DEAR DR. GOTT: There seems to be some confusion about whether or not an older person should take the shingles shot. My husband is over 70 and has been advised that, because he can’t remember having chickenpox (even though he might have been exposed to it), he does not need to take it. In fact, if he takes it, it might even prove harmful.
He has been further advised that there is a simple test his doctor should administer before giving him the shingles shot if he (my husband) is unsure as to whether he ever had chickenpox or not. Please advise. Thank you.
DEAR READER: Once a person acquires chickenpox, the virus lives in a dormant state in specific nerve roots within the body. If it becomes active later in life, it is known as shingles.
Zostavax (the shingles vaccine) for people 60 and older was designed to prevent shingles. The older a person is, the more severe the effects of shingles can be, so it is likely he should get the injection that will protect him for about six years. According to the Centers for Disease Control and Prevention, this recommendation is made regardless of whether he remembers having the disease. It’s not uncommon for people as they age to forget whether they had chickenpox.
The probability of getting shingles rises at around age 50; however, the vaccine is recommended for people 60 and older because the safety and effectiveness of the vaccine has been studied only within that age bracket. There is no specific time a person should wait after having shingles before receiving the vaccine; however, it is recommended he or she wait until the rash is completely cleared following an attack.
That said, there are definitely some people who should not receive the vaccine. They include those on chemotherapy, radiation or other treatment for cancer; those with a history of cancer; those on steroids because of the effect the steroids may have on a person’s immune system; those with HIV/AIDS; and women who are pregnant.
The most common side effects of the vaccine are slight pain, swelling, itching or a rash at the site of the injection.
For most people, the pain associated with shingles lessens as the rash heals. For others, shingles can lead to pain that lasts for years, a condition known as postherpetic neuralgia. Long-term nerve pain can be difficult to deal with and may require pain medication for control.
Your husband’s primary-care physician can better direct him as to whether the vaccine is right for him. There is testing to determine whether your husband had chickenpox as a child; however, if we follow the CDC recommendations, that testing becomes a moot point.
To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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