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Ongoing Study Provides Hope for Shingles Prevention


There are many options to relieve or inhibit pain in shingles sufferers, but none of them are routinely effective. They include antiviral drugs, which are often effective at lessening the duration of shingles if taken soon after an outbreak. "Antiviral drugs only stop further virus multiplication. They don't make a dead nerve cell come to life. So the earlier you get diagnosed and treated, the more likely it is to have some impact," Oxman tells WebMD.

Although no agreement has been reached on the appropriate management of shingles, steroids have been tried, as have antidepressants, anticonvulsants, and topical agents such as the anesthetic lidocaine, which has recently become available in patch form. For some, the lidocaine is effective at helping with the chronic pain, but as Oxman points out, it's hard to put it over your eye. About 15% of shingles sufferers are affected in that area, sometimes to the point of blindness. Perkin, whose mother had shingles, said she described the feeling as "having an icepick through your eye."

Other methods such as electrical stimulation and acupuncture are used, and in severe cases surgery is an option. But once the shingles awaken and come down to the skin, "the horse is out of the barn," Oxman says. Prevention is the key. Unfortunately, none of these approaches has been proven to prevent shingles.

The VA study "is an attempt to see if we can prevent shingles with a vaccine, and it's based on very compelling circumstantial evidence," Oxman tells WebMD. He and his colleagues are trying to enroll 37,000 people at 21 VA sites nationwide. So far, they've enrolled just over 6,000 people but are actively seeking more to reach their goal.

To qualify, the people need to be over 60 and to have had chickenpox, but not shingles. The reason for this, dating back to a landmark study in 1965, Oxman says, is that the incidence and severity of shingles apparently increases with advancing age. Most of the cases of shingles are seen in patients 60 and older. People who live to age 85 have a 50/50 chance of developing shingles.

The fact that the virus normally lies dormant until the later years suggests that a decreased immunity may play a role in triggering it. In addition, after a person with a healthy immune system gets shingles, they are unlikely to get it again, thus pointing to an immune response.

That's why this study is inoculating subjects with a vaccine similar to the one that's been effective in preventing chickenpox in children. Oxman says, "It doesn't take a lot of virus to do the job in children. What we have done is taken the same attenuated [weakened] virus of the children's vaccine, and just used more of it, nothing very complicated."

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