Posts Tagged ‘Shingrix’

Shingles is a painful rash that develops on one side of the face or body. The rash appears as a single stripe along either the left or the right side of the body. The rash consists of blisters that typically scab over in 7 to 10 days and fully clears up within two to four weeks.

Shingles on the face is quite serious as it can affect the eye and lead to vision loss.

The most common complication of shingles is long-term nerve pain called postherpetic neuralgia. This pain occurs in the areas where the shingles rash was, even after the rash clears up. The neuralgia can last for months or years after the rash goes away. Postherpetic neuralgia pain can be excruciating to the point that it can interfere with daily life and may require long-term prescription pain medications.

Chickenpox and shingles are related because they are caused by the same pathogen called the varicella-zoster virus. After a person recovers from chickenpox, the virus continues to live inside the body in an inactive state. As a person grows older and their immune system weakens, varicella can eventually reactivate and cause shingles.

There is an effective vaccine for protection against shingles called Shingrix. The vaccine is easily accessible by visiting your local pharmacy.

If you are 50 years or older, it is recommended to get two doses of Shingrix, separated by two to six months. Those 19 years and older who have weakened immune systems due to a disease state such as cancer or immunosuppressive drugs should also get two doses of Shingrix.

Shingrix is 90% effective at the prevention of shingles. For those who previously received the old shingles vaccine called Zostavax, it is recommended to get the two doses of the Shingrix vaccine. Zostavax, unlike Shingrix, is only 50% effective in preventing shingles. Zostavax gives a 50/50 chance of being protected. Not the best odds.

If you ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix, currently have shingles, or are a woman who is currently pregnant, it is advised to not get the Shingrix vaccine.

If you had shingles in the past, Shingrix can help prevent future occurrences of the disease. There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.

Like all vaccines, a sore arm with mild or moderate pain is very common after the Shingrix vaccine administration. The following day after the vaccine, some people may feel tired, have muscle pain, experience a headache, shivers, fever, stomach pain, or nausea. These bothersome side effects may hinder a person’s ability to do normal daily activities for a couple days. These side effects might occur after the first or second dose of Shingrix, or both doses. Side effects such muscle pain or fevers, can be combatted with over-the-counter pain medicine such as ibuprofen or acetaminophen.

Insurance coverage regarding Shingrix:

• Medicare Part D plans cover Shingrix, but there may be a cost to you depending on your plan.
• Many private health insurance plans cover Shingrix, but there may be a cost involved.
• Medicare Part B does NOT cover Shingrix.
• Medicaid may or may not cover Shingrix; contact your insurer to find out.
• The manufacturer of Shingrix, GlaxoSmithKline, offers vaccine assistance programs to provide vaccines to eligible adults who cannot afford to get the vaccine or who lack health insurance. To get help, go HERE.

References:

Shingles. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054. Published September 17, 2021. Accessed March 25, 2022.

Shingrix shingles vaccination: What everyone should know. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html. Published January 24, 2022. Accessed March 25, 2022.

What is “shingles”?

Shingles (herpes zoster) usually refers to an infection caused by the varicella zoster virus (VZV). It is the same virus responsible for chickenpox (varicella). Shingles typically manifests as a painful rash that forms where nerves from the spinal cord connect with the skin. This area is called a dermatome. The rash appears along a dermatome located on one side of the body. It is red, blistering, and can last up to thirty days. The pain associated with the rash is commonly described as “a deep burning,” “throbbing,” or “stabbing” sensation. Dermatomes are considered contagious until they dry and crust over (about 7 to 10 days after first symptoms appear). Scarring and changes in skin color at the lesion sites may occur.

The most common complication of shingles is postherpetic neuralgia (PHN), a condition characterized by persistent numbness, itching, and pain. This condition affects 10-15% of shingles patients and is defined by significant pain lasting for 90 days after onset of rash.

Are you at risk?

If you have had chickenpox, the virus that causes shingles is inside your body and can reactivate.

• 99% of people over the age of 50 are living with the virus that causes shingles.

• There are 1.2 million cases annually in the United States.

• The risk is greatest in those whose immune system is weaker.

• 1 in 3 people will get shingles in their lifetime, and your chances increase as you age.

• 1 in 4 people will have a complication related to shingles. This could mean long term nerve pain, lasting months or even years after the rash has healed.

How do we treat shingles?

Shingles is treated with antiviral medications to enhance healing of skin lesions and decrease the severity of nerve pain. It is recommended to administer antiviral medications within 72 hours of the onset of symptoms for the most benefit. Pain relievers such as acetaminophen and NSAIDs (ibuprofen, naproxen) are used to manage mild to moderate pain. Other medications may be considered for treating associated skin infections and nerve pain in extreme cases.

How can we prevent shingles?

Fortunately, a vaccine exists to prevent shingles. The vaccine, Shingrix, is a two-dose vaccine series recommended for those over the age of 50, even if they have previously been vaccinated with Zostavax. Shingrix is 90% effective at preventing shingles  – far superior to Zostavax, which has shown to be only 51% effective.

What should I know about the vaccine, Shingrix?

• Shingrix is NOT a live vaccine. It is a recombinant vaccine with an adjuvant. It works to boost your body’s protection against shingles.

• Complete vaccination with Shingrix requires two doses.The second dose should be received 2 to 6 months after the first dose. This is important to prevent shingles.

• It is administered into the muscle of the upper arm.

• Common side effects include pain, redness, swelling at the injection site, muscle pain, tiredness, headache, and flu-like symptoms. These effects should be temporary, and certainly far less severe than shingles itself.

What if I am immunocompromised ?

Being immunocompromised refers to having an immune system that is not working as well as it should as a result of advanced age, taking certain medications like steroids or chemotherapy, or other conditions such as HIV/AIDS. Low levels of immune system suppression are generally acceptable, but not all conditions have been evaluated by the Centers for Disease Control and Prevention (CDC) yet. Talk to your pharmacist to see if Shingrix is appropriate for you.

References:

Epidemiology, clinical manifestations, and diagnosis of herpes zoster. UpToDate. Wolters Kluwer. Available at https://www.uptodate.com. Accessed June 4, 2020.

Answer questions about the new shingles vaccine Shingrix. Pharmacist’s Letter: 2018.https://pharmacist.therapeuticresearch.com. Accessed June 4, 2020.

Shingles Vaccine: FAQs. Pharmacist’s Letter. 2018. https://pharmacist.therapeuticresearch.com. Accessed June 4, 2020.

Shingrix (Zoster Vaccine Recombinant, Adjuvanted). GSK. https://www.shingrix.com/index.html. Published 2018. Accessed June 4, 2020.

Vaccination for the prevention of shingles (herpes zoster). UpToDate. Wolters Kluwer. Available athttps://www.uptodate.com. Accessed June 4, 2020.

What everyone should know about Zostavax. CDC. 2018.https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/. Accessed June 4, 2020.

Images:

1. https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054#dialogId45719376

2. https://www.shingrix.com/discover-shingrix.html

3. https://www.webmd.com/skin-problems-and-treatments/shingles/ss/slideshow-shingles-pictures