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Doctors urge those 60 and older to get shingles vaccine By Connie Cone Sexton The Republic | azcentral.com Wed Mar 13, 2013 4:40 PM The pain is so severe that even a piece of cloth touching the skin can feel like a burning knife. Dr. Karen Lewis, medical director for the immunization office for the Arizona Department of Health, made the analogy as she talked about the agony of suffering with shingles, a virus that affects nerves and causes pain and blisters in adults. “You can be just incapacitated for weeks or months,” Lewis said. “Some get it in the nerve section of the face and can go blind from it.” The risk for the disease rises after age 50 and more than half of the people who get shingles are older than 60, she said. “If you live to be 85, there is a 50 percent chance of getting shingles.” That’s why she urges people 60 and older to talk to their doctors about getting the shingles vaccine, which can reduce the risk of getting the virus or shorten its duration. The vaccine, approved for use in 2006, is also recommended for those who’ve already had shingles. It’s the same varicella-zoster virus that causes chicken pox in children and can continue to live in nerve cells even after symptoms — the rash, scabs, fever — disappear. When it activates in adults, sometimes decades later, it is called shingles. Doctors say you can’t get shingles if you’ve never had chicken pox. But Lewis warns that people could have had chicken pox and not known it, especially if they’d had a mild case. The vaccine is not recommended for everyone, including those who have weakened immune systems because of HIV/AIDS. Shingles gets its name from the Latin word “cingulum,” meaning belt, because it usually appears in the form of an encircling rash, according to the National Institute on Aging. The virus travels along the nerve path and shows on the surface of the skin, generally concentrated. And then? Itching. Burning. Fluid-filled blisters. Pain. Possible complications such as neuralgia. To treat an outbreak, doctors generally prescribe antiviral medication. Until the blisters dry up, shingles is a contagious disease and those infected should avoid contact with others, especially anyone who is pregnant or has cancer or an immune deficiency, said Walter Nieri, program director for Banner (Health) Family Medicine Geriatric Fellowship Program in Phoenix and the West Valley. Nieri suggests shingles may be brought on by stress or a serious infection. He said the vaccine “can decrease the incidence of post-herpetic neuralgia,” which is severe nerve pain that usually doesn’t respond to medication. After watching a friend suffer from shingles, Phoenix resident Rebecca Flowers would like to get the vaccine. “She said it was a horrible burning pain,” Flowers said. “I don’t want to experience that.” But Flowers, who is 57, said her doctor told her she must wait three more years. That’s consistent with what the Centers for Disease Control and Prevention recommends, though the Food and Drug Administration says the vaccine can be given at age 50. Lewis said the CDC suggests people wait because “they don’t know how long the vaccine lasts, and they don’t want it to wear off.” Another reason to wait: Many insurance plans will not cover any portion of the vaccine’s cost, which ranges from $100 to $200, until a patient reaches 60. John Bajusz, 77, a retired volunteer chaplain, said he got the vaccine about five months ago. He encounters patients with shingles during hospital visits and was “amazed at how much pain they were in.” Bajusz’s insurance co-pay was $89. “Even though the co-pay is higher than many of us can afford, it’s a must,” he said. “You’ve got to get it.” Nancy Hannahoe, a 71-year-old retired court clerk, urges eligible people to get the vaccine. She said she suffered through a case of shingles 10 years ago with a rash across the base of her head and upper back and had to miss a week of work. When her doctor told her she had shingles, she recalled, “I said, ‘Shingles is for old people like my grandmother,’ and then my co-worker said, ‘You’re old, sweetie.’” Hannahoe worries she might get the disease again; though uncommon, shingles can recur. No matter how old you are, Nieri recommends getting medical treatment as soon as possible if you get symptoms. Phoenix resident Sondra Lynch, 68, echoes that advice. “I had shingles on my face, under my lip and on my neck,” she said. “The doctor told me he was glad I came in when I did because it can spread. And that really scared me.”
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