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New, High-in-Demand Vaccine Goes on Offensive to Prevent Shingles

It often begins with a rash on the torso or the hairline. The red dots spread into a distinct line and swell into little blisters, growing itchy and often shockingly painful.

Many people are baffled, and most head to their doctor’s office. Baptist Health Primary Care [1] physician Patricia Feito-Fernandez, M.D. [2], sees patients with these symptoms several times a month in her Kendall office. The diagnosis: shingles, a viral infection that can last for weeks and leave some with lingering, sometimes severe, pain.

“I see the telltale signs — red blisters, usually in a strip on one side of the body that patients describe as an intense, sensitive, burning sensation,” she said. “It’s a common illness and very uncomfortable.”

One out of three people in the United States will develop shingles in their lifetime, and the risk increases with age. Doctors see about a million cases a year.

Thanks to a new, more effective vaccine, however, shingles is now largely preventable. Shingrix, approved in 2017, also protects people from the serious complication of postherpetic neuralgia (PHN).  Currently, the demand for Shingrix is so high across the nation that the vaccine’s manufacturer, GlaxoSmithKline, conceded recently that “demand has exceeded supply.” So there may be delays in some areas, but you should check with your primary care physician if you are a candidate for the vaccine.

Some 10 to 15 percent of shingles sufferers develop PHN, a debilitating pain along the nerves where they had the rash. The pain from PHN can last for months or years, interfering with daily life.

Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. Once you have chickenpox, the virus remains in your body in a dormant state. It can reactivate and cause shingles at any time, often during periods of stress or when your immune system is compromised. Shingles commonly appears on the torso or face but can develop anywhere on the body. You can’t catch shingles from another person with shingles, but someone who has never had chickenpox (or the chickenpox vaccine) can be infected with the varicella virus by a shingles patient and may come down with chickenpox.

Some people get shingles more than once. Mercedes Forero of Coral Gables (pictured above with husband, Gustavo) has almost lost count of the number of shingles outbreaks she has had — close to 10. “First I got it in my back, right here where I sit,” recalled Ms. Forero, an active 88-year-old who enjoys knitting and her twice-a-week senior aerobics class. “It got itchy. Not painful, but very itchy.”

Ms. Forero has had recurrences in the same area of her back and also two outbreaks near her knee, even though she received the original shingles vaccine, Zostavax, which is less effective than the newer Shingrix. The new vaccine, delivered in two doses two to six months apart, is said to be 90 percent effective in preventing shingles. The U.S. Centers for Disease Control and Prevention recommends that adults over age 50 receive it.

“We recommend this vaccine to all our [over-50] patients, even those who have received Zostavax or have had a case of shingles in the past,” Dr. Feito-Fernandez said. “While nothing is 100 percent, this vaccine is an excellent prevention tool. If a patient does get shingles, it will be a less intense course of the disease.”

The treatment for shingles is an antiviral medication that can shorten the illness and lessen its severity. Topical creams can help with the itchy rash, and pain medication may be needed if the discomfort is severe.

Chris Wang was still in her 40s, the busy mother of two girls, when she developed a rash at her hairline. She went to her doctor when it crept dangerously toward her eye. “I was getting sharp pain in my ears,” the Coral Gables resident recalled. “I had no idea what it was.”

Ms. Wang, now 53, got the original vaccine and suffered a second bout of shingles, this time on the back of her neck, also beginning at her hairline. “Every once in a while, I still get a shooting, fl ashing pain. It’s there, and then it’s gone. And sometimes, I want to scratch the back of my neck raw.”

Ms. Wang recently received the first dose of the new shingles vaccine, as did her husband, Tim, 55. They’re hoping it will prevent the viral infection once and for all.

Shingles can affect patients differently, Dr. Feito-Fernandez said. “For some, especially those with other health issues, it can be extremely diffi cult to endure. One of our goals is to prevent illness, and this vaccine allows us to do that.”

This article was previously published in Resource Magazine [3].