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Understanding the Shingles Vaccine

Experts talk to WebMD about a new vaccine that cuts the risk of shingles by 50%.
By
WebMD Feature
Reviewed by Louise Chang, MD

Over 500,000 Americans get the painful illness shinglesshingles every year. But that could be changing. In May 2006, the FDA approved the first shingles vaccine -- called Zostavax -- for people 60 and older.

"It's a very important vaccine," says Robert H. Dworkin, PhD, a professor in the department of anesthesiology at the University of Rochester Medical Center in Rochester, N.Y. "It cuts the risk of developing shingles in half."

While shingles could be treated with antiviral drugs to lessen its impact, up until now, doctors had no way to prevent it.

Shingles can be painful in itself, but some of its complications are worse. About 20% to 30% of people who get it go on to develop severe neurological pain called postherpetic neuralgia, or PHN. It can last for months, years, or the rest of a person's life.

Shingles is a disease that primarily affects older people. So a shingles vaccine could make a huge difference as baby boomers reach their sixties.

However, because the vaccine has only just been approved, there are still many unknowns. Researchers don't know whether the vaccine is safe for people under sixty. And it's unclear how much coverage insurance companies -- and MedicareMedicare -- will provide for it.

What Is Shingles?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpoxchickenpox. The problem is that once you get the virus, it may not go away. It just lies dormant. Then, if your immune system weakens -- because of illness, medication, or age -- the virus can become active again. The very same infection that gave you chickenpox as a toddler can give you shingles seventy years later.

The illness causes a painful rash that usually appears in a band or belt on the body. (The word has nothing to do with what's on your roof: it comes from the Latin word for "belt.") If the pain lasts for at least four months after the shingles rash appeared, a person is diagnosed with PHN.

The Zostavax vaccine contains a live but weakened version of the virus. This allows your immune system the chance to "learn" to fight the virus with no risk of infection.

"The vaccine is really just a triple dose of the chickenpox vaccine," says Donald H. Gilden, MD, chair of the department of neurology at the University of Colorado School of Medicine in Denver. He says that it doesn't seem to have any significant risks. "The minor side effects included things like itching and redness," he says, "and they were more than outweighed by the benefits."

It's unclear how long the vaccine's effects will last. Gilden believes that its immunity may last decades. Dworkin is less sure.

"All we know is that it protects people for four to five years," he tells WebMD. "In the long run, people might need booster shots. We don't know yet."

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