Doctor's Blog

Herpes Zoster Vaccine
March, 2009

Approximately 1 million cases of herpes zoster (shingles) occurs each in the US. Anyone who has had chicken pox is at risk for developing shingles. It can occur in all age groups, but is most common in those over the age of 60. The risk increases with age.

When shingles develop, a rash or blisters appear on the skin. The virus that has been dormant in the nerve cells reactivates and travels from the nerves out to the skin. The nerves along the path become inflamed and painful. Pain that last for months after the rash has healed is called post herpetic neuralgia (PHN). For some people, this pain can be severe and chronic. The vaccine reduces the frequency of PHN.

CDC’s Advisory Committee on Immunization Practices (ACIP) recommends the herpes zoster vaccine to be given to persons over the age of 60. It is a live, attenuated virus given in the arm. A single dose is all that is required. This vaccine is more potent than the varicella vaccine routinely used in children. Persons who have previously been vaccinated against the varicella-zoster virus should not be re-immunized. Persons who have had an episode of shingles in the past can receive the vaccine, but the vaccine does not treat an acute outbreak of shingles.

Common side effects from the vaccine included redness, tenderness, swelling at the injection site and headache.

Immunocompromised persons such as those taking chemotherapy and AIDS patients should not receive the vaccine. Persons with a history of anaphylactic shock caused by neomycin should not receive the vaccine. However, a mild skin rash caused by neomycin is not a contradiction to receiving the vaccine. Pregnant women should not receive the vaccine. Person on antiviral therapy such as acyclovir, famciclovir, and valacyclovir should not receive the vaccine because the antiviral medication can decrease the efficacy of the vaccine.

Who should not receive the vaccine?

• Cancer patients on chemotherapy
• HIV/AIDS
• Chronic steroid use
• Neomycin allergy
• Pregnancy
• Persons on antiviral medications

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