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Shingles Vaccine
Old 01-18-2008, 11:38 AM   #1
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Shingles Vaccine

I received the new shingles vaccine VARICELLA (ZOSTAVAX) yesterday.

From what I have found out Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox. Only someone who has had chickenpox can get shingles. The virus stays in your body. It can reappear many years later to cause a case of shingles. It is far more common in folks age 50+. Also, I understand that it is more common in people whose immune systems are weakened by cancer or drugs (steroids, chemotherapy). Over a million people in the USA get shingles each year.

This Vaccine was just licensed in 2006 and I believe that in clinical trials it prevented shingles in about 50% of folks age 60+.

My mother had shingles for about the last 15 years of her life and I recall her having much pain and discomfort due to simple activities like hugging, reclining, physical activity where clothing would rub on the skin surface.

If you have an opportunity to receive the vaccine, you may wish to ask your doctor about it as it may be beneficial to your long-term health.
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Old 01-18-2008, 11:42 AM   #2
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We've discussed this before....

Shingles Vaccine
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Old 01-18-2008, 11:42 AM   #3
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Mickeyd, I understand many if not most insurance will not cover the vaccine and the cost can run around $200. What was your experience?
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Old 01-18-2008, 12:02 PM   #4
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It's a winner. I'll be taking it.

So far it seems safe and reasonably effective. Severe shingles is something you definitely do NOT want.

Lately it has also been advised that over-50s take a final dose of tetanus-pertussis vaccine as well. A surprising number of prolonged coughs in adults are due to pertussis (whooping cough). No longer is it only for kids. The tetanus part is precautionary, the pertussis part is for the above, and some contain diphtheria vaccine as well; not a serious risk in North America but wise to maintain general community immunity to prevent recurrences.

Worth $200 if insurance doesn't cover.
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Old 01-18-2008, 12:10 PM   #5
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Lately it has also been advised that over-50s take a final dose of tetanus-pertussis vaccine as well.
Nine years ago I got a tetanus vaccine when I was injured and paid a visit to the ER. What are the chances that vaccine was the tetanus-pertussis combination?
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Old 01-18-2008, 12:15 PM   #6
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Nine years ago I got a tetanus vaccine when I was injured and paid a visit to the ER. What are the chances that vaccine was the tetanus-pertussis combination?
Maybe 25%. You probably got plain tetanus but may have gotten tetanus-diphtheria, a common variation. DPT, which adds pertussis, would have been less likely.
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Old 01-18-2008, 12:21 PM   #7
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Thanks. Guess I need to add that one to my list...
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Old 01-18-2008, 12:28 PM   #8
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Had shingles about 10 years ago. Got the vaccine last July. Insurance paid for it (either medicare .. primary ... or united healthcare ... secondary).
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Old 01-18-2008, 12:33 PM   #9
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Had shingles about 10 years ago. Got the vaccine last July. Insurance paid for it (either medicare .. primary ... or united healthcare ... secondary).

I was wondering if I could get the vaccine since I also had shingles years ago and would not like to repeat that torture .
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Old 01-18-2008, 12:41 PM   #10
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Use of zoster vaccine in people who already had a bout of shingles has not been studied.

For perspective, the incidence of shingles in adults is a bit over 1% per year. Vaccine cuts that in half, and makes the break-through cases more mild.
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Old 01-18-2008, 01:59 PM   #11
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Use of zoster vaccine in people who already had a bout of shingles has not been studied.

For perspective, the incidence of shingles in adults is a bit over 1% per year. Vaccine cuts that in half, and makes the break-through cases more mild.
Rich, is the minimum age still considered to be 60 years old for the vaccine?
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Old 01-18-2008, 03:06 PM   #12
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Rich, is the minimum age still considered to be 60 years old for the vaccine?
60 is just about where the frequency of occurrence starts to justify the cost, efficacy, etc. Nothing holy about it. I'll take it at my next (age 59) checkup.
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Old 01-18-2008, 03:09 PM   #13
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If you waited and didn't take the vaccine and then got shingles, would taking the
vaccine then be useful or not in minimizing effects of the current problem and
in preventing future problems? Or would that not be done/dangerous?
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Old 01-18-2008, 03:11 PM   #14
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My business partner just got it a couple months ago (59). His doctor said to wait until 60...........oops...........
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Old 01-18-2008, 03:39 PM   #15
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Mickeyd, I understand many if not most insurance will not cover the vaccine and the cost can run around $200. What was your experience?
I understand that the cost is normally in the $200 range and that most physicians do not stock it in the office as it is a live virus and needs to be stored in a frozen state.

My MIL had to obtain the vaccine on her own, keep it frozen and then deliver it to her doctor who administered the shot because he refused to stock it. I do not recall what her cost was, but $200 sounds familiar.

As I am covered by Tricare Prime with the military, my entire cost was picked up by my fellow citizens. Thanks folks.
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Old 01-18-2008, 04:41 PM   #16
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If you waited and didn't take the vaccine and then got shingles, would taking the
vaccine then be useful or not in minimizing effects of the current problem and
in preventing future problems? Or would that not be done/dangerous?
No benefit for the current outbreak. As to future prevention once an attack has occurred, it has not been studied.

Part of this issue is that with even the first attack you are vulnerable to "post-herpetic neuralgia" - a painful and chronic complication even after the acute flare has subsided. Best to have it in advance of any outbreaks.
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Old 01-18-2008, 08:17 PM   #17
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So why are they now saying the diptheria and whooping cough immunity do not last from the childhood vaccination and people must be revaccinated? They actually got results from subjects who lived a "lifetime" and still got the disease? What was wrong with the initial studies that said the immunity would last forever?
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Old 01-18-2008, 08:34 PM   #18
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I asked my doc if I could get the vaccine because 2 of my friends had shingles in the last year and they are about my age (50s). They are both strong healthy women in stressful jobs.
My doc said I should wait until 60 and keep my immune system strong. Just another reason to remain ERed and take care of myself, I guess.
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Old 01-18-2008, 09:38 PM   #19
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They actually got results from subjects who lived a "lifetime" and still got the disease? What was wrong with the initial studies that said the immunity would last forever?
I'd like to see that study (the one that says it "would last forever") but I don't think it exists.

Most initial studies of vaccines continue for some years, perhaps 5 or 6. As a population ages, the immunity of almost all vaccinations wanes. You need to combine that along with the likelihood of being exposed to the index disease along with the cost and safety profile of the vaccination to determine whether it is worth giving a booster.
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