Are you at risk of shingles? LVPG physician assistant talks about the virus
If you’re of a certain age, you probably know someone in your circle of friends who has gotten the shingles vaccine. Maybe your doctor has suggested to you to get the vaccine. If you’re like me, then you’re probably thinking, “Really? Do I have to?”
If you’re 50 years old or older, then the answer is yes, you really should, even if you’ve never had the chickenpox. What does shingles have to do with chickenpox?
Heaven Martin, a physician assistant in internal medicine at LVPG Schuylkill in Pottsville, explained that shingles is “a reactivation of the varicella virus, which is commonly known as chickenpox. The virus causes a neuropathic pain and a blistering skin rash in a dermatomal plain.”
In the United States, shingles rears its ugly head in 1 to 3 people per 1,000 people 50 years old and older. That is about 1 million cases in the U.S. each year, Martin said.
After a person has chickenpox, the virus lies dormant in the nervous system. When it reactivates, inflammation in the nerves is visible in a rash pattern often on the back that follows along the line of the nerves stemming out from the spinal cord. This specific rash pattern is recognizable by medical professionals.
“There are different dermatomes from the spinal cord, so every nerve has a different dermatome. It’s not a random rash,” Martin said.
The nerve pain usually presents itself before the rash. Sometimes traditional pain medications won’t work, because its nerve pain.
The rash will occur three to five days after the pain starts, and will typically resolve in two to four weeks, but the pain can linger for months or years, she said.
Shingles affects both men and women, but is most common in people over the age of 60. It is not known what causes the virus to flare up, but people over 60 tend to be more immune compromised and may have multiple medical conditions.
Martin said that if a person suspects that they have shingles, especially if they have the rash, then they should seek medical attention soon.
Antiviral medications reduce the severity of the disease, but they are most effective if administered within 72 hours of the onset of symptoms.
“One thing to remember about the antiviral medication is that it’s not going to completely get rid of the shingles, but it will help with the pain and help the rash resolve sooner,” she said.
Antivirals are usually prescribed for 10 days. An example of one of the common antivirals is valacyclovir, also known as Valtrex, she said.
Shingles is contagious to people who have never had chickenpox. If they come in contact with a person who has the blisters, then they can get it, too. It will manifest as chickenpox in them, but now they are at risk for developing shingles as well.
The shingles vaccine can help prevent shingles in both people who have had chickenpox and those who have not.
“I recommend it for anyone over 50,” Martin said.
There are two different shingles vaccines. Zostavax was the first one and used live virus. It was a one dose vaccine. The newer one is Shingrix. It is not a live virus.
“That’s the one that they are actually recommending now,” Martin said. “I don’t really think anyone is carrying the other one, because Shingrix is so much better.”
Shingrix is given in two doses, and does not need a booster shot. The most common adverse effects have been muscle pain, fatigue, headaches, fever, nausea and vomiting.
“We do recommend that they get the new one, the Shingrix, as well, just because it’s a much better vaccine,” Martin said. “Studies show that it is much better at preventing singles and the long-term complications of it.”
There is no maximum age to receive the vaccine, but it is not recommended for people under 50. There are no vaccines for younger people.
As far as timing the shingles vaccine with the COVID-19 vaccine, Martin said people getting the shingles vaccine should wait 14 days before getting the COVID-19 vaccine or vice versa.
If the first dose of the shingles vaccine was received before the COVID-19 vaccine, then finish getting the COVID-19 vaccine with its second dose before getting the second dose of the shingles vaccine.