GHS Cares: Shingles Vaccinations are Not Created Equal

6/7/2018

Shingles vaccinations -- yes, you read that right, there are TWO shingles vaccinations now! At Granville Primary Care, Butner-Creedmoor, we try to keep our patients up to date with the Center for Disease Control (CDC) recommendations for vaccines. It is important to know how it’s different from the first one and why you may want to get it.

Fact #1 According to the CDC, almost one out of every three Americans will get shingles in their lifetime.

Shingles is the reactivation of the chickenpox virus, also known as Varicella Zoster Virus or “VZV.” This virus can cause an illness with widespread rash and high fever. The virus then “hibernates” in a nerve root — sometimes never to be seen again. However, it can become reactivated where it grows along the nerve to form a sharp, burning nerve pain and blistering rash. Children who get the varicella vaccination are less likely to get shingles. However it’s important to note that everyone is at risk, including people who think they never had the chickenpox.

Shingles has been diagnosed nearly everywhere on the body -- the pain and rash can pop up in every spot where you have nerve endings, including the eye and other sensitive areas. The worst part of shingles is the risk of post-herpetic neuralgia or “PHN,” which is nerve pain that does not go away. Experience with patients having PHN makes physicians all the more eager to talk about the shots to help prevent shingles!

Fact #2 Shingrix and Zostavax are two different shingles shots.

Zostavax is made by Merck Pharmaceuticals and was approved for use in the U.S. in 2006. Shingrix is made by Glaxo Smith Kline and was more recently approved in the U.S. in October 2017. Zostavax is a live virus vaccine that is a single shot approved for ages 60 and older. Shingrix is a dead virus protein vaccine and a two-shot series given at least two months apart that is approved for ages 50 and older.

They both offer protection against shingles, but according to two large international trials (over 16 thousand patients enrolled), Shingrix offers better protection. Zostavax was shown to reduce the risk of shingles by 51% and post-herpetic neuralgia by 67%. Shingrix showed protection for 97% of people in their 50s-60s and 91% of people in their 70s-80s. Shingrix also resulted in reducing the risk of post-herpetic neuralgia by 86%.

Fact #3 Shingrix is recommended, even for those who already got Zostavax.

If you got a single shingles shot before spring 2018, then you probably received Zostavax. We recommend you ask your provider about getting Shingrix. All Medicare part D plans and most private health insurances cover Shingrix, which is about $150 per shot. Please check with your pharmacist on any drug-related copay. Given that it is covered by insurance as a pharmaceutical, most clinics will recommend that you get it at a local pharmacy. Among the pharmacies in Creedmoor and Butner, the majority are now offering Shingrix.  If you consult your doctor and Shingrix is recommended for you, your doctor may provide a prescription.

 Fact #4 There are still some people who shouldn’t get the shingles shots.

Shingles shots are currently not recommended for anyone younger than age 50, even if they have had shingles. It is also not recommended for women who are pregnant or breastfeeding. The shingles shots are not recommended for anyone who is immunocompromised (from medications or diseases that prevent the immune system from fully functioning). Since Shingrix is a dead protein vaccine, it may eventually be proven safe even for those without a fully functioning immune system, but the CDC is currently awaiting more data to aid in that decision.

Most people who get the shot will have some arm pain at the site. Getting a shot is never a walk in the park, but it is far better than shingles!

Dr. Liz Baltaro and Dr. Amy Nayo are primary care physicians expanding community access to quality pediatric and family medicine at Granville Primary Care, Butner-Creedmoor, located at 1614 NC Highway 56, Butner. To schedule your primary care appointment, please call 919-575-6103 or schedule online at ghshospital.org. You can schedule a primary care appointment with a provider as far as 12 months in advance through online scheduling.

Have a health-related question for Dr. Liz Baltaro and Dr. Amy Nayo? Please visit ghshospital.org/GHSCares to submit your question and receive an answer in a timely manner!

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