Shingles vaccination

Has anyone had experience of having a shingles vaccination when on Pred. for PMR. I have been offered one as I am the right age group this year (born 1937) and although I would hate to suffer the pain of shingles, in addition to PMR pain, I worry this jab may upset my PMR. I am currently down to 10mg Pred.

Any advice from this excellent forum would help.

27 Replies

  • Hi jilldrog. I thought I read somewhere that you shouldn't have it, as it a live Vaccine. Please don't take any notice of me though, as I might have it totally wrong.

    I am sure someone with experience will be along to answer your question shortly. I will be interested to see their reply too.

    Attic x

  • Hi,

    Think Attic is correct. There is a warning in the Pred paperwork re coming into contact with anyone with chicken pox or shingles (variant affecting adults) so I would have thought a vaccination was a no - no.

    Did you have chicken pox as a youngster? if so, you are likely, although not necessarily guaranteed, to be immune from shingles anyway.

    Suggest you double check with your surgery just to be sure.

  • DL, it is having chickenpox in childhood that can actually re-awaken the virus and result in shingles in future years. The following helps to explain it:

    "People who have had chickenpox (varicella zoster) in their youth can develop shingles (herpes zoster) in later years. During an acute attack of the chickenpox virus, most of the viral organisms are destroyed, but some survive, travel up nerve fibers along the spine, and lodge in nerve cells where they may lie dormant for many years.

    A decrease in the body's resistance can cause the virus to reawaken decades later. It then travels back down the nerve fibers to the skin's surface.

    The reawakened virus generally causes a vague burning sensation or tingling over an area of skin. A painful rash usually occurs two to five days after the first symptoms appear."

    If anyone suspects that they have shingles, it is most important to quickly get confirmation so that antiviral medication can be prescribed - the quicker the better so as to reduce both the duration and the likelihood of ongoing nerve pain.

  • ok, stand corrected - ta!

  • The risk for coming in contact with cases of CP or shingles when on pred is actually only for people WHO HAVE NEVER HAD CHICKENPOX.

    You can only develop shingles IF you had chickenpox as a child - the virus goes into hibernation in the nerve endings in certain parts of the body. Something wakes it up - and you develop shingles. If you are in contact with someone with shingles and you have not had CP in the past - you can catch CP from shingles, but you can't "catch" shingles from CP.

  • Ditto to Celtic's reply!

  • We were writing at the same time - as so often!

    I write these essays every year!

  • Yes, apologies to those who think they are seeing double!

  • Yes but usually were saying the same thing. This time I got it completely wrong - oops!

  • No - I meant Celtic and me, it happens with us as well as with you!

    It is difficult to get your head round the CP/shingles thing - you are by no means the only one to get it wrong way round. I have to keep re-reading what I've written to make sure it is right and not confusing the issue all the more. Stupid herpes zoster!

  • Poking my nose in again! Think I'll stick to reading this avo might be safer!

  • Can I say this without you having a hissy fit? I will anyway: Don't be daft!

  • Me! hissy fit! To repeat - don't be


  • DL, don't you dare just stick to reading - your replies to posts are invaluable. Plus they so often make me chuckle, and no doubt many others too!xx

  • It was written tongue in cheek. But thnx anyway.

  • jilldrog, yes Attic is right. The shingles vaccine is a live vaccine and, as such, is not recommended whilst on steroids.

  • The received wisdom has been that live vaccines are unsuitable for any patients taking pred - which suppresses the immune system so a) you may not develop the expected immunity anyway or not as efficiently and b) as a result you might develop the very disease the vaccine is meant to protect against.

    However - the small print that comes with the shingles vaccine says it is safe for patients who are on low dose pred (which is certainly 10mg/day or less) but should not be used for patients on 20mg/day or more.

    There is a better development of immunity in patients ages 50-59 than in patients aged 70-79 - probably reflecting the natural decline in the immune system with age. A study found:

    "... that overall (in persons age 60 years and older) the vaccine reduced the occurrence of herpes zoster (shingles) by about 50%. The vaccine effect was highest at 64% in people between the ages 60-69, but its effectiveness declined with increasing age; to 41% for the 70-79 age group, and 18% for those 80 years of age and older.

    In those who were vaccinated with Zostavax, but still developed shingles, the duration of pain was a bit shorter for them versus those who received a placebo. Specifically, the pain of those in the Zostavax group lasted on average for 20 days and for those who received placebo, it lasted for about 22 days. The severity of the pain did not appear to differ among the two groups.

    For people 50-59 years of age, approximately 22,000 people were studied; half received Zostavax and half received a placebo. Study participants were then monitored for at least one year to see if they developed shingles. Compared with placebo, Zostavax reduced the risk of developing shingles by approximately 70 percent."

    So really - is a considerably less than half the risk of developing shingles worth the risk of side effects from the vaccine (you are well over 70, so somewhere between 40% and 20%)? If you were already 80 the effectiveness is under 20% and, personally, I wouldn't bother. They push the fact it reduces the length of the post-herpetic neuralgia - which is by far the worst aspect of shingles. But only by a few days.

    If you have already had shingles there is no evidence that having the vaccine will prevent future attacks. It is unusual to have more than one attack but not impossible - the attack generates the same immunity as the vaccine is supposed to so if that didn't generate immunity, it is unlikely that the vaccine will either.

    A final warning - and I know one person on the forum this applies for: if you are allergic to neomycin - do NOT have the vaccine as it contains it. Nor is it for you if you are allergic to gelatin or are vegetarian.

  • Thank you PMRpro I think your reply makes everything quite clear, and I don't think I will risk it. I did have CP as a child I believe, but haven't had shingles but some of my friends have.

    Thank you to everyone else who responded to my post.

  • Hi Jilldrog, I have had PMR for about 2 years now and have gotten down to 5.5mg Pred. I was told by both or my Dr's(RA & Family) to take the shot. I had Shingles about 8 years ago and because of my family Dr. I got over it in 5 to 6 weeks with two drugs given to me the first day I got the rash. I have not gotten the shot yet but if I can get below 5mg Pred. I will. I hope this helps.

  • Thanks. I thought I might reconsider having the vaccine when I get my Pred down further, after reading your post.

  • Hi Jilldrog,

    I asked my Dr about the shingles vac., but he said he wouldn't give it to me while I had PMR. He didn't mention the pred. Medication was the reason he didn't want me to have it.

  • Thanks joy-bells. Yes I think I will delay the shingles vac. until I've spoken to GP and suggest waiting until I'm on a much lower dose of press.

  • I was told that if you have a cold sore take lysine. Would this help with shingles too.?

  • If you think you are developing shingles you need to go straight to the doctor who can give you antiviral medication which should reduce the severity of the attack and also shorten it. It is important to start it within 48 hours of the first signs so don't waste time. I would call the out of hours service if it happened at the weekend. I doubt anything other than that would make much difference to shingles though lysine probably wouldn't do any harm.

  • Thanks, to have shingles on top of PMR or GCA would be just awful.

  • It is a live virus, you cannot have it while on Prednisone, I already asked my Rumy.

  • Thanks for that. I cancelled my appointment for the vaccine today as I wanted to get more information first.My surgery doesn't seem to have a clue.

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