by Part D, although most of the Medicare patients may have to make copayments.
Your provider can administer the shingles vaccine at your next visit. If you need a provider, visit Novant Health.
