Herpes Zoster Vaccine
Associated With Lower Risk of Shingles in Most Older Adults
studies showing more than half of seniors will be protected by shot but
they are still not getting it (not covered by Medicare) - link to
video in story
Jan. 11, 2011
A new study confirmed what previous research has shown about the
effectiveness of the shingles vaccination for senior citizens it
protects slightly more than half who get the shot from the painful rash
that can be disabling. This study looked at a large group of older
adults and found the vaccination reduced the risk of shingles,
regardless of age, race or the presence of chronic diseases.
It did not,
however, shed new light on why so many senior citizens are not getting
the preventive shot. A significant reason that is not often discussed,
however, is that Medicare does not pay for the treatment. The Centers
for Disease Control and Prevention reports the vaccination is covered by Medicare Part D
prescription drug plans, although, the senior will have to cover the
price for a vaccination is between $200 and $250.
known as herpes zoster, is caused by reactivation of the virus that
causes chickenpox. Once chickenpox infection has run its course, the
virus is not eliminated; rather, it retreats to clusters of sensory
nerve cells usually located near the spinal cord, where the virus
persists in a dormant state.
weakens with advancing age, the virus can reactivate, multiply in and
damage sensory nerve cells to cause pain. It then migrates to the skin,
causing the blistering rash of shingles.
shingles first manifests as pain, itching or tingling in an area of skin
on one side of the body or face. Then a painful blistering rash develops
in that same area of skin; the rash can take two to four weeks to heal.
Anyone who has
had chickenpox - which includes most adults in the United States - could
develop shingles, though not all will. The two major risk factors are
increasing age and declining immunity. Half of all people who live to
age 85 will get the disease.
"The pain of
herpes zoster is often disabling and can last for months or even years,
a complication termed postherpetic neuralgia. Approximately one million
episodes of herpes zoster occur in the United States annually, but aside
from age and immunosuppression, risk factors for this condition are not
known," the researchers write in the January 12 issue of the Journal of
the American Medical Association (JAMA).
Zostavax is the
only US licensed vaccine that reduces the risk of reactivation of the
varicella zoster virus, the same one that causes chicken pox, and
remains dormant in the body after recovering from this infection.
provided evidence that herpes zoster vaccine works in a select study
population under idealized circumstances, but these researchers decided
the vaccine needed to be evaluated in field conditions to show whether
benefits of the vaccine can be generalized to conditions of clinical
note that this is particularly important for the herpes zoster vaccine,
given the medical and physiological diversity in the elderly population
for whom the vaccine is recommended by the Centers for Disease Control
Hung Fu Tseng,
Ph.D., M.P.H., of Southern California Kaiser Permanente, Pasadena,
Calif., and colleagues evaluated the risk of herpes zoster after receipt
of herpes zoster vaccine among individuals in general practice settings.
included community-dwelling adults, age 60 years or older, who were
members of a managed care organization. There were 75,761 members in the
vaccinated cohort, who were age matched (1:3) to 227,283 unvaccinated
the unvaccinated cohort, individuals in the vaccinated cohort were more
likely to be white, women, and to have had more outpatient visits, and a
lower prevalence of chronic diseases.
There were 5,434
herpes zoster cases identified in the study (6.4 cases per 1,000 persons
per year among vaccinated individuals and 13.0 cases per 1,000 persons
per year among unvaccinated individuals).
virus - the
It may not
As you get
who has it.
one side of
the body or
pain can be
from one to
14 days. If
There is no
60 or over.
In the fully
adjusted analysis, vaccination was associated with reduced risk of
herpes zoster. The reduction in risk did not vary by age at vaccination,
sex, race, or with presence of chronic diseases.
vaccine recipients had reduced risks of ophthalmic (near the eye) herpes
zoster and hospitalizations coded as herpes zoster.
vaccine was associated with a 55 percent reduction in incidence of
vaccine (Zostavax) was licensed recently, which means the durability of
its protection needs to be assessed in future studies. Meanwhile,
however, this vaccine has the potential to annually prevent tens of
thousands of cases of herpes zoster and postherpetic neuralgia
To date, herpes
zoster vaccine uptake has been poor due to weaknesses in the adult
vaccine infrastructure and also due to serious barriers to the vaccine
among clinicians and patients. Solutions to these challenges need to be
found so that individuals seeking to receive herpes zoster vaccine will
be able to reduce their risk of experiencing this serious condition,"
the authors conclude.
The Food and
Drug Administrations says other studies have shown the vaccination to
reduce the frequency of pain associated with shingles for older people.
people who were 70 years of age and older, and still
developed shingles, even though they had been
vaccinated, Zostavax reduced the frequency of PHN, the
pain associated with the illness. Overall, the benefit
of Zostavax in preventing PHN is due to the effect of
the vaccine on reducing the risk of developing herpes
zoster (shingles). Zostavax will not work to treat PHN,"
according to the FDA website.