The Centers for Disease Control and Prevention urges people age 50 and older to get vaccinated for shingles…and that’s for very good reason, says rheumatology fellow Sharon Abada, MD, MPH. In addition to causing a painful, blistering rash, shingles can bring persistent nerve pain that lasts for months or years and, in rare cases, it can even be deadly.
In younger people, shingles can be triggered by psychological stress or sleep deprivation as well as by steroids and other medications that can weaken the immune system.
The characteristic shingles rash tends to form in a single line on one side of the chest or abdomen. The rash also can appear on the face or head, and in those cases, permanent vision or hearing loss can result.
People with severely compromised immune systems may be vulnerable to a potentially deadly form of shingles known as disseminated zoster, in which the brain and/or other organs are affected. In some cases, shingles can herald an underlying medical condition, including HIV infection, an autoimmune disease and even cancer.
If you develop a rash that might be shingles: Seek medical care immediately. The antiviral drugs acyclovir and valacyclovir can be highly effective against shingles, but they are most effective when given within three days of the onset of symptoms…and the sooner, the better.
Shingles Vaccine
The shingles vaccine, called Shringrix, is about 90% effective at preventing the disease. How it works: It blocks reactivation of the varicella zoster virus that most older people harbor in their bodies.
It’s smart to get the new shingles vaccine even if you were vaccinated against chickenpox in childhood and even if you received the vaccine known as Zostavax, which was discontinued in 2020 after Shringrix became available and Zostavax was shown to have only limited effectiveness and caused rare but serious side effects among some people.
The Shingrix vaccine is widely available in drugstores and doctor offices. Two shots are administered two to six months apart. Given the risk for short-term side effects including fatigue and soreness at the injection site, it’s best to schedule each shot on a day when you know you can rest the next day or two.
The vaccine is very safe and is highly effective at preventing shingles, but it is of no use against existing cases of shingles. The vaccine does not (and cannot) itself cause shingles because it does not contain any live virus.
Can You Get Shingles More Than Once?
Yes, so even if you’ve already had shingles, you should get the Shingrix vaccine. Patients who have had Shingles should wait for the rash to resolve completely before considering getting the vaccine. Each person should speak with his/her physician directly to discuss timing in such cases.
If you get the vaccine and still develop shingles, you will have milder symptoms for a shorter period. The vaccine has also been shown to significantly decrease risk for and severity of postherpectic neuralgia.
Another reason to get the vaccine: It protects others as well. While shingles itself isn’t contagious, people who have the disease can spread the varicella zoster virus to others, causing chickenpox in those who weren’t vaccinated in childhood.
If You Get Shingles…
To control shingles-related pain, including the persistent form of chronic pain known as postherpetic neuralgia that can last for months or even years, doctors commonly prescribe steroids such as prednisone or nerve stabilizers like gabapentin. You also can take ibuprofen, naproxen or another non-steroidal anti-inflammatory drug to manage pain.
Home remedies to ease shingles pain include cool compresses, oatmeal baths, calamine lotion, and lidocaine patches or gels. Also be sure to wear comfortable, loose clothing to reduce discomfort.
