Several months ago, I wrote about the shingles shot and recommended (or at least the article I cited did) that just about everyone receive it at or after the age of 60. Quite a few of my patients called and told me they had followed up and were vaccinated. Others who were not yet 60 questioned why they should wait. The new news is that the FDA just lowered the age range for the shingles vaccine.
In this week’s JAMA, it was reported that the US Food and Drug Administration (FDA) announced its approval of expanding the age range for the vaccine (marketed as Zostavax) to adults aged 50 to 59 as well as those aged 60 years and older. The Center for Biologics Evaluation and Research (I won’t even bother to give an acronym for that one) stated “The availability of Zostavaz to a younger age group provides an additional opportunity to prevent this often painful and debilitating disease.”
A quick shingles review: (I discussed it fully in a previous newsletter titled “Out, Out, Damn Pox!” posted January 2011.) Shingles is caused by the varicella zoster virus, a herpes virus which triggers chicken pox. (Sorry, I seem to be fixated on herpes viruses lately….I promise to become non-viral next week.) After a bout of chicken pox (which we can assume we have had if we are now 50 or older), the virus remains dormant in certain nerve cells. Then one day, decades later, perhaps due to a combination of factors including age and a weakened immune system, the virus awakens (obviously without need of a sleeping beauty kiss), “climbs up” the nerve root to the skin where it erupts as a cluster of blisters that appear on the part of the body that is enervated but the inflamed nerve. The result is pain that can be excruciating. Though the lesions eventually heal, the pain can remain for months and in some cases, years.
The CDC based its expanded approval on a study carried out in 4 countries on 22,000 participants aged 50 to 59. Half received the vaccine and half received a placebo. After just a year of follow-up, the vaccine reduced the risk of developing shingles by 70% compared with placebo. In the US about 200,000 adults between 50 and 59 develop shingles annually; hence the use of this vaccine could have a significant impact for these not-so-young-any-more baby boomers.
Merck manufactures the vaccine. It’s not cheap. The cost is in the range of $200. You can check with your insurance to see if it’s covered. Many drug stores have it on supply and (like the flu shot) will have a nurse administer it. You can also get it through your physician’s office; just call to make sure it’s in stock.
Bottom line: If you or a family member (or someone you care about) is over 50, a one time (and timely) shingles vaccine is advisable.