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Health & Medicine for Senior Citizens

Study of Seniors Finds Less Response to Shingles Vaccine for Those with Untreated Depression

If antidepressants increase the effectiveness of the shingles vaccine, it may have similar effect on depressed patients to other important vaccines, such influenza

Feb. 15, 2013 – Senior citizens are encouraged to get the vaccination for shingles, which can guard against the painful condition caused by the reactivation of the varicella-zoster virus. There has been concern, however, that the vaccine is not more successful. Researchers seeking answers have found a link between untreated depression in older adults and decreased effectiveness of the vaccine.

More than a million new shingles cases occur each year in the U.S. The vaccine boosts cell-mediated immunity to the virus and can decrease the incidence and severity of the condition, according to information published with the study in Clinical Infectious Diseases.

In a two-year study, led by Michael Irwin, MD, at the University of California-Los Angeles, researchers measured the immune responses to shingles vaccination among 40 subjects aged 60 or older with a major depressive disorder and compared these responses to similar levels in 52 control patients matched by age and gender.

 

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Measurements were taken at baseline, and then 6 weeks, 1 year, and 2 years after the patients received the shingles vaccine or a placebo.

Depressed patients not being treated with antidepressants (selective serotonin uptake inhibitors) had lower cell-mediated immunity to the varicella-zoster virus - and were less able to respond to the shingles vaccine - compared with patients who were not depressed, or who were depressed but were receiving treatment with antidepressants, the researchers found.

About Shingles

Shingles is a disease caused by the varicella-zoster virus - the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. As you get older, the virus may reappear as shingles. Unlike chickenpox, you can't catch shingles from someone who has it.

Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. The pain can be mild to severe. Blisters then form and last from one to 14 days. If shingles appears on your face, it may affect your vision or hearing. The pain of shingles may last for weeks, months or even years after the blisters have healed.

There is no cure for shingles. Early treatment with medicines that fight the virus may help. These medicines may also help prevent lingering pain.

A vaccine may prevent shingles or lessen its effects. The vaccine is for people 60 or over.

NIH: National Institute of Allergy and Infectious Diseases

>> More on shingles at MedlinePlus

>> More about Shingles for Senior Citizens at NIH_SeniorHealth

Watch video, "What is Shingles" by NIHSeniorHealth.gov

The findings suggest that patients with untreated depression were “poorly protected by shingles vaccination,” said Dr. Irwin.

Depression treatment, on the other hand, boosted cell-mediated immunity and increased the effectiveness of the vaccine among those studied, even when the treatment did not lessen depression symptoms, the researchers found.

Treating depression, noted Dr. Irwin, appeared to “normalize the immune response to the zoster vaccine” in the study.

Larger studies are needed to evaluate the possible relationship between untreated depression and the risk of shingles, the study authors noted, along with research to establish what mechanisms are responsible for patients’ reduced immune response.

The possible connection, however, is potentially significant: If antidepressants increase the efficacy of the shingles vaccine in those who are depressed, such treatment may have a similar effect on the immune response of depressed patients to other important vaccines, such those against influenza.

Diagnosis and treatment of depression in older adults may increase of the effectiveness of the shingles vaccine and help diminish the risk of shingles, the study authors conclude from their findings.

“Efforts are also needed to identify and diagnose depressed elderly patients who might benefit from either a more potent vaccine or a multi-dose vaccination schedule,” Dr. Irwin said.

The study is available online:
Varicella Zoster Virus–Specific Immune Responses to a Herpes Zoster Vaccine in Elderly Recipients With Major Depression and the Impact of Antidepressant Medications – click here.

Clinical Infectious Diseases is a leading journal in the field of infectious disease with a broad international readership. The journal publishes articles on a variety of subjects of interest to practitioners and researchers. It is an official publication of the Infectious Diseases Society of America (IDSA),is a professional society representing nearly 10,000 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org.


Links to More Archived Reports About Shingles

Shingles, a Disease Primarily Striking Senior Citizens, Increases Risk of Multiple Sclerosis

A virus associated with MS is varicella zoster virus, the cause of herpes zoster (shingles) - see video on shingles - June 8, 2011


Herpes Zoster Vaccine Associated With Lower Risk of Shingles in Most Older Adults

Confirms other 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


Family History of Shingles May Be Motivator to Get Vaccination

May 19, 2008 ... Researchers report those who do get herpes zoster, or shingles, are much more likely than others to have a family history of the condition.


FDA Says Senior Citizens Should Get Shingles Vaccine but Many Docs Not Buying It

Mayo Clinic study finds two issues – cost and perception that shingles primarily affects just those with weakened immune systems

Dec. 18, 2007


Top 10 Stories of 2006 by Harvard Health Letter Picks Key Ones for Senior Citizens

Lucentis for macular degeneration, Zostavax for shingles make list

December 4, 2006


Shingles Vaccinations Recommended for All 60 and Over

CDC committee says action needed to prevent painful disease

October 26, 2006


Zostavax Shingles Vaccine Approved for Senior Citizens

FDA says it is for those age 60 and older who are most at risk

May 26, 2006

 

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