Shingles and vaccinations

[Suzita76]

Sorry folks.... this is a long post !!

The Shingles vaccine used in the UK is Zostavax, available to over 70s as a single dose. It contains weakened (attenuated) virus and as such, can cause problems (i.e. infection) for people with weakened immune systems (for example, due to medication). Zostavax is only 50 to 64% effective in preventing Shingles (and even less so the older you are).

The vaccine used in the USA is called Shingrix and has been shown to be more than 90% effective. (They are no longer using Zostavax in the USA).

You need 2 doses of Shingrix (one, followed by a booster 2 to 6 months later). Shingrix does not contain live varicella zoster virus, only a small part of it that produces an immune response in the body, and as such it can be used in immunocompromised patients.

I had a mild dose of Shingles in early 2017 and shortly afterwards developed symptoms of GCA. I am convinced Shingles triggered GCA for me, and there is evidence that 78% of temporal artery biopsies from patients with GCA had the Varicella zoster virus in the cells.

(References, for nerdy people like me who might like to read scientific papers

1. oatext.com/pdf/CMR-2-115.pdf

2. Gilden D (2015) Prevalence and distribution of VZV in temporal arteries of patients with Giant Cell Arteritis. Neurology 84: 1918-1919)

Like most people in the UK, I was offered the Zostavax vaccination just after I reached 70. Unfortunately, I had just started injections of Tocilizumab and so could not have the live Shingles vaccination. (Whilst on Tocilizumab, I have had a mild Shingles outbreak, but knowing what to look for, I immediately got my GP to prescribe Aciclovir which cleared it up in 8 days).

I have a dear friend who had really dreadful Shingles more than 3 years ago. He has been on morphine for the terrible pain and it still shows no signs of ever disappearing.

My conclusion is that we should be able to get Shingles vaccinations in the UK from the age of 50 (as in many other countries). 70 is far too late. We should also be using Shingrix and not Zostavax. Of course, it is all down to money, but it is false economy when you see the devastating effect Shingles can have on people’s lives. (I have been looking into getting Shingrix privately though apparently it costs £525, and is currently unavailable anyway).

[PMRpro Ambassador]

It isn't all down to money at present - it is supply and demand. There is insufficient stock to supply all public health services with enough vaccine for them all to offer it immediately. The USA bought up the stocks at an early point and the manufacturer has to catch up. There has also been considerable demand worldwide for the vaccine privately - as you have discovered, it has been used! Making large quantities of vaccine is time consuming - and a lot of facilities are currently involved with Covid vaccine...

[Suzita76 in reply to PMRpro]

... but in the NHS, Shingrix doesn’t seem to have been an option. My GP didn’t know about it.

[PMRpro Ambassador in reply to Suzita76]

It isn't yet - because as I said the stocks aren't adequate to supply enough for everyone who would be entitled to and want to have it. You are talking about millions of doses across almost all of Europe who all have state funded healthcare. It has been available privately in the UK because of private enterprise - but at a price. It has to be enough to entirely replace the Zostavax rather than a mixture being available.

[Suzita76 in reply to PMRpro]

Still, even if Zostavax were available to people aged 50 and over( instead of 70), that would be infinitely better.....1 in 3 people over 70 get Shingles and who knows what other conditions it triggers.

[GOOD_GRIEF in reply to Suzita76]

Not exactly.

Lifetime prevalence increases with age: 54–59 (9.7%), 60–64 (10.7%), 65–69 (12.7%), 70–74 (14.9%), 75–79 (17.1%), 80–84 (20.4%), 85–89 (22.9%), 90 and older (25.8%).

So no, 30% of people over 70 do not get shingles.

BTW: It seems having had a chicken pox vaccination in childhood cuts the risk of shingles later in life.

[Suzita76 in reply to GOOD_GRIEF]

Thanks for these details ( only cases confirmed by medics of course, so definitely an underestimate), but the main point remains valid; Shingles can be dreadful, recurring, and (like some other viral infections- HPV for instance) possibly responsible for triggering a number of other conditions.

On an entirely different subject, we are following the US election results very closely - nail-biting! (We lived in Georgia for 8 beautiful years, and really miss it!).

Stay safe.

[GOOD_GRIEF in reply to Suzita76]

Thanks, we'll be OK. Democracy is messy, especially during a pandemic. The good thing is, we've had the highest voter turnout in more than 100 years, so it's going to take a bit longer than usual to count all the votes. We can wait.

[Jan_Noack in reply to Suzita76]

I got shingles at about 45 ..and I do suspect the PMR symptoms as starting after that too..so why stop at 50?

[HeronNS]

The reaction to Shingrix vaccine is quite severe. My husband has had it. The first shot knocked him out for a day, the second for at least two days. He just sat in a chair with a cat in his lap and didn't move. He felt like he had the flu. I've decided to take a chance and if I show shingles symptoms will promptly go to the pharmacy around the corner where they can prescribe an anti-viral. I didn't even know I'd ever had chicken pox until a recent blood test.

[teddyd]

Our health board offers it to the 70+.

I just presumed that possibly they were more at risk in some way. Maybe getting it younger would be better.

Unfortunately I think thats very unlikely to happen any time soon. The NHS is under more strain now than ever before.

Until my husband was offer the jag for shingles I didnt even know it was available.

[Pome]

I have shingles now for the fifth time in 3 years.

[Jan_Noack in reply to Pome]

crikey. My husband has had it twice in three years! I've also had it twice but over 15 years (maybe three times?) Is there any point I often wonder in getting the injection when one still has a couple of fine stripes of spots?

[benhemp]

I just completed my 2nd of two Shingrix shots two weeks ago. I reacted to both shots the same way: fever/chills/shaking the first night, very low energy the 2nd day, very sore in the shoulder muscle that received the shot for about 3 days. Glad to have it behind me! It is heavily marketed here in the U.S. - just about every grocery store has a sign near the entrance encouraging people over 50 to get their Shingrix shots.

My mother had bad chronic pain from a case of shingles that she was very slow to treat. Another friend of mine had very bad chronic pain from his case of shingles; he was being treated with oxycodone and neurontin for several years until I introduced him to kratom, which he found worked better and was not addictive, allowing him to quit both pain killers.

Because of the above cases I know quite well, I believe the Shingrix vaccine is worth getting despite its three days of discomfort you may experience each time (many do, but not all). Sorry to hear it is not available on the other side of the pond.

[PMRpro Ambassador in reply to benhemp]

It IS available - but you have to pay for it. It is a hefty price for anyone, especially if you are on a fixed income.

[benhemp in reply to PMRpro]

We have to pay for it here in the states too. Even with Medicare insurance, I paid about $300 total to get it.

[PMRpro Ambassador in reply to benhemp]

That is about half what it costs in the UK.

[Suzita76 in reply to PMRpro]

I just found this article ( I imagine you’ll have seen it already- from 2018), recommending that Shingrix be used in the UK at least for immuno-compromised individuals who can’t have the live vaccine. Maybe one of these days, eh?! Not in my lifetime though.

wchh.onlinelibrary.wiley.co...

[HeronNS in reply to benhemp]

I think my husband paid about $80 Can for it, but I'm not sure if that was for each shot or for both. Prescribed by doctor but administered and paid for at pharmacy.

[Spanky2019]

Hubby & I both had first of two Shingrix vaccine. Neither one of us had side effects ither than little arm soreness. His was free thru VA (veteran). Mine cost us $340 total for both shots. Doctors warned us that there would probably be severe side effects. We lucked out.