Vaccine for adult shingles now available

The Food and Drug Administration in May 2006 announced the approval of Zostavax, the first vaccine for adult shingles.

The agency cleared the vaccine for use in adults age 60 and older. Studies showed it prevents shingles in about 51 percent of the population.

The vaccine, manufactured by Merck & Co. and slated for coverage under the Medicare Part D prescription program, is given in one dose and costs approximately $275, says Maria Dela Rosa, M.D., who practices at St. John’s Senior Health Center, which offers Zostavax.

Dr. Maria DelaRosa

“We highly recommend the vaccine because shingles is so common in the older adult population, and because it can be very painful and debilitating,” says Dr. Dela Rosa. “For those who get vaccinated but still get shingles, their outbreaks are usually less severe and with fewer long-lasting effects, such as nerve pain.”

There are approximately 50 million Americans over age 60. More than 95 percent had chickenpox as children, making them vulnerable to shingles. The illness causes a rash with painful blisters that usually lasts two to four weeks.

Shingles is treated with antiviral drugs and prescription pain medication during and shortly after the outbreak, but symptoms can persist long after the blisters have gone away, Dr. Dela Rosa says.

After the initial outbreak, nerve pain called postherpetic neuralgia can set in. This pain lasts anywhere from 30 days to several months or even years, and can be severe.

“We’ve had to refer many people to the pain clinic because the postherpetic neuralgia becomes a chronic condition,” Dr. Dela Rosa says.

Postherpetic neuralgia is more common in people older than 60. It occurs in less than 10 percent of people younger than 60 after a bout of shingles but in more than 40 percent of people older than 60.
Shingles is caused by varicella, the same virus that causes chickenpox, and occurs when the chickenpox virus lying dormant in nerve cells “wakes up” in older people or others with health problems. The vaccine is actually a boosted dose of the chickenpox vaccine currently given to children.

Who Should Not Be Vaccinated

Up to one in 10 older patients are not candidates for the vaccine because of weakened immune systems due to cancer therapy, organ transplants, HIV/AIDS, or other causes.
The vaccine contains live but weakened varicella virus that could overwhelm the immune systems of those patients, Dr. Dela Rosa added.