Herpes Zoster Vaccine
Associated With Lower Risk of Shingles in Most Older Adults
Confirms other
studies showing more than half of seniors will be protected by shot but
they are still not getting it (not covered by Medicare) - link to
video in story
Jan. 11, 2011
A new study confirmed what previous research has shown about the
effectiveness of the shingles vaccination for senior citizens it
protects slightly more than half who get the shot from the painful rash
that can be disabling. This study looked at a large group of older
adults and found the vaccination reduced the risk of shingles,
regardless of age, race or the presence of chronic diseases.
It did not,
however, shed new light on why so many senior citizens are not getting
the preventive shot. A significant reason that is not often discussed,
however, is that Medicare does not pay for the treatment. The Centers
for Disease Control and Prevention reports the vaccination is covered by Medicare Part D
prescription drug plans, although, the senior will have to cover the
copayment.
The typical
price for a vaccination is between $200 and $250.
May 19, 2008 ...
Researchers report those who do get herpes zoster, or shingles,
are much more likely than others to have a family history of the
condition.
Shingles, also
known as herpes zoster, is caused by reactivation of the virus that
causes chickenpox. Once chickenpox infection has run its course, the
virus is not eliminated; rather, it retreats to clusters of sensory
nerve cells usually located near the spinal cord, where the virus
persists in a dormant state.
As immunity
weakens with advancing age, the virus can reactivate, multiply in and
damage sensory nerve cells to cause pain. It then migrates to the skin,
causing the blistering rash of shingles.
Generally,
shingles first manifests as pain, itching or tingling in an area of skin
on one side of the body or face. Then a painful blistering rash develops
in that same area of skin; the rash can take two to four weeks to heal.
Anyone who has
had chickenpox - which includes most adults in the United States - could
develop shingles, though not all will. The two major risk factors are
increasing age and declining immunity. Half of all people who live to
age 85 will get the disease.
"The pain of
herpes zoster is often disabling and can last for months or even years,
a complication termed postherpetic neuralgia. Approximately one million
episodes of herpes zoster occur in the United States annually, but aside
from age and immunosuppression, risk factors for this condition are not
known," the researchers write in the January 12 issue of the Journal of
the American Medical Association (JAMA).
Zostavax is the
only US licensed vaccine that reduces the risk of reactivation of the
varicella zoster virus, the same one that causes chicken pox, and
remains dormant in the body after recovering from this infection.
Earlier data
provided evidence that herpes zoster vaccine works in a select study
population under idealized circumstances, but these researchers decided
the vaccine needed to be evaluated in field conditions to show whether
benefits of the vaccine can be generalized to conditions of clinical
practice.
The researchers
note that this is particularly important for the herpes zoster vaccine,
given the medical and physiological diversity in the elderly population
for whom the vaccine is recommended by the Centers for Disease Control
and Prevention.
Hung Fu Tseng,
Ph.D., M.P.H., of Southern California Kaiser Permanente, Pasadena,
Calif., and colleagues evaluated the risk of herpes zoster after receipt
of herpes zoster vaccine among individuals in general practice settings.
The study
included community-dwelling adults, age 60 years or older, who were
members of a managed care organization. There were 75,761 members in the
vaccinated cohort, who were age matched (1:3) to 227,283 unvaccinated
members.
Compared with
the unvaccinated cohort, individuals in the vaccinated cohort were more
likely to be white, women, and to have had more outpatient visits, and a
lower prevalence of chronic diseases.
There were 5,434
herpes zoster cases identified in the study (6.4 cases per 1,000 persons
per year among vaccinated individuals and 13.0 cases per 1,000 persons
per year among unvaccinated individuals).
About
Shingles
Shingles is
a disease
caused by
the
varicella-zoster
virus - the
same virus
that causes
chickenpox.
After you
have
chickenpox,
the virus
stays in
your body.
It may not
cause
problems for
many years.
As you get
older, the
virus may
reappear as
shingles.
Unlike
chickenpox,
you can't
catch
shingles
from someone
who has it.
Early signs
of shingles
include
burning or
shooting
pain and
tingling or
itching,
usually on
one side of
the body or
face. The
pain can be
mild to
severe.
Blisters
then form
and last
from one to
14 days. If
shingles
appears on
your face,
it may
affect your
vision or
hearing. The
pain of
shingles may
last for
weeks,
months or
even years
after the
blisters
have healed.
There is no
cure for
shingles.
Early
treatment
with
medicines
that fight
the virus
may help.
These
medicines
may also
help prevent
lingering
pain. A
vaccine may
prevent
shingles or
lessen its
effects. The
vaccine is
for people
60 or over.
In the fully
adjusted analysis, vaccination was associated with reduced risk of
herpes zoster. The reduction in risk did not vary by age at vaccination,
sex, race, or with presence of chronic diseases.
Herpes zoster
vaccine recipients had reduced risks of ophthalmic (near the eye) herpes
zoster and hospitalizations coded as herpes zoster.
Overall, the
vaccine was associated with a 55 percent reduction in incidence of
herpes zoster.
"Herpes zoster
vaccine (Zostavax) was licensed recently, which means the durability of
its protection needs to be assessed in future studies. Meanwhile,
however, this vaccine has the potential to annually prevent tens of
thousands of cases of herpes zoster and postherpetic neuralgia
nationally.
To date, herpes
zoster vaccine uptake has been poor due to weaknesses in the adult
vaccine infrastructure and also due to serious barriers to the vaccine
among clinicians and patients. Solutions to these challenges need to be
found so that individuals seeking to receive herpes zoster vaccine will
be able to reduce their risk of experiencing this serious condition,"
the authors conclude.
The Food and
Drug Administrations says other studies have shown the vaccination to
reduce the frequency of pain associated with shingles for older people.
"In
people who were 70 years of age and older, and still
developed shingles, even though they had been
vaccinated, Zostavax reduced the frequency of PHN, the
pain associated with the illness. Overall, the benefit
of Zostavax in preventing PHN is due to the effect of
the vaccine on reducing the risk of developing herpes
zoster (shingles). Zostavax will not work to treat PHN,"
according to the FDA website.
