Should you get the shingles vaccine?

HYANNIS – When my mother noticed a rash on the side of her nose, she assumed it was an irritation caused by the bridge of her eyeglasses. The rash spread, but what sent her to the doctor four days later was an excruciatingly painful headache.

My mother has rheumatoid arthritis and lives with unimaginable pain every day. She never complains, so when she showed up at my house in tears after a doctor’s appointment last winter I knew something was terribly wrong.

“I have shingles,” she said. “And it’s on the cornea of my eye. I could go blind.”

Her primary care physician at Brewster Medical Associates immediately made an appointment for her with an ophthalmologist, who she saw two hours later.

At 72, my mother was at the age that is a high risk of shingles, but it never occurred to her she would get them. Like many people, she assumed that the shingles vaccination Zostavax would protect her.

She was wrong. And that assumption caused her a lot of unnecessary pain.

“If you are not in the medical field, you don’t know about this until it happens to someone in your family,” said Mita Gupta, MD, at Oppenheim Primary Care in Chatham.

Cuts The Risk In Half

The shingles vaccine only cuts your risk of getting shingles by 50 percent, she explained. But it also decreases, by two-thirds, your risk of getting post-herpetic neuralgia, which is the painful syndrome after shingles are resolved.

“So if you still get shingles after the vaccine, you have a milder case of shingles,” Gupta said.

Shingles, also known as Herpes Zoster, is a painful skin rash that lasts for two to four weeks. The main symptom is pain, but sufferers may also experience fever, headaches, chills and an upset stomach.

The condition is caused by the Varicella Zoster virus, which is the same virus that causes chickenpox. The virus lies dormant near your spine and later in life can reactivate, causing shingles.

The Centers for Disease Control and Prevention estimates that at least 1 million people in the U.S. get shingles, most commonly after age 50. The risk increases with every decade of life and those with compromised immune systems are especially at risk.

Dr. Gupta recommends the vaccine for anyone over 60. My mother’s story is not unusual, she said. One of her patients had a spot on his cheek. He went to the dentist and was treated for a dental abscess. The next day he had an enormous shingles rash on his face.

Episode Is Cut Short

Floyd McIntyre, MD, a family practitioner in South Dennis, said he recently had a 68-year-old patient who had shingles despite getting the vaccine.

“People should be aware that you can still get shingles if you have the vaccine,” Dr. McIntyre said. “It’s a rash that’s in a line and it eventually turns into clusters of little blisters. If it’s in a line they should think about shingles.”

The difference between a bug bite or heat rash and shingles is that the pain comes before the rash—and it’s usually a shooting or stabbing pain. Time is of the essence when seeking treatment.

“If you prescribe anti-viral medication within the first 72 hours of the first sign of the shingles, it will lessen the episode,” Dr. Gupta said. “Even if people come in after 72 hours, I still give it because what else can you do? I feel like I need to do something.”

Shingles is contagious, but it doesn’t spread as shingles. It spreads as chicken pox. People with shingles should limit their contact with people who have never had the chicken pox, as well as pregnant women and babies.

The chicken pox vaccine Varicella is typically given to babies between the ages of 12 and 15 months, with a booster shot between ages 4 and 6.

Since Varicella contains weakened live varicella zoster virus, it is still possible, although rare, for those vaccinated to get shingles later in life.

My mother did not go blind, but a year later she still has lesions on her eye that require continuous monitoring by her ophthalmologist.

“I wish I had this information before I got the shingles,” she said. “I would have gone to the doctor earlier.”

By LAURIE HIGGINS, Cape Cod Health News

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