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Shingles vaccination

Q. I know lots of people who have had shingles, and I hear there is a vaccination to prevent this condition. Does it work? Is it safe?

A. Shingles is a localized recurrence of the chickenpox virus. It causes a painful rash that usually lasts seven to 10 days, and affects about 20% of people during their lifetimes. In 10% to 15% of people who develop shingles (about 2% to 3% of the general population), the pain lingers for two to three months. This is called post-herpetic neuralgia (PHN). Even less common (1% to 2% of people with shingles) are complications in the eye, ear, or nervous system. There is now a vaccine, called Zostavax, to prevent shingles. Zostavax is safe for healthy people, but not for anyone on chemotherapy or who has a weakened immune system.

Zostavax was approved in 2006. In a study of people over the age of 60, it decreased the risk of developing shingles by 50% over a three-year period. In absolute terms, vaccination reduced the risk of developing shingles from about seven in 200 unvaccinated people to about three in 200. More importantly, the vaccine also prevented PHN—the less common but more prolonged and painful form of shingles. Vaccination reduced the chance of developing PHN from four in 1,000 to one in 1,000.

Should you be vaccinated? It depends on how you weigh the odds. The chance of developing shingles is one in five over a lifetime. (In contrast, about one in 10 people get the flu every year). Unlike the flu, shingles is not easily contagious and does not usually cause deaths or hospitalizations. PHN is relatively uncommon—roughly one in 50 people get it during their lifetimes—but it is more severe. Concern about developing PHN should drive your decision on whether to get vaccinated.

— William Kormos, M.D.
Editor in Chief, Harvard Men’s Health Watch

Posted by: Dr.Health

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