The Shingles Vaccine
| Shingles arises from the re-activation of the chicken pox virus that most people over 40 had as a child. It causes a rash but also can cause significant and prolonged pain. The initial pain can proceed the rash by 24-48 hours and often confuses ER physicians. If the rash is to appear on the chest then the pain can be confused with a heart or lung problem. When the patient returns the next day with the classic rash then the diagnosis becomes clear. With back or leg pain it can mimic sciatica or a herniated disk. If the pain starts on the face it can mimic a severe migrane. The rash has tiny vesicles and it follows a nerve root thus making it quite clear cut as to the diagnosis. The major problem with Shingles is that even after the rash is gone pain can go on for months and even years. The chicken pox vaccine that children get now may decrease the incidence of Shingles for them in the future. For those above 60 years of age a new vaccine has just been made available. It is a stronger version of the one given to children. It appears safe. It is only approved for those over sixty. It decreases the chance of getting Shingles by 64% in those patients between 60-70 years while for those over 70 it decreases it only by 37%. However in both groups it decreases the incidence of long term pain significantly. Thus you might still get the Shingles but it will not have the same disability as before. If you have the Shingles you can not take the vaccine. It is expected to cost $140.00 and it is not clear if Medicare will cover it. Medical therapy is available for Shingles with an anti-viral drug. If started at once it shortens the initial illness and the rash however it only helps a little with long-term pain. The vaccine will have a major impact on this illness which causes so much grief. The Shingles in the elderly can also stress the body so much as to cause other illness such as heart failure or stroke to occur. It will take time to measure the full impact of the vaccine but hopefully it will make the life of senior citizens more pleasant. If you are over age 59 then check with your doctor to see if this is good for you. | ||||||||||||||||||||
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