Thursday, January 13, 2011

CDC: Older Adults Need Shingles Vaccine

The new shingles vaccine (2006) is effective and reduces the incidence of shingles by 55%, according to a new study. The CDC recommends that older adults age 60 and older to get vaccinated against shingles.

The new study, published this week in the Journal of the American Medical Association, surveyed the use of the vaccine among a population of over 75,000 subjects (Kaiser Permanente members in California) who were vaccinated between Jan 1. 2007 and Dec 31, 2009, against a control group of over 225,000 subjects who were not vaccinated. The study showed that the vaccine decreased the incidence of shingles by 55% across all age groups, the incidence of ophtalmic ophthalmic herpes zoster (eye infection by the virus) by 63 percent, and hospitalization by 65 percent. While these numbers might appear low compared to some childhood vaccines which often have success rates in the 80 to 90% range, they are very good for adult vaccines. There were no side effects recorded.

Shingles, also knows as herpes zoster, is caused by the chickenpox virus. The chickenpox virus, which infects approximately 99% of the population that was not vaccinated against it (i.e. all of us above the age of approximately 30), remains dormant in the body, and can reappear tens of years later, typically when the immune system is depressed by stress or sickness. Shingles typically comes with a rash, can be extremely painful for multiple weeks, reoccur several times, and is followed, 10% to 30% of the time, by postherpetic neuralgia, a painful chronic syndrome which cannot always be treated, and which can significantly affect quality of life. The Mayo Clinic estimates that up to 30% of Americans will get shingles in their lifetime.

The probability of getting shingles goes up significantly after age 50, but research for the shingles vaccine is only available for age 60 and up. As a consequence, the CDC recommendation at this time is for older adults above the age of 60 to get vaccinated against shingles. Merck, the manufacturer of the shingles vaccine (brand name Zostavax), has petitioned the FDA to extend its recommendation to populations 50 years old and above.

What should you do about it? If you know anyone affected by the very painful postherpetic neuralgia, it is very unlikely that you will feel the need to ask the question - you probably are right now in line for a vaccination. Merck has not always been able to provide enough vaccine to satisfy demand, and the vaccine is delicate to handle, as it needs to remain frozen until a few minutes prior to injection. Vaccination rates as of now are low. There is enough vaccine right now in the supply chain, and we suggest you get vaccinated as soon as possible, in case a new shortage occurs again.

Want to know more about it? Try USAToday, Reuters, New York Times, US News & World Report, Business Week, WebMD, Business Week, AFP, ACSH, Medical News Today, Doctor's Lounge, and MedPage Today.

Study Abstract in the Journal of the American Medical Association
Full Text Study in the Journal of the American Medical Association 

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