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Preventing Shingles: A New Vaccine

Contributed by: Laura Leone, Pharm.D.

Community Pharmacy Resident

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Text Box: On May 25, 2006, the Food and Drug Administration (FDA) approved a new vaccine called Zostavax®. This vaccine is to be used for the prevention of herpes zoster, otherwise known as shingles, for adults 60 years of age or older. Zostavax® cannot be used to treat shingles or postherpetic neuralgia, the pain associated with shingles, or be used as a substitute for the chicken pox vaccine, Varivax®. What Is Shingles and Who Is At Risk? Anyone who ever had chickenpox is at risk for shingles. The same virus that causes chickenpox, the varicella-zoster virus, also triggers herpes zoster, which is more commonly known as shingles. Herpes zoster may affect any age group, but is much more common in adults over 60 years of age. When a child recovers from chickenpox, the virus does not disappear. Instead, it hides out, inactive, in clusters of nerve cells near the spinal cord. For most people the virus remains dormant the rest of their lives. However, it is believed that a weakened immunity brought on by advancing age, stress or disease may reactivate the virus causing it to multiply, damage these nerve cells and then migrate to the skin. It is there that the blistering rash of shingles appears. It is usually localized on one side of the body and begins as a cluster of small red spots that develop into blisters. Although the rash heals in approximately four weeks, many people with shingles experience nerve pain lasting three months or longer. For some, the pain can be aggravated by something as slight as clothing touching the skin or a cool breeze. The pain, termed postherpetic neuralgia, can be described as burning, itching, gnawing, stabbing, throbbing, and aching. This pain may last from months to years and can make life extremely miserable. Postherpetic neuralgia is extremely difficult to treat. Antiviral medications can speed the healing of shingles and reduce the severity of

Text Box: nerve damage caused by the disease, but only if used within 72 hours of the first sign of a shingles rash. Antiviral medications do not help relieve postherpetic neuralgia once it has begun. How Does Zostavax® Work? This vaccine is a preparation of the live varicella-zoster virus. According to the FDA, the vaccine boosts the varicella-zoster virus specific immunity that people have from when they had the chicken pox. This will help your immune system to protect you from getting shingles and the associated pain and complications. How Is Zostavax® Given? This vaccine is given as a single dose by injection under the skin. Although clinical studies have demonstrated efficacy lasting four years, the duration of prevention against shingles has not been determined. Therefore, the need for revaccination has not been defined yet. What Are The Possible Side Effects Of Zostavax®? The majority of side effects experienced are mild. The most common side effects that people reported in the clinical trials were redness, pain, swelling, itching, warmth, and bruising at the site of injection and headaches.

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