The Sting of Shingles

If you’ve ever had chickenpox, you may be at risk for a painful disease called shingles as you grow older. Shingles is a sometimes-agonizing skin rash and nerve disease that’s caused by a virus. Fortunately, you can take steps to prevent shingles or ease its serious effects.

Shingles usually affects adults after age 50, although it can strike at any age. “In the U.S., the incidence of shingles is actually increasing,” says Dr. Jeffrey Cohen, an infectious disease researcher at NIH. “If you live to be 85 years old, you have a 50% chance of getting shingles.”

Shingles is caused by the varicella-zoster virus—the same virus that causes chickenpox. Once you’ve had chickenpox, the virus stays with you for life, hidden and inactive in your nerve cells. Your immune system helps keep chickenpox from returning. But later in life, the virus can re-emerge and cause shingles (also known as herpes zoster).

You can’t “catch” shingles from someone else. But it is possible for a person with a blistery shingles rash to pass on the varicella-zoster virus to someone who’s never had chickenpox or a chickenpox vaccine. If that happens, the other person would get chickenpox, not shingles.

Shingles may cause skin sensitivity ranging from mild itching to severe pain along with burning, tingling, or numbness. A rash with fluid-filled blisters nearly always appears on just one side of the body or face. The rash usually lasts for 7 to 10 days. Other symptoms may include chills, fever, upset stomach, and headache.

Shingles can lead to some serious problems. If it appears on your face, it can affect your hearing and vision. It may cause lasting eye damage or blindness. After the rash fades, the pain may linger for months or years, especially in older people. This lasting pain, called post-herpetic neuralgia, affects nearly 1 out of every 3 older people with shingles. The pain can be so severe that even the gentlest touch or breeze can feel excruciating.

To help prevent these problems, see your doctor at the first sign of shingles. Early treatment can shorten the length of infection and reduce the risk of serious complications.

To treat shingles, your doctor may prescribe antiviral drugs to help fight the varicella-zoster virus. Steroids can lessen pain and shorten the time you’re sick. Other types of medicines can also relieve pain.

Fortunately, a vaccine called Shingrix can help prevent shingles or decrease its severity.

Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia (PHN), the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine), separated by 2 to 6 months, to prevent shingles and the complications from the disease. Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.

Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated. Shingrix is the preferred vaccine, over Zostavax® (zoster vaccine live), a shingles vaccine in use since 2006. Zostavax may still be used to prevent shingles in healthy adults 60 years and older. For example, you could use Zostavax if a person is allergic to Shingrix, prefers Zostavax, or requests immediate vaccination and Shingrix is unavailable.

Who Should Get Shingrix?

Healthy adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. You should get Shingrix even if in the past you

• had shingles
• received Zostavax
• are not sure if you had chickenpox

There is no maximum age for getting Shingrix.

If you had shingles in the past, you can get Shingrix to help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.

You can get Shingrix whether or not you remember having had chickenpox in the past. Studies show that more than 99% of Americans 40 years and older have had chickenpox, even if they don’t remember having the disease. Chickenpox and shingles are related because they are caused by the same virus (varicella zoster virus). After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. It can reactivate years later and cause shingles.

If you had Zostavax in the recent past, you should wait at least eight weeks before getting Shingrix. Talk to your healthcare provider to determine the best time to get Shingrix. 

If you have questions about Shingrix, talk with your healthcare provider.

How Can I Pay For Shingrix?

 There are several ways shingles vaccine may be paid for:

 Medicare

• Medicare Part D plans cover the shingles 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 then get reimbursed for a certain amount.
• Medicare Part B does not cover the shingles vaccine.

Medicaid

• Medicaid may or may not cover the vaccine. Contact your insurer to find out.

 Private health insurance

• Many private health insurance plans will cover the vaccine, but there may be a cost to you depending on your plan. Contact your insurer to find out.

 Vaccine assistance programs

• Some pharmaceutical companies provide vaccines to eligible adults who cannot afford them. You may want to check with the vaccine manufacturer, GlaxoSmithKline, about Shingrix.

Source: NIH