There Is A New And Much More Effective Vaccine For Shingles

Question: I am taking care of my aging mother; she is in her 80s. A couple of weeks ago, she complained of pain on one side of her head. A few days later, I found blisters and a rash on that side of her neck. The following day, her doctor confirmed that she had shingles. She took a medicine for one week; her rash and pain did subside. I remember that I had chickenpox as a child. I am worried that I will get shingles also. Our grandchildren have received chickenpox vaccine; is there one for adults to prevent shingles?

Answer:

I am glad that your mother recovered from shingles without complication.  Some seniors can develop severe and persistent pain in the same area after shingles had healed.

Chickenpox and shingles are caused by the same virus: varicella zoster virus (VZV).  Before chickenpox vaccine was widely adopted in North America, chickenpox was a common childhood illness.  Virtually every child had chickenpox sooner or later.  Since then, it has become a rare illness, and if they do get chickenpox, it is a lot milder with few complications.

Shingles usually happens in adults decades after getting chickenpox; it becomes more common as we get older.  VZV has the unique ability to stay dormant in our nerve cells near the spinal cord.  When we get older, and as our immune system becomes weaker, the virus can reactivate one day and spread along the nerve fibres to the skin, and produce blisters and a rash recognized as shingles.

We don’t know what wakes up the virus after decades of being dormant.  Stress seems to trigger shingles in some adults.  Medications that affect our immune system, like cancer treatment, can reactivate the virus also.

There are two vaccines available to prevent shingles: Zostavax and Shingrix.  Zostavax was licensed in Canada in 2008; it is a live virus vaccine.  Unfortunately, the immunity that it produces is weak, and this immunity disappears after several years.  As a result, it is not very effective in protecting seniors from developing shingles.

Further research showed that a particular protein on the surface of the chickenpox virus, called glycoprotein E, is responsible for immunity against chickenpox after infection.  By combining this glycoprotein E with a substance called adjuvant, it can induce very strong immunity against chickenpox virus.  This became the new shingles vaccine: Shingrix.

Extensive research around the world showed that Shingrix can induce strong immunity in adults in their 50s as well as seniors over 80 years of age.  Furthermore, the immunity stays at high levels in the body for years, protecting most seniors who otherwise are very susceptible to develop shingles in their golden years.  This vaccine was approved in Canada in 2017.

When compared with Zostavax, Shingrix is clearly a superior vaccine.  It requires two doses, administered two to 6 months apart.  The biggest problem is that most provinces are not providing this vaccine free to seniors; private insurance may not cover it either.  Judging from the effectiveness of the vaccine, as well as its potential to prevent moderate to severe pain that can continue after one gets shingles, it is a very worthwhile vaccine, if you can afford to pay for it yourself.

You should discuss with your family doctor about Shingrix at your next visit.  It can be given at the same time when you receive other vaccines recommended by your doctor.