Shingles

Hey everyone! I hope you and your family are healthy and have mentally, physically, and financially survived October 2020. I hope you have gotten your flu and pneumonia vaccines by now, if not, now is the time to get vaccinated. My pharmacy has actually run out of high-dose flu vaccines twice in the past 6 weeks. We were blessed to get the third shipment, but once these are gone I can tell you we will not be getting any more in so NOW is the time. Anyway, enough about flu and pneumonia, let’s talk SHINGLES.

Why shingles?? My husband recently had a bout of shingles, thankfully his rash was minimal but boy did it bother him for several weeks. My brother-in-law has also been dealing with a horrible case of shingles and has been so miserable he wasn’t even able to wear a shirt for days. Shingles are serious, unfortunately, it isn’t something you can catch from someone else, but simply already lives in your body if you had chickenpox as a child. The CDC states that if you were born before 1980, you are 99% likely to have had chickenpox even if you do not remember it, and therefore are at risk for developing shingles. 1 out of 3 people in the United States will develop shingles in their lifetime, that is 33% of Americans, that is a pretty good chance that you will be affected. Now on to the worst part about shingles. 1 in 10 people who get shingles will develop nerve pain that will last months, if not years after the rash has cleared up. This means that if you develop shingles, it could affect you for the rest of your life! That is big and means you need to pay attention and learn what you can do to protect yourself. Let’s start with defining what shingles actually are.

[Shingles is a viral infection also known as zoster or herpes zoster, that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles are caused by the varicella-zoster virus (VZV) — the same virus that causes chickenpox. After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. Shingles aren’t a life-threatening condition, but they can be very painful. Vaccines can help reduce the risk of shingles. Early treatment can help shorten a shingles infection and lessen the chance of complications. The most common complication is postherpetic neuralgia, which causes shingles pain for a long time after your blisters have cleared.] (All information in this section is from the Mayo Clinic’s website www.mayoclinic.org)

What are the signs and symptoms of shingles? In the days before a rash presents itself, you might have itching, irritation, tingling, or pain in the area where the rash will ultimately develop. When the rash typically occurs, it appears as a single stripe appearing on the right or left side of the body usually on the torso, but can also appear on the face. If shingles appear on the face, this can be very serious possibly resulting in vision loss if the eye is affected. The rash eventually results in fluid-filled blisters that eventually crust over. You may also experience sensitivity to the touch, fever, headache, sensitivity to light, fatigue along extreme pain. (All information in this section is from the CDC website: www.cdc.gov)

So who can get shingles and should you be worried? Let me start by explaining that shingles are NOT contagious. You cannot get shingles from someone else who has it, but you could get chickenpox if you have never had them or have not been vaccinated with varicella (chickenpox vaccine). I heard you ask how do you get shingles? I am so glad you asked! As explained above, if you had chickenpox as a child, you are at risk for shingles as an adult. Shingles virus lives dormant in the nerve endings in your body, and at some point, it is reactivated and causes shingles. There is a lot of evidence to suggest that high amounts of stress can lead to the virus reactivating in your body (trucking industry….stress anybody?). So the bottom line is that you had to have had chickenpox to get shingles, otherwise you would just get chickenpox. I think it is interesting to think that in 50 years, shingles will probably be eradicated because almost all children are vaccinated with varicella at a young age and therefore will never have had chickenpox (including my own children) and therefore shingles will be no more.

What can you do to prevent shingles? Thankfully, there are two vaccines available that help to reduce the risk of getting shingles. The first is Zostavax, it has been available since 2006. It is about 40 to 45% effective. It is now only recommended for patients who are allergic to the preferred vaccine, who need to be vaccinated immediately and the preferred vaccine is not available. Zostavax will actually no longer be commercially available after November 2020. So what is available? A new vaccine called Shingrix became available in 2017. It is a two-shot series with 2 to 6 months between each vaccine. The vaccine is more than 90% effective at preventing shingles. The patient can be vaccinated after age 50 and can get vaccinated at your local pharmacy without a prescription. The cost without insurance varies between pharmacies but is typically between $200-$250 per shot. Most insurances cover the vaccine to some degree, but Medicare Part D will force patients to meet their deductible before paying for the vaccine, and even if they do pay the patient will have a co-pay. The biggest takeaway that I cannot stress enough is that if you are working and have commercial insurance you should consider getting the shingles vaccine before you go on Medicare Part D. Most commercial insurance pay very well for the shingles vaccine, possibly even at zero $0 charge to you. It costs a lot more money to get vaccinated with Medicare Part D and should be avoided if you can. I tell all my patients 64 and under to get this vaccine now before they hit Medicare age.

Can I get shingles after I have been vaccinated? The unfortunate answer is YES. The good news is the extent of your rash and nerve pain will be much less than if you had not been vaccinated, and you will recover quicker and probably 100% with no long-lasting nerve pain.

Should I get vaccinated if I have already had shingles? YES!!!!!!!!!!!!! You can get shingles over and over again. There is no question, you should get vaccinated even after having shingles once, twice, or even three times.

In my practice, I have seen a lot of patients who have suffered from this ugly virus. I would suggest everyone get vaccinated on or after their 50th birthday. You can even get vaccinated before 50, but that will require a prescription from your healthcare provider and consent from your insurance company which usually requires paperwork to show a need before age 50. If you don’t have insurance or don’t want to use it, simply present to the pharmacy with a prescription, pay cash, and get vaccinated.

I hope this blog was helpful to you and you have learned a bit more than you knew 5 minutes ago. If you have questions about this vaccine or any other vaccine please shoot me an email @ jennifer@mjdispatch.com and I will be more than happy to help answer your questions or direct you to the right person to answer them for you. I thank you for taking the time to read my blog, and hope and pray you will consider getting vaccinated. It is so important to take charge of your health, and getting vaccinated is taking the first step.

God Bless,

Dr. Jen

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