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-   -   Shingles Vaccine (https://www.early-retirement.org/forums/f38/shingles-vaccine-28517.html)

travelover 06-28-2007 03:35 PM

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.

haha 06-28-2007 03:59 PM

:)
Quote:

Originally Posted by travelover (Post 530334)
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

Moemg 06-28-2007 04:05 PM

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 .

Meadbh 06-28-2007 06:13 PM

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.

__________________________________________________ __

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)]

__________________________________________________ __

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.

travelover 06-28-2007 06:41 PM

Quote:

Originally Posted by Meadbh (Post 530390)
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.

Brat 06-28-2007 08:08 PM

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.

Achiever51 06-28-2007 08:54 PM

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!:eek:

Nords 06-29-2007 11:18 AM

Quote:

Originally Posted by haha (Post 530344)
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...

haha 06-29-2007 11:25 AM

I am convinced; I will gt it asap.

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

Ha

bright eyed 06-29-2007 11:32 AM

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...

Meadbh 06-29-2007 12:40 PM

Quote:

Originally Posted by bright eyed (Post 530596)
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!

bright eyed 06-29-2007 01:22 PM

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...

Meadbh 06-29-2007 02:46 PM

Quote:

Originally Posted by bright eyed (Post 530638)
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......

Brat 07-01-2007 07:04 PM

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.

travelover 07-02-2007 07:35 AM

Quote:

Originally Posted by Brat (Post 531256)
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.

TromboneAl 07-02-2007 10:03 AM

Why is it only for those over 60?

Note that it only prevents shingles half the time.

Brat 07-02-2007 10:09 AM

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.

Meadbh 07-02-2007 10:11 AM

Al said: "Note that it only prevents shingles half the time."

Quote:

Originally Posted by Meadbh (Post 530390)
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.

travelover 07-02-2007 12:54 PM

Quote:

Originally Posted by Brat (Post 531366)
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.

Meadbh 07-02-2007 02:16 PM

Quote:

Originally Posted by travelover (Post 531429)
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.

oma 03-23-2008 03:32 AM

Quote:

Originally Posted by TromboneAl (Post 531364)
Why is it only for those over 60?

Note that it only prevents shingles half the time.

I had the same question. I guess form the WEBMD article, the vaccine hasn't been studied in younger patients. Also, the length of immunity hasn't been studied - may be a waste of $$$ while possibly increasing risk of reaction (anaphylaxis).

As a 44 yo, I was tempted to have my imms nurse give it to me. However, I'm sure she'd object, so I'd have to give it myself, most likely. Will think about it.

Rambler 03-23-2008 04:40 AM

DW had shingles a few weeks back, and was in tremendous pain. Looking back though, as much pain as she had, it must have been a mild case with just a few splotches on her left front and rear trunk. I guy I knew had it all over, front and back, and the pain was apparently horrible. He was off work for months with the pain...finally came back part time and promptly left. He said that his doc told him stress was often a trigger (certainly was in his case), and DWs doc asked her what kind of stress she had been having.

Sounds to me like a good reason to RE!;D

Caroline 03-24-2008 11:24 AM

Quote:

As a 44 yo, I was tempted to have my imms nurse give it to me. However, I'm sure she'd object, so I'd have to give it myself, most likely. Will think about it.
I asked for this last month when I was still only 50 yrs old (sigh) and my Dr. prescribed, no problem. Worth asking for -- all they can do is say no.

W2R 03-24-2008 11:55 AM

Quote:

Originally Posted by Rambler (Post 632655)
guy I knew had it all over, front and back, and the pain was apparently horrible. He was off work for months with the pain...finally came back part time and promptly left. He said that his doc told him stress was often a trigger (certainly was in his case), and DWs doc asked her what kind of stress she had been having.

My brother got a bad case of shingles last fall after our mother died. He was very close to her and took her death pretty hard. Then he had to dispose of her things and serve as executor for her estate. All in all, it makes sense that stress might have caused his shingles! It was on his back, and he has been miserable with it for months, poor guy.

I had shingles when I was seven, the year after I had chickenpox. I was not stressed, nor was I miserable. I was just a kid in second grade! I remember hating the lotion my mother kept painting on my shingles, since I thought it worsened the itching and pain.

mickeyd 03-24-2008 01:05 PM

My received the vaccine a few months ago. I mother suffered with shingles for the last 15 years of her life. Very uncomfortable and often painful.

Walt34 03-24-2008 06:11 PM

DW had it a couple of years ago, very painful. Key, we found, was early treatment. If you even think you might maybe possibly have it SPRINT to your Dr.'s office and camp there until he/she sees you.

If stress was the trigger it was her dad getting an artificial hip because it was right about that time.

Stevewc 03-24-2008 06:41 PM

Shingles vaccine
 
Hello Group,
Do you have to be 60 years old? A man I worked with just got over a severe case of shingles. After seeing him suffer I know I don't want it. Can a 55 years old get the dose?
Thanks for info,
Steve

Brat 03-24-2008 09:13 PM

Odds are the health care system is focusing the vaccine on the population most at risk.

My DH was a part of the research study, the VA was the group who tested it in our area. He got shingles during the study (mild case). It turned out that he got the placebo and at the end of the study received the vaccine. As a result of his participation he will receive treatment for shingles for the rest of his life (likely follow-up to the study).

JB 03-25-2008 12:44 AM

Strange that it's only FDA approved for people over 60. I've seen many people suffer (some in their 20s and 30s), and I'd definitely get the vaccine if it significantly reduced my chances of getting it. But I doubt my HMO would give it off-label.

Red Rover 03-26-2008 08:44 PM

Last summer my mom had shingles in and around her eyes. She said she was hoping she would die so the pain would stop. It was the most painful thing she's ever been through and she has been through a lot. I'm going to suggest she have this vaccine. I wouldn't wish what she went through on my worst enemy.

loosechickens 03-30-2008 02:22 PM

You only need to observe one family member or friend with shingles to make you willing to pay for the vaccine. I got mine at the Public Health department, paid $196 for it (Medicare doesn't cover it, go figure, considering what Medicare is probably having to shell out for cases of shingles.....our gov.....pennywise and pound foolish).

I had no side effects, even the shot site wasn't tender. I'd definitely recommend getting it. The CDC recommends it for everyone over 60. I don't know why it isn't more publicized.

LooseChickens

OldGuy 03-30-2008 04:34 PM

LooseChickens is spot on. Having watched FIL suffer for 3+ years with the after-effects of a bad bout of shingles, my PCP absolutely agreed that I should get the vaccine as soon as I turned 60. Our health care plan covered the cost (~$180), but it would have been worth every penny even if they hadn't covered it. A lot of plans are getting wise to this preventative measure and starting to cover it.

SlowTwitcher 03-30-2008 06:02 PM

In my area I have seen that Medicare Part D prescription plans have paid
for the vaccine with about a thirty dollar copay. Most other Rx insurance
plans have not paid for and retail cost is about $200-$220.

travelover 03-30-2008 06:48 PM

Update
 
When I started this thread last June, my brother was just recovering from his initial bout with shingles. It left him with a droopy eyelid and he recently had that fixed for $22K, covered by his insurance. His vision is still not 100% in the one eye most affected.

The one mistake that he made was not getting immediate medical attention - he waited a day or so. A hard lesson to learn - we are all older and less bullet proof now, so we need to seek medical attention more readily.

redduck 03-30-2008 11:02 PM

I got my shingles shot just this last Friday. My doc had been recommending it for about a year. This thread convinced me. This thread is a lot scarier than my doc. My shot cost $250. I'm sure that's on the high end. I'll see if my insurance company will kick in. But, in any case, I believe (hope) it was well worth the money. So, if you folks are looking for a deal, you will easily beat my cost and maybe that will be incentive enough to get the shot.


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