Shingles is a painful, blistering rash that usually appears on one side of the body. It is caused by reactivation of the virus that causes Chickenpox [Varicella Zoster] and can lead to persistent pain in the site of blistering and scarring.
How do you get Shingles ?
Once you have had Chickenpox, the virus [Varicella Zoster] stays in your body within the nerve cells. The virus can be reactivated in the future, usually at times of body stress or infection to cause Shingles. It is estimated that the risk of getting Shingles is 1 in 4 over your lifetime. Although Shingles can occur at any age, it is most common over 50 years.
What are the complications of Shingles ?
Shingles can be a serious infection that can cause several complications. These include:
- Post Herpetic Neuralgia – this is long lasting nerve pain that can persist at the site of infection. The pain can be described as shooting, burning or like electric shocks and can be extremely debilitating. There is no cure for this and this pain can persist for months or even years after infection with Shingles has resolved.
- Visual disturbances or loss of vision that can be caused by shingles infection in the eye
- Encephalitis or Meningitis – these are conditions where there is inflammation of the brain or lining of the brain
What vaccines are available against Shingles ?
There are now two types of vaccination available to protect against Shingles. Zostavax, the live Shingles vaccine used currently by the NHS (for selected individuals), is a single-dose vaccine. Shingrix, the new non-live recombinant Shingles vaccine, requires 2 doses given 2-6 months apart. This is not currently available on the NHS and is unlikely to be in the near future.
What are the differences between the old live Shingles vaccine and new non-live Shingles vaccine ?
Although the live Shingles vaccine is a single dose, it can reduce the risk of shingles by 51%, post-herpetic neuralgia by 67%, and the overall burden of illness by 61%. The live Shingles vaccine also becomes less effective the older one gets, and the effectiveness reduces approximately 10 years after vaccination.
The new non-live Shingles vaccine requires two doses 2 to 6 months apart, and has a substantially higher efficacy than the live vaccine, reducing risk of shingles by 97%. Initial studies suggest a single dose does not produce a robust immune response, therefore attendance for both doses is important to ensure continued immunity. Unlike the live Shingles vaccine, the efficacy of new non-live Shingles vaccine is high even for patients over 70.
The new non-live shingles vaccine might carry a greater risk of side effects (non-serious) at injection sites such as pain, redness and swelling. Side effects of the new non-live shingles vaccine are more frequent after the second dose than after the first.
The new non-live shingles vaccine is safe and effective in patients previously vaccinated with the live shingles vaccine.
Can the new non-live Shingles vaccine be given to anyone with a compromised immune system ?
Unlike the old live Shingles vaccine, Shingrix, the new non-non live vaccine can be given to those who have compromised immune systems. Those who are immunocompromised, such as those with cancers or HIV infection, or those taking immunosuppressive medicines such as steroids are at greater risk of developing Shingles. The old live Shingles vaccine, Zostavax, cannot be given to those who are immunocompromised.
I have had shingles infection; can I receive the new non-live Shingles vaccine ?
Yes, if you have had shingles infection in the past you can have the new non-live Shingles vaccine to help prevent any future occurrences. There is no official recommendation on when to receive the vaccine but it is best to wait until the shingles rash as disappeared before starting the vaccination course.
I received the old live Shingles vaccine. Can I still have the new non-live Shingles vaccine ?
Yes, if you have received the old live Shingles vaccine, either privately or on the NHS, you are able to have 2 doses of the new Shingles vaccine.
Can anyone have the new non-live Shingles vaccine ?
The vaccine is licensed to adults over 50 years and there is no upper age limit for either vaccine. The new non-live Shingles vaccine provides much higher protection in all age groups, especially in those over 70 years.
I have had shingles infection; can I receive the new non-live Shingles vaccine ?
Yes, if you have had shingles infection in the past you can have the new non-live Shingles vaccine to help prevent any future occurrences. There is no official recommendation on when to receive the vaccine but it is best to wait until the shingles rash as disappeared before starting the vaccination course.
Will there be any side effects from the new non-live Shingles vaccine ?
There are some mild side effects following vaccination with the new Shingles vaccines. These include:
- Sore arm
- Redness and/or swelling at the injection site
- Headache, tiredness & fatigue (general cold & flu like symptoms)
These side effects typically last 2 or 3 days, unlike pain from Shingles which can last a lifetime after infection.
I feel healthy; am I really at risk of shingles ?
Around 99% of the population have had chickenpox, the virus that if reactivated causes shingles. It is estimated that 1 in 4 people will develop shingles in their lifetime, a risk that increases as we get older. No matter how healthy you feel, as your immune system declines with age, you are at an increased risk for shingles.
