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Older Adults Should Line Up for Shingles Vaccine


Vaccinations are not just for kids, and if you are an older adult, you should consider getting vaccinated against a painful condition known as herpes zoster, more commonly called shingles. A new study appearing in the January 12 issue of the Journal of the American Medical Association finds that the shingles vaccine significantly reduces the risk of contracting this condition.

Shingles can be painful and debilitating

Hung Fu Tseng, PhD, MPH, of Southern California Kaiser Permanente, and his colleagues evaluated 303,044 community-dwelling adults ages 60 years and older (mean age, 69.6 years), including 75,761 who had been vaccinated with the shingles vaccine and 227,283 who had not. Adults who had been vaccinated were more likely to be female, white, to have had more outpatient visits, and to have a lower prevalence of chronic disease.

The investigators found a total of 5,434 cases of shingles among the participants: 6.4 cases per 1,000 persons per year among individuals who had been vaccinated and 13.0 cases per 1,000 persons per year among those who did not receive the vaccination. Overall, having received the vaccination was associated with a 55 percent reduced risk of developing shingles.

Despite the availability of a shingles vaccine, a recent survey conducted among general internists and family medicine physicians found that patient acceptance has been low, about 2 to 7 percent nationally. Results of the National Health Interview Survey 2009 for Adult Vaccination Coverage revealed a higher acceptance figure of 10 percent among adults 60 years and older.

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Approximately 1 million cases of shingles occur in the United States each year. Signs and symptoms of shingles typically affect only a small section of one side of the body. Most often, a rash develops that wraps around the chest from the spine to the breastbone.

Infrequently the rash appears around an eye or on one side of the neck or face. A rash near the eye can result in an infection and permanent eye damage if not treated. In this study, individuals who received the vaccine were less likely to have shingles that affected the eyes.

Other signs and symptoms include pain, burning, numbness, or tingling, fluid-filled blisters that eventually break and crust over, and itching. The pain can be intense and even debilitating. Some individuals also experience fever, chills, headache, and fatigue.

Tseng noted that a complication of shingles, postherpetic neuralgia, can last for months or years. Postherpetic neuralgia occurs when damaged nerve fibers send abnormal pain signals from the skin to the brain. An estimated 20 percent of people who get shingles develop this very painful complication of shingles.

The results of the JAMA study indicate that older adults who receive the herpes zoster vaccine have a reduced risk of developing shingles regardless of age, race, and the presence of chronic diseases. Additional studies are needed, however, because the recent licensure of the shingles vaccine means the durability of its protective abilities need to be assessed.

Hurley LP et al. Annals of Internal Medicine 2010 May; 152(9): 555-60
Mayo Clinic
Tseng HF et al. JAMA 2011; 305(2): 160-66