Understanding Shingles

Shingles, also known as herpes zoster, is a painful skin rash caused by the re-activation of the chickenpox virus (varicella-zoster virus) in people who have previously had chickenpox. The virus can be re-activated because of a range of issues that include advancing age, immune-suppressants, illness, or stress.

It is estimated that around one in five people who have had chickenpox would later develop shingles. The pain of shingles can, in some cases, linger for several weeks or months after the rash has disappeared. This lingering pain is called post-herpetic neuralgia (PHN) and is more likely to take place with increasing age.

Shingles begins with a burning sensation in the skin, followed by a rash of painful fluid-filled blisters which break down and turn into sores before healing. It often affects a particular area on one side of the body such as the chest, but can sometimes affect the head, face, and eye. Patients with shingles can also transmit chickenpox to susceptible individuals.

Preventing Shingles with Vaccination

Shingles is preventable with vaccination. There is no specific length of time one must wait after having shingles before receiving the shingles vaccine, although it would be best to make sure the shingles rash has disappeared before getting vaccinated. It is given as an injection into the upper arm.

There are two vaccines available – Zostervax (live vaccine) and Shringrix (non-live vaccine). Both are approved for use for ages 50 years and older.

Zostervax

Zostervax is not recommended for immunocompromised persons and those with a history of anaphylaxis to any component of the vaccine or to neomycin and gelatine. It is given as a single dose and booster doses are not required.

Clinical trials on elderly individuals without prior zoster incidents reported a 50 to 70 per cent reduction in the incidence of shingles.

Shringrix

This is a re-combinant vaccine.  It contains an ingredient called an adjuvant which helps to boost the immune response to the vaccine.  Shringrix could be a more suitable choice for individuals with weakened immune systems where live vaccines are not recommended. Studies confirmed that Shingrix is safe and immunogenic when administered five or more years after Zostavax.

A randomised, placebo-controlled study that included older adults (≥50 years of age) found that the vaccine had an overall vaccine efficacy of 97.2 per cent against zoster. It is given in two doses with an interval of two to six months and booster doses are not required.

It can also be given to persons who had taken Zostervax, after a period of give years, to retain the protection. Shingrix is not recommended for persons with a history of anaphylaxis to any component of the vaccine or a previous dose.

Possible Side Effects of Shingles Vaccine

It is generally regarded as a very safe vaccine. Common adverse events include redness, pain and swelling at the injection site, fever, fatigue, headache, body aches, malaise, and nausea.

Both Zostervax and Shingrix are available at most Raffles Medical Clinics. To receive the vaccine, please contact your preferred branch to place an order for the vaccine.