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
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."