What is Herpes Zoster (Shingles)? 

For anyone who had chickenpox before, the virus remain dormant in the nerves and can be re-activated and travelled to the skin to cause Shingles also known as herpes zoster. It can occur in all ages but the risk increases with age. 

When shingles occur, there will be a rash or blister appearing on the skin following the nerve root. As the nerve is involved it can cause extreme pain. The pain may persists for months after the rash disappear and this condition is called post-herpetic neuralgia. For some the pain can become chronic pain. The older a person is, the more severe is the shingles attack. 

The causes of shingles remain aren't completely known. Some possible triggers are reduced immune system and ageing. 

Zostavax (Shingles vaccine)

Zostavax is the vaccine to prevent shingles and is recommended for elderly above 60 years old. It does not protect against other forms of herpes infection like Sexually transmitted diseases genital herpes. It is not to be used to treat acute shingles. 

Zostavax reduce the occurrence of shingles by 51% and reduce the risk of post-herpetic neuralgia by 67% in one clinical trial. The vaccine is most effective for people between 60-69 years old but its effectiveness decrease with increasing age; to 41% for age 70-79 and 18% for those above 80 years old. 

For those who were vaccinated against zostavax before but still get shingles, the symptoms will be milder than those who were never vaccinated before. 

Zostavax is a single dose vaccine given subcutaneously under the skin) on the upper arm. Protection against zostavax decreases within the first five years after vaccination. Protection beyond five years is uncertain. 

Who should get vaccinated? 

Anyone above the age of 60 should be vaccinated against zoster. There is no maximum age limit. 

Zostavax is approved by FDA for people aged 50 years and older.But CDC does not recommend routine use of zostavax in people aged 50 through 59 years old.

Zostavax should not be given during acute shingles attack. It can only be given after patient has recovered. 

Contraindications to Zostavax vaccination

• Person who is immuno-compromised like patients with HIV/AIDS infection, patients on long term steroids, cancer patients on chemotherapy and patients with cancer involving lymphatic system like leukaemia and lymphoma
• People who had developed severe anaphylactic reaction to content of vaccine like neomycin. 
• Pregnant women 
• It is not a substitute for varilix chicken pox vaccine and should not be given to children. 

Side effects of Zostavax

• There has not been serious complications from vaccinations 
• common minor side effects include headache, swelling, pain and redness at site of injection which will resolves spontaneously. 
• There is no report of someone getting chickenpox from another person who has been vaccinated against zostavax. 
• Some people may develop chickenpox-like rash at site of injection. This is uncommon but if it occurs, do cover the rash till it recovers.