Ask The Expert

Q. WHAT IS SHINGLES, AND WHO SHOULD GET THE NEW VACCINE?

A. Most people first hear of shingles when an elderly friend or relative is diagnosed with it. The truth is, shingles is much more common than people think, affecting about 1 million people each year. It's been estimated that half of all American adults who had chickenpox when they were kids and live to age 85 will get this unpleasant illness at some time in their lives – usually after age 60. The new vaccine cuts that number in half.

Shingles is the common name for herpes zoster, a painful nerve and skin infection caused by the chickenpox virus, which lies dormant in the nine out of 10 adults who have had chickenpox. When the virus becomes reactivated decades later (by unknown causes), it causes itching, burning and a blistery rash. The most troublesome symptom, however, is often a severe nerve pain called postherpetic neuralgia that can be long lasting. Until recently, the only therapy has been immediate treatment with anti-viral agents to decrease the severity of symptoms, which can last four weeks or longer.

In May 2006, a vaccine proven to reduce shingles incidences by 51 percent was approved by the U.S. Food and Drug Administration. Last fall, the immunization advisory committee for the Centers for Disease Control and Prevention recommended that the vaccine become routine for all Americans age 60 and older. The recommendation is expected to be adopted by the CDC, which will influence decisions by insurance companies on whether they will cover the vaccine.

The vaccine is Zostavax^® and it's given in a single shot. The cost is approximately $150, plus the cost of an office visit. Zostavax is not yet covered by most insurance providers, including Medicare, but may be in the future. Call your family doctor or county health department to find out more.

Only 12 years ago, there was virtually no way to prevent the common childhood illness chickenpox. Most children contracted the highly contagious illness by age 15 and suffered for a week with a miserable, itchy rash and mild fever; a few suffered more serious effects. A bright spot was that a case of chickenpox provided immunity from ever getting it again.

That all changed in 1995 when the American Academy of Pediatrics recommended the new varicella (chickenpox) vaccine for all healthy children between the ages of 12 months and 13 years who have not had chickenpox. It is now a part of the routine immunization schedule for children 12 to 18 months of age, and older children can receive the vaccine if they haven't had chickenpox.

Chickenpox is largely a thing of the past for today's youngsters. The effect of the varicella vaccine on incidences of shingles, a painful illness caused by reactivation of the dormant chickenpox virus in later years, is not yet known.

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