Please visit the Vaccine Education Center for general information about shingles and the vaccine.
Originally published in June 2011 Parents PACK newsletter
It’s not every day that the sports section comes up in a Web search related to vaccine-preventable diseases, but that is just what happened last month when Tony La Russa, manager of the St. Louis Cardinals, was diagnosed with shingles.
Shingles is caused by the same virus that causes chickenpox. Anyone who has ever had chickenpox can get shingles because during the initial infection (chickenpox), the virus remains in the nervous system living silently. Often as people age — or in some cases in younger people with weakened immune systems — the virus reactivates causing shingles. Anyone, even healthy young people who have had chickenpox, can get shingles.
As with La Russa, shingles is often not considered initially. According to reports, La Russa had symptoms of redness and swelling around his right eye for about a month before being diagnosed with shingles. Because the virus remains in nerve tissues, the rash appears along a nerve and typically only on one side of the body. About 10 to 15 of every 100 people with shingles have involvement of the nerves around the eye, as La Russa did.
Often a pain described as “shooting” or “throbbing” occurs a few days before the rash appears. The pain can be steady or recurring and be accompanied by extreme itchiness. The pain can be so severe that it interferes with everyday activities. In La Russa’s case he admitted to taking naps in his office before games and not wanting to do much besides go to work.
The most common complication of shingles is the severe, long-lasting pain that can linger for months after the infection. Up to 4 of every 100 people will have pain that lasts 30 to 90 days after the rash begins. This pain, known as postherpetic neuralgia or PHN, can be so debilitating that sufferers continue to forego everyday activities for months after having shingles. Sometimes the pain is so severe and so unrelenting that shingles sufferers take their own lives.
Other complications can include bacterial co-infection (the so-called “flesh-eating bacteria”) of the sores caused by shingles, or nerve damage. Depending on which nerves are involved, patients may also suffer limb weakness, impaired vision, or impaired bladder or bowel function.
Someone with shingles cannot cause another person to get shingles; however, if someone who is not immune to chickenpox is in contact with the open sores, that individual may develop chickenpox.
While the shingles vaccine is licensed as a one-time shot for people 50 years of age and older, it is only recommended for people 60 years or older. This is because of of increased risk in the older age group and the large quantity of the vaccine virus used in the shingles vaccine. The virus used in the shingle vaccine is the same as that used for the childhood chickenpox vaccine, but is contained in the shingle vaccine at a quantity fourteen times greater.
Some healthcare providers do not carry the shingles vaccine because it is expensive and demand for adult vaccines is not high; however, many pharmacies carry the vaccine. The manufacturer, Merck and Co., offers an online vaccine locator. Check with your individual insurer to determine whether the cost of the vaccine is covered.
About 5 of every 100 people who had shingles will get it again, so the vaccine is still of benefit.
Shingles disease and vaccine
Personal stories of people with shingles
Pictures of shingles
Q. My grandmother recently had shingles. Can she infect my 6-month-old son?
A. Because the virus that causes shingles is already in a person's body, others cannot get shingles from a person with shingles. However, the person with shingles can expose others to the chickenpox virus from their rash, so people who have not had chickenpox can become ill.
In your case, since your son is young enough that he has not had his chickenpox vaccine and presumably has not had chickenpox disease, he could get chickenpox if he is exposed to the virus from your grandmother's rash. Once the rash has crusted, your grandmother is no longer contagious.
Q. If I have already had shingles, do I still need the shingles vaccine?
A. Although you are less likely to get shingles if you have had them, there is still a chance that you could, so the shingles vaccine can still be of benefit. Up to 5 of every 100 people will get shingles more than once.
Q. My husband just turned 60 and was going to get the shingles vaccine, but he does not remember ever having chickenpox. Can he still get the shingles vaccine?
A. Yes, existing data suggests that almost everyone over 40 years of age has been exposed to chickenpox, so even if your husband does not remember having chickenpox, he can get the shingles vaccine.
Q. Where can I get a shingles vaccine?
A. If your primary care physician does not offer the shingles vaccine, you can check with your local health department and pharmacies in your area. You can also use the vaccine locator on the shingles vaccine manufacturer’s website.
Q. My grandmother has shingles. Is that contagious?
A. You cannot get shingles from someone who has shingles; however, because shingles is caused by the same virus that causes chickenpox, you can get chickenpox if you have not had chickenpox disease or a vaccine that provided protective immunity.
You would not need to stay away from your granddaughter after getting the shingles vaccine. A small number of people get a chickenpox-like rash after getting the vaccine; if this would happen, you need only keep your granddaughter from coming into contact with the blisters.
Updated: January 2013
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