Loading...Shingles, also known as Herpes Zoster is an infectious disease that occurs due to the reactivation of the dormant Varicella Zoster virus that is left behind in the body of an individual after an attack of chickenpox [1].
There is no cure available for Shingles and managing the condition and controlling the signs and symptoms and stopping the infection from spreading are the only treatment remedies that can be used for the infection.
Shingles however, can be prevented in individuals with the administration of two types of vaccines. These two types of vaccines are:
– The chickenpox vaccine Varivax
– The Shingles vaccine Zostavax
While the vaccines reduce the risk of encountering Shingles by up to 50%, the vaccines also reduce the risk of encountering postherpetic neuralgia by up to 66%.
Chickenpox Vaccine – Varivax
The Varicella vaccine available as Varivax is administered in childhood during immunization in order to prevent the onset of chickenpox. This vaccine may also be administered in adults who have never suffered from chickenpox. This vaccine reduces the chances of complications or the severity of the disease even if not able to completely prevent Shingles from occurring.
While both chickenpox and Shingles are caused by the same Varicella Zoster virus, it has been noticed that children are more prone to developing chickenpox while adults are more prone to developing Shingles [2].
Varivax is administered to any person who is above 12 months old in order to prevent both chickenpox in the near future and Shingles in the later future.
The following types of individuals are recommended to avoid the use of Varivax:
- Individuals allergic to neomycin and gelatin, active components of the vaccine
- Individuals suffering from bone marrow problems such as leukemia, cancer of the blood, lymphoma or infection of the bone marrow
- Individuals undergoing medications which suppress the immune system
- Individuals who have a weakened immune system such as those suffering from HIV/AIDS
- Individuals who have a family history of members having weak immune systems
- Individuals who suffer from an unrelated and active case of tuberculosis
- Individuals who currently have a fever
- Breastfeeding women, pregnant women and women who plan to get pregnant within the next three months
- Individuals who have undergone a blood transfusion or a plasma transfusion within five months of the vaccine being administered
Some medications may prove to interfere with the functioning of Varivax and as such, it is advised to always seek professional medical consultation and recommendation before resorting to vaccine administration.
Shingles Vaccine – Zostavax
The Varicella Zoster vaccine is available as Zostavax and is usually administered in adults above 60 years of age. While the vaccine is allowed to be administered after the age of 50, usually medical practitioners hold it off until an individual attains the age of 60.
Zostavax is essentially a much larger and a much more concentrated form of the Varivax vaccine. It does not guarantee 100% prevention of Shingles but may lower the severity and complications of the disease. This vaccine also lowers the risk of post-herpetic neuralgia in the individuals suffering from Shingles.
Zostavax vaccine is not recommended to be administered to the following types of individuals:
- Individuals who are allergic to gelatin , neomycin or other components of the Shingles vaccine
- Individuals who suffer from HIV/AIDS or other underlying diseases which cause the immune system of the body to be greatly weakened
- Individuals who are currently undergoing medication which involves suppressing of the immune system of the body, as in the case of organ transplants, or radiation therapy and chemotherapy in cancer
- Individuals who have had a bone marrow transplant
- Individuals who are looking to get pregnant or are pregnant or breast feeding a child
- Individuals should not get a booster dose of the vaccine if an allergic reaction was suffered on the administration of the first vaccine shot
Zostavax is safe to be used with other vaccines as well. However, professional medical recommendation should be sought before taking multiple vaccination shots. The Shingles vaccine is generally safe and is recommended to all individuals over the age of 60.
Indications for Shingles vaccine
Individuals who had never suffered from chickenpox or Shingles in their lifetime still face the risk of developing Shingles in their further life above 50 years of age [3]. These individuals may go for Varivax or Zostavax.
While neither of the two vaccines can provide a 100% guarantee against the infection, they can greatly reduce the risk of encountering the disease and if the disease in encountered, it proves to be much milder and does not result in any associated complications.
The Shingles vaccine is recommended to people who have already suffered from an episode of the infection in order to prevent recurring outbreaks in the future. Vaccines against Shingles are the most effective way to ensure prevention of the infectious disease in individuals. However, vaccines are only meant to be a preventive measure and must never be administered to an individual already suffering from the disease. Both the vaccines contain live forms of the Varicella Zoster virus and if administered to an individual who has a weakened immune system, it may instead prove to result in an outbreak of Shingles itself. However, it is fine to administer the vaccine to individuals who have face an outbreak of Shingles in the past, provided that the outbreak occurred at least a year before the vaccine is administered.
Complications of Shingles Vaccine
There are several complications that may be associated with the two Shingles vaccines. These complications include the following:
- People with suppressed immunity should avoid taking the Varicella vaccine as lowered immunity may lead to triggering of the weakened virus in the vaccine that may instead prove to cause Shingles. It may be in case of individuals suffering from HIV or other active infections that lowers the immune response.
- People undergoing radiation therapy and chemotherapy for cancer treatment must avoid the Varicella vaccine as they too have a weakened immune response following the cancer medications.
- People who are allergic to certain drugs like neomycin should not go for either vaccine.
- Vaccines should be avoided in infants, young children or pregnant women who have never had chickenpox.
How does Varicella Vaccine work?
The varicella vaccines (both Varivax and Zostavax) contain weakened chickenpox and Shingles causing virus in a live form, which on being injected into the body may invoke the immune response of the body of these individuals to actively suppress infection [4]. The body then produces antibodies to fight these weakened foreign bodies which remain in the bloodstream thereafter. These antibodies remain in bloodstream throughout the lifetime of the individual and provide immunity against further attack by varicella virus in future.
Vaccines are typically administered by injecting the upper arm of the body. The recommended dosage is two doses of the vaccine for prevention against chickenpox and a single dosage in case of prevention against Shingles.
Although this vaccine is effective in reducing the threat of developing Shingles but as per studies it has been found that it lowers the risk by only 50%.
The long term duration of the immunity provided by the vaccine is still largely debated, with studies having reported both individuals enjoying healthy immunity for up to thirty years and others having become vulnerable to the disease in as less as six years.
The vaccines should always be administered as per the appropriate age group. As such, younger individuals should be provided with Varivax while elderly individuals should be administered Zostavax.
Side effects of the vaccine
Since both Zostavax and Varivax are live vaccines which contain a weakened form of the Varicella Zoster virus, there are a few common side effects of this vaccine. These include redness, swelling, itching, pain and bruising at the site of injection. Besides the person may feel headache, pain in muscles or joints, breathlessness, swelling in the face, lips, throat or tongue. There may be chances of allergic flare with occurrence of rashes on the body.
It is recommended to consult the physician as soon as the signs of allergic reaction or other side effects appear.
Some of the less common side effects of the vaccine are the following:
- Appearance of bluish tinge on the lips and the fingernails
- Pain being experienced in the chest
- Skin rashes on the site of administration of the vaccine
- Pink and frothy sputum accompanied with cough
- A decreased output of urination
- Difficulty in breathing, often proving to be noisy and tending towards wheezing
- Dilation of the veins around the neck
- Feeling of lethargy, tiredness and fatigue
- A general feeling of sickness
- An increase in sweating
- Irregularities in the heartbeat
- General irritability and paleness of the skin
- Swelling in some parts of the body such as the face, the fingers, the toes and the ankles
- A sudden gain in weight
Generally, both the vaccines are considered to be pretty safe and there have been very few reported cases of serious side effects or complications caused by the vaccine.
While serious side effects are largely unheard of, the following side effects need to be provided with immediate medical attention as they prove to be quite harardous:
- Symptoms of flu with high fever, swelling of glands and a sore throat
- Extreme difficulty in breathing
- Appearance of severe and painful skin rashes
Other methods of prevention
Individuals who had never contacted chickenpox or Shingles in their life should avoid contact with the individuals with chickenpox or Shingles patients. The fluids searing from these blisters are contagious and may transfer infection to the healthy individuals. Thus it is always recommended to cover up the wounds with dressing or to avoid going out in order to prevent spread of infection.
Shingles is a highly contagious and infectious disease which is also quite widespread among elderly individuals. Some experts estimate that after the age of 80, almost half of the people will be subject to this condition.
Transmission of the Varicella virus from individuals who have been vaccinated to individuals who are susceptible to the disease or have a weak immune system has also been reported.
Medications for prevention of Shingles are rarely effective and vaccines are the best method of prevention of the infection. Unfortunately, there are not many ways by which Shingles can be prevented. Vaccination is the best way to prevent outbreak of the infection, but even vaccination is not 100% effective and it is accompanied with its own set of complications and side effects [5]. The Varicella vaccines have nevertheless been recognized by the WHO to be amongst the most essential vaccines that are required for maintaining basic health conditions.
References
[1] Clinical Infectious Diseases: Characteristics of Patients with Herpes Zoster on Presentation to Practitioners in France, Chidiac, C., Bruxelle, J., Daures, J. P., Hoang-Xuan, T., Morel, P., Leplège, A., and de Labareyre, C; Volume 33, Issue 1 62-69 – November 2000 – DOI 10.1086/320884 http://cid.oxfordjournals.org/content/33/1/62.short
[2] America Journal of Epidemiology: History of Chickenpox and Shingles and Prevalence of Antibodies to Varicella-Zoster Virus and Three Other Herpesviruses among Adults with Glioma and Controls, Wrensch, M., Weinberg, A., Wiencke, J., Miike, R., Sison, J., Wiemels, J … and Kelsey, K.; Volume 161, Issue 10929-938 – May 2005 – doi: 10.1093/aje/kwi119 http://aje.oxfordjournals.org/content/161/10/929.short
[3] British Medical Bulletin: Recent developments in anti-herpesvirus drugs, Field, H. J., & Hodge, R. A. V.; Volume 106, Issue 1213-249 – February 2013 – doi: 10.1093/bmb/ldt011 http://bmb.oxfordjournals.org/content/106/1/213.short
[4] Journal of the American Board of Family Medicine: Update on Adult Immunizations, Wolfe, R. M.; vol. 25 no. 4 Pp. 496-510 – July 2012 – doi:10.3122/jabfm.2012.04.100274 http://www.jabfm.org/content/25/4/496.short
[5] Annals of Internal Medicine: Barriers to the Use of Herpes Zoster Vaccine, Hurley, L. P., Lindley, M. C., Harpaz, R., Stokley, S., Daley, M. F., Crane, L. A., … & Kempe, A. ; Volume 152, Issue 9 Pp. 555-560. – September 2008 – doi:10.7326/0003-4819-152-9-201005040-00005 http://annals.org/article.aspx?articleid=745758