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Shingles Vaccine
Old 06-28-2007, 04:35 PM   #1
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Shingles Vaccine

Anyone had experience with ZOSTAVAX, a vaccination against shingles? My brother had a rough bout recently with shingles and did not realize this vaccine was available for anyone over 60 years old who had chicken pox as a kid.

Seems like a prudent measure, but I'm curious if there is a down side.

Thanks.
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Old 06-28-2007, 04:59 PM   #2
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Seems like a prudent measure, but I'm curious if there is a down side.
Me too!

I saw some statistic that maybe 50% of those who had chicken pox get shingles. That seems like a lot, so I had planned to ask Rich about it. In any case, from what I have seen, you do not want shingles.

Also, does Medicare pay for this?

Ha
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Old 06-28-2007, 05:05 PM   #3
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I had shingles on my arm and into my chest .The only way to describe it is stick your arm in the gas grill and that's what it feels like .
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Old 06-28-2007, 07:13 PM   #4
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Here is the abstract of the Shingles Prevention Study, published in the New England Journal of Medicine, Volume 352:2271-2284, June 2, 2005.

ABSTRACT

Background The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella–zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults.
Methods We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine ("zoster vaccine"). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia.
Results More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild.
Conclusions The zoster vaccine markedly reduced morbidity from herpes zoster and postherpetic neuralgia among older adults.

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And here is a link to the drug company's website. There is a link for healthcare providers on reimbursement.
Information on ZOSTAVAX® [Zoster Vaccine Live (Oka/Merck)]

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Herpetic neuralgia is the pain Moemg is referring to. It can last for months. Another nasty side effect of shingles, if you happen to get them on your upper face, is ulceration of and permanent damage to your cornea.
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Old 06-28-2007, 07:41 PM   #5
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Herpetic neuralgia is the pain Moemg is referring to. It can last for months. Another nasty side effect of shingles, if you happen to get them on your upper face, is ulceration of and permanent damage to your cornea.
Wow, I'm surprised there is not more publicity about this vaccine. That is why I was curious if there was a serious downside.
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Old 06-28-2007, 09:08 PM   #6
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My DH was in the study (which in our area was run by the Seattle VA), he did not get the real thing.. and during the study got shingles. As soon as the study was over he got the vaccine.

You can get shingles more than once. It is painful.. no fun at all. Both of our parents had it when they least could manage the illness. I highly recommend the vaccine. Pay for it yourself in necessary.

The effective period of the vaccine is yet to be determined, but if you contract shingles the cost of the anti-viral will exceed by many multiples the cost of the vaccine.
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Old 06-28-2007, 09:54 PM   #7
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Last year I had what was diagnosed as a "mild" case of shingles. If this was mild, I cannot imagine what a severe case would be like. Absolutely unbearable pain on my back -- made even worse by the slightest touch of fabric! I was able to get the vaccine after the symptoms subsided and I most definitely recommend it for anyone who may be at risk. Shingles can be a very serious illness!
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Old 06-29-2007, 12:18 PM   #8
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Also, does Medicare pay for this?
I've watched my MIL and a couple friends (one in her low 30s) go through the process. If you ever have shingles this will be the least of your concerns...
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Old 06-29-2007, 12:25 PM   #9
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I am convinced; I will gt it asap.

It seems that it is much more common and more severe than I thought.

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Old 06-29-2007, 12:32 PM   #10
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my mom had it recently, it was absolutely terrible. she was just curled up in a fetal position and crying! you never want to see someone you love feeling like that.

she also has continued pain from the shingles which a high percentage of people do...

so Brat - i'm assuming you can still get the vaccine after you get the real thing (like your bro?)? i wouldn't want anything to exacerbate what she already has been through...
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Old 06-29-2007, 01:40 PM   #11
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so Brat - i'm assuming you can still get the vaccine after you get the real thing (like your bro?)? i wouldn't want anything to exacerbate what she already has been through...
Shingles is caused by Herpes Zoster, the same virus that causes Chickenpox. To get shingles, you must have previously been exposed to the virus. What usually happens is that during a bout of chickenpox (which may be symptomatic or asymptomatic), the HZ virus sets up camp in one or more of your nerve roots, and becomes dormant. Many years later, when you are stressed or immune suppressed, it wakes up and causes shingles. The presence of the virus in the nerve root explains why the pain of shingles always corresponds to the distribution of that sensory nerves on your skin. This is called the dermatome Dermatomic area - Wikipedia, the free encyclopedia .

So, of course, this can happen again!
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Old 06-29-2007, 02:22 PM   #12
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yes, which would be a nightmare and mom has not done much to improve her lifestyle - still works niteshift, doesn't sleep well etc...so very likely!


will have to look into the vaccine more. her doctor sucks and i've been trying to get her to find a new one, instead of the insensitive jerk who barely got out of med school she has now...
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Old 06-29-2007, 03:46 PM   #13
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her doctor sucks and i've been trying to get her to find a new one, instead of the insensitive jerk who barely got out of med school she has now...
Remember that half of all doctors graduated below the median. Same goes for all lawyers, engineers, etc......
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Old 07-01-2007, 08:04 PM   #14
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Hey, since DH got the vaccine after having shingles I expect to get a dose too.

Shingles seems to follow a nerve network. I got it on my back.. a trail of little blisters. I have seen people get it down their arm. I think my in-law had it on her tummy.
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Old 07-02-2007, 08:35 AM   #15
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Hey, since DH got the vaccine after having shingles I expect to get a dose too.
Seriously, if you are over 60 years old, you should ask your doc about this vaccine. The consensus is clear that you want to avoid shingles if at all possible. My brother still has blurry vision as a result of his bout - over a week later. Also the antibiotics (to prevent a secondary bacterial infection) are pretty rough on your digestive tract.
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Old 07-02-2007, 11:03 AM   #16
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Why is it only for those over 60?

Note that it only prevents shingles half the time.
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Old 07-02-2007, 11:09 AM   #17
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Because those of us over 60 have the highest rate of Shingles, and because the virus seems to impact us the most.

I will gladly accept a 50% effectiveness rate. The Shingles vaccine is a variant of the Chicken Pox vaccine. Both are relatively new.
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Old 07-02-2007, 11:11 AM   #18
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Al said: "Note that it only prevents shingles half the time."

Quote:
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Here is the abstract of the Shingles Prevention Study, published in the New England Journal of Medicine, Volume 352:2271-2284, June 2, 2005.

The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001).
Yes, that is what the study abstract said. No vaccine is 100% effective.
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Old 07-02-2007, 01:54 PM   #19
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Because those of us over 60 have the highest rate of Shingles, and because the virus seems to impact us the most.

I will gladly accept a 50% effectiveness rate. The Shingles vaccine is a variant of the Chicken Pox vaccine. Both are relatively new.
My original question was "What is the downside?" I really heard no downside cited - but a 50% reduction in risk for $150 seems like a bargain.
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Old 07-02-2007, 03:16 PM   #20
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My original question was "What is the downside?" I really heard no downside cited - but a 50% reduction in risk for $150 seems like a bargain.
This is a live attenuated vaccine so you should not get it if you have immune suppression, e.g. AIDS. You would just end up with a bad infection.
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