When she was 26 years old and pregnant with my brother, my mom broke out with red, itchy, blister-like spots and patches, mainly on her torso and back. Her doctor in rural South Dakota diagnosed with her German or “hard” measles, maybe chickenpox, or perhaps something called shingles. Each of those maladies has similar characteristics.
“Back in the mid-1960s we had never really heard of shingles or knew much about them,” she told me.
Her doctor prescribed some ointment to help with the itch and sent her home — pregnant and in agony. There was nothing more he could really do.
The chickenpox and shingles connection
At least 1 million people in the United States get shingles every year, a painful and often debilitating skin rash, that can cause blisters and scabs and take weeks to resolve, according to the Centers for Disease Control and Prevention.
Anyone who has ever had chickenpox can get shingles. That’s because shingles is caused by the varicella-zoster virus, which remains dormant in the body long after the last chickenpox has faded. It can become active again decades later.
The most common complication of shingles is postherpetic neuralgia (PHN), which causes severe and sometimes debilitating pain in the rash area and can last weeks or months — and occasionally years — after the rash has cleared. Other serious complications include vision loss, pneumonia, or inflammation of the brain (encephalitis).
The main symptom of shingles is pain, which can be severe, according to the Washington State Department of Health. Other symptoms of shingles can include:
- Upset stomach
The shingles vaccine may help
The first vaccine to protect against shingles was approved and licensed by the U.S. Food and Drug Administration in May 2006. Called Zostvax, it is not guaranteed to prevent the development of shingles, but the vaccine will reduce your risk by 51 percent, according to the Centers for Disease Control and Prevention, and cuts the risk of PHN by 67 percent.
Zostavax, given in one dose as a shot, is made by Merck and costs about $220.
In October 2017 the FDA approved another vaccine, a two-dose shot called Shingrix, made by GlaxoSmithKline. It will soon be available in the United States at a cost of $280. The new shot was recently approved in Canada for the prevention of shingles and is under review in the European Union, Australia, and Japan.
The CDC’s Advisory Committee on Immunization Practices in October 2017 recommended that the CDC endorse Shringrex over Zostavax. It also recommended that adults 50 and up get the vaccine (whereas Zostavax is recommended for people 60 and up).
Here’s what else you need to know about the shingles vaccine:
- The CDC recommends the vaccine for most adults age 60 and older, even those who have already had a bout of shingles.
Some experts say that people in their 50s should consider being vaccinated, but they may face the possibility of developing shingles later in life once the vaccine is no longer effective, and when complications may be more severe.
Zostavax is most effective for the first five years, although there may still be modest protective benefits for a few years after that.
Currently, there is no recommendation to administer booster shots to people; it’s therefore important to discuss any risk factors or concerns with your doctor about the timing of your vaccination.
If you don’t recall having chickenpox as a child, you should still get the shingles vaccine, the CDC says. More than 99 percent of people over 40 had chickenpox as young children, experts say, so chances are great that you had the disease. Even if you’ve had shingles before, the vaccine could help prevent a new case of it.
People who shouldn’t get the vaccine include those who are allergic to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine; have a condition that weakens their immune system, such as HIV, leukemia or lymphoma; are undergoing cancer treatment; are using high-dose corticosteroids; or may be pregnant.
Medicare Part D plans cover the vaccine, but there may be a cost to you depending on your plan. There may be a copay for the vaccine, or you may need to pay in full and then get reimbursed for a certain amount. To assure reimbursement, get your vaccination from a pharmacy instead of your doctor. You’ll still need to get a prescription from your doctor, but the pharmacy will bill your insurance company and you’ll pay the lowest out-of-pocket costs available under your plan.
Most private health insurance plans cover the vaccine for people 60 years of age or older.
How the shot helped my mom
At age 74, upon my urging, both my mom and my dad decided to finally get a shingles shot. Even though my mom may have had shingles decades earlier, she knew she could get them again. And she had no desire to live through that pain.
Still, four years later, my mom came down with shingles. They were on one side of her body — on her stomach, over her hip, and on back to her spine. The ailment lasted about six weeks, but she says it was not as bad as it could have been, and she believes the vaccine helped.
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