Shingles vaccine?

[Skeptic Ginger]

No, it doesn't.

I don't. And I already mentioned where the symptoms were: upper left-side torso (heart region) and scalp.

Signs and Symptoms (not the best web site, but I like the clear presentation that they give, and it seems to correspond to what other, more reliable sites say):

No.

No.

I know that these symptoms are by no means as conclusive as lab tests, but shingles still seems to be the most obvious diagnosis in my case. That the pain wasn't so bad the second time around, 15 years later, may have been due to the medicine I got.

I said "might have been." Your link and most links with general information on shingles won't address the issues of misdiagnosis and recurrent zoster in immunocompetent persons.

Herpes Zoster Differential Diagnoses

Diagnostic Considerations
Herpes simplex virus (HSV) infection may be recurrent and may appear in a dermatomal distribution, mimicking herpes zoster and leading to misdiagnosis if no confirmatory laboratory tests are performed. [68] Lymphangioma circumscriptum may occasionally also resemble herpes zoster. [69]

In severely ill or immunocompromised patients, general central nervous system (CNS) involvement can be observed in the form of meningoencephalitis or encephalitis. Such presentations are indistinguishable from other forms of meningoencephalitis, though other evidence of acute herpes zoster usually is present. [13] Cerebrospinal fluid (CSF) studies frequently reveal pleocytosis without elevated protein. These infections can be-life threatening.

In addition to the conditions listed in the differential diagnosis, other conditions that should be considered include the following:

See link for the list.

Why do so many clinicians believe that recurrent zoster is common?

...more than a half dozen peer reviewers and journal editors who have summarily dismissed our attempts in the past 2 years to address the issue of recurrent zoster in immunocompetent individuals. Recurrent zoster, they contend, is not reported in the literature because it is a commonplace occurrence. Is that really the case?

Articles dating back to 1900 purport cases of recurrent zoster, but most of these reports predated routine laboratory testing for varicella zoster virus (VZV), ... reports as early as 1950 noted that HSV could clinically imitate herpes zoster [2]. Ironically, there are actually more laboratory-confirmed cases of misdiagnosed recurrent zoster in the literature than there are of actual recurrent zoster in immunocompetent patients. Heskel and Hanifin described three patients initially diagnosed with recurrent herpes zoster, but all with HSV by culture, again raising the question as to whether earlier cases of recurrent zoster represent instead misdiagnosed cases of HSV [3]. ...

A colleague in internal medicine spoke to us about a case of recurrent zoster in her clinic. This patient was seen by several different physicians who all concluded with the diagnosis of recurrent zoster. After seeing our review of the literature, she subsequently performed laboratory testing on this patient and confirmed the diagnosis of HSV-mediated zosteriform simplex. There are several other patients in their clinic who are also thought to have "recurrent zoster". We predict that laboratory testing of these patients will confirm what is already demonstrated by the evidence at hand: recurrent zoster in the immunocompetent is an extremely uncommon event.

(1984 and behind a paywall) “Recurrent herpes zoster”: An unproved entity?

Physicians sometimes misdiagnose recurrent zosteriform herpes simplex virus (HSV) skin infections as “zoster” or “recurrent zoster.” Misdiagnosis can lead to inappropriate therapy with potentially harmful consequences, particularly in patients with ophthalmitis or immunosuppression, in which early institution of the correct antiviral therapy may be crucial. We report three patients who were originally misdiagnosed to have recurrent herpes zoster skin infections before we cultured HSV from their vesicles. We suggest: (1) that most recurrent zosteriform eruptions are caused by HSV; (2) that “recurrent zoster” has yet to be documented; and (3) that the diagnosis of “recurrent zoster” be reserved for those patients who have laboratory confirmation of recurrent varicella zoster (VZ). Viral culture or examintion of vesicle contents by indirect immunofluorescent technic can provide definitive diagnosis of the etiology of a zosteriform eruption.

Misdiagnosis is more common that actual recurrent zoster in immunocompetent persons. Doesn't mean it never happens but it does mean just because a doctor tells you it's recurrent zoster, without a culture it doesn't mean the diagnosis is correct.

 

[Cainkane1]

I had mine today. It's a new, more effective vaccine called Shingrix. The old vaccine was about 50% effective, the new one about 90% effective. Needs a single follow-up shot in 3 months.

Apparently shingles happens when chicken pox virus that had been dormant in cell bodies migrate out to nerve endings, causing a skin rash and nerve pain. If it occurs on the face it can lead to vision problems up to blindness.

It occurs more commonly in older people. I've never had it, but at 68 I'm in a high risk group.

I have a friend thats suffering from it now and its nasty, and something to be avoided if at all possible.

Anyone else had the vaccine or had shingles? Its all rather new to me.

I had my shingles shot some years ago along with my pneumonia shot, my tetanus shot and my yearly flu vaccine.

 

[Skeptic Ginger]

Well shame on me not looking the new vaccine up.

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles-recombinant.html

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles-recombinant.pdf

It's a killed vaccine, not an attenuated live vaccine.

You need 2 doses 2-6 months apart. Boosters may be needed in the future but they are not needed currently.

You should get the vaccine whether you had the attenuated vaccine or not.

I stand corrected and will get this vaccine myself in the next month or so.

 

[Rincewind]

Well shame on me not looking the new vaccine up.

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles-recombinant.html

https://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles-recombinant.pdf

It's a killed vaccine, not an attenuated live vaccine.

You need 2 doses 2-6 months apart. Boosters may be needed in the future but they are not needed currently.

You should get the vaccine whether you had the attenuated vaccine or not.

I stand corrected and will get this vaccine myself in the next month or so.

We've just been learning this.

Also, I learned that my insurance doesn't cover it - so it's $167 per dose.

 

[casebro]

Dead virus, live virus- How long does an actual infection protect for? I would think the longest, meaning that a vax can't last that long.

 

[casebro]

From WebMD:

If your immune system is healthy:

Your short-term chances of getting shingles again are very low. One study of people over age 60 found that only 1% got shingles again within about 3 years. Having shingles once lowers your chances of getting it a second time, at least for a while.

Over time, your chances of a second bout go up. Another study found that within 7 years, the odds of getting it again may be almost 6% in people 22 and older. That's about the same as the odds of getting shingles the first time.

Lemme cogitate- Nearly 1% per year (6% in 7 years) adults (people over 22). Older folks who have had the actual disease, 1/3 of 1% (1% in 3 years). So, having the actual disease to kick up you immune system (best vax possible?) improves your per year risk of NOT getting it from 99% to 99 2/3 ?

You've got to be practically immortal to realize a gain, statistically. (that is called "comparative risk". Big Pharma likes "relative risk". In this case, a 67% reduction. ) I'l let one of youse look for the efficacy study of either vax.

Meantime, I've had a vax- thanks HMO. . And I had the disease actual. I'm probably protected until I turn 109 years old. And since my plan is to be immortal (so far, so good) I should get the new-new-NEW VAX in 25-30 years.

 

[Capsid]

Dead virus, live virus- How long does an actual infection protect for? I would think the longest, meaning that a vax can't last that long.

It's complicated. Chickenpox infection doesn't give you lifelong protection since shingles can happen but that's because of the virus's lifecycle and latency in nerve cells. Yet hepatitis b (recombinant vaccine ie not live virus), polio (inactivated virus) yellow fever (attenuated live virus), measles, mumps and rubella (attenuated live viruses) vaccinations appear to provide lifelong protection. I say appear because it is possible that subclinical infections are occurring all the time which can boost the immune system. Anyway, the immune system has memory B cells that are very long lived but what maintains their longevity is not well understood (maybe it's the subclinical infections). Immune memory through vaccination is working otherwise older people would be succumbing to childhood infections, wouldn't they?

 

[dann]

I got the two Shingrix jabs in December 2023 and March 2024.

The researchers found that people who got Shingrix had a 17% lower chance of being diagnosed with dementia in the six years after their shots than people who got the less-effective Zostavax vaccine.
People who were vaccinated didn’t avoid dementia completely, but it did seem to be associated with a delayed diagnosis. On average, the researchers said, this represents about 164 diagnosis-free days, or about five months more time, in people who were eventually affected.
Shingles vaccines may reduce dementia risk, two large new studies suggest (CNN, July 30, 2024)

The recombinant shingles vaccine is associated with lower risk of dementia (Nature, July 25, 2024)
New shingles vaccine could reduce the risk of dementia (University of Oxford, July 25, 2024)
Shingles vaccine may help delay dementia - study (BBC, July 25, 2024)

 

[dann]

Dead virus, live virus- How long does an actual infection protect for? I would think the longest, meaning that a vax can't last that long.

In clinical trials, Shingrix was 97% effective at preventing shingles, compared with 65% to 70% effectiveness for Zostavax, depending on a person’s age. Shingrix also appears to give longer protection, although that’s still under study.
Shingles vaccines may reduce dementia risk, two large new studies suggest (CNN, July 30, 2024)

Shingrix provides strong protection against shingles and PHN. In adults 50 years and older who have healthy immune systems, Shingrix is more than 90% effective at preventing shingles and PHN. Immunity stays strong for at least the first 7 years after vaccination. In adults with weakened immune systems, studies show that Shingrix is 68%-91% effective in preventing shingles, depending on the condition that affects the immune system.
Shingles Vaccination (CDC)

When I got the first Shingrix jab, I was told that the effect was expected to last at least 10 years, i.e. it is so new that they don't really know how long it will last.


ETA: At your age, you don't get to choose between infection and vaccination. It is very unlikely that you weren't infected, so you probably have the virus already. The bad news is that COVID-19 seems to reactivate the chicken pox virus. And the protection, i.e. reactivation of the virus and thus of the immunity, that you get from a case of shingles gives you some protection but it doesn't make you immune. I had shingles twice. It was unpleasant both times, but it didn't last long. Some people have excruciating pain for months and even years.

One-in-five people diagnosed with shingles suffer complications resulting in PHN, or after-shingles pain resulting from nerve damage caused by the virus. PHN pain, which may last for months or sometimes even years, can be devastating to those it affects.
"PHN pain can erode a person's quality of life, especially for elderly patients," says Dr. Christopher Gharibo, director of Pain Medicine and assistant professor of Anesthesiology at NYU School of Medicine, "The pain can make everyday activities, like bathing or dressing, excruciating. Chronic pain often leads to serious depression. In fact, PHN is the most common cause of pain-related suicide in the elderly."
PHN disproportionately affects the 50-and-over population and people with weakened immune systems. In fact, shingles patients age 50 or older have a more than 50 percent chance of developing PHN, and patients age 80 or older have an 80 percent chance of developing the condition.
After-shingles pain: Significant impact on elderly (KSAT, June 19, 2012)

 

[bruto]

Good news there. I've had both. There's some dementia in the family, and I've had a traumatic brain injury, so I'm happy for any little improvement. So far so good.

 

[Skeptic Ginger]

Oh dear I answered a necro post. Oh well. People should always go to the latest CDC ACIP guidelines regardless.

Oooh, I'll need to keep that in mind, I got chicken pox at 6 months of age or so (thanks, older brothers ). Should I be asking my doctor about vaccination even though I just turned 50?

Yes, And if the provider brushes you off pull up the CDC ACIP guideline. I'm sure 50 is not too young.

 

[Skeptic Ginger]

We've just been learning this.

Also, I learned that my insurance doesn't cover it - so it's $167 per dose.

Double check on that insurance coverage, The ACA (Affordable Care Act) mandated more than a few vaccinations.

 

[dann]

I'm sure 50 is not too young.

I got shingles the first time when I was 49. I had an undiagnosed food allergy at the time. The second time was ten years later, probably due to work-related stress. I know somebody who got it at 30, also due to work-related stress.
Anything that weakens the immune system may give the virus the chance to get reactivated. Age. HIV. SARS-CoV-2 ...

Herpes zoster (HZ), also known as “shingles,” is a vaccine-preventable disease that occurs due to the reactivation of the latent varicella-zoster virus in the sensory ganglia. Several studies have reported the reactivation of HZ in COVID-19 patients and those vaccinated against COVID-19. Currently, vaccines against HZ are not accessible globally, especially for those in LMICs.
(...)
HZ usually presents as acute, painful vesicular rashes that can be debilitating and lead to physical disability and emotional distress. The most common complications of HZ are post-herpetic neuralgia (PHN) (occurring in 5–30% of cases), which could impact the quality of life for months or even years, and HZ ophthalmicus (HZO) (occurring in up to 10% of cases), which can lead to blindness. Moreover, HZ patients have an increased likelihood of developing a stroke within 30 days following infection, a risk that is mitigated with at least one zoster vaccination. The risk of major adverse cardiac and cerebrovascular events has also been shown to be 19% higher among HZ patients.
The risk of HZ increases as immune function declines, which is linked to aging and/or immunocompromising or immunosuppressive diseases or therapies. Other risk factors include asthma, chronic heart disease (CHD), chronic obstructive pulmonary disorder (COPD), depression, and rheumatoid arthritis (RA).
COVID-19 and herpes zoster: a call to action (NIH, July 17, 2023)

As mentioned in the NIH article, even C19 vaccination may reactivate HZ. I had no side effects other than a sore shoulder from my seven C19 jabs, which I got before the two recent Shingrix jabs.

 

[dann]

Shingles is treatable if, and that's a critical if, you can start an anti-viral within 24 hours of onset.

Not saying not to get vaccinated, mind you. Just saying if you learn the symptoms and know you have to get treatment urgently, you have options.

I wouldn't bet on it. Unfortunately, the pain comes before the rash. It may take a couple of days before the rash appears. I didn't even recognize the symptoms the second time I had shingles.

 

[Gord_in_Toronto]

In related news:

Shingles vaccines may reduce dementia risk, two large new studies suggest

 

[Spektator]

My wife has it right now. She did have the Shingrix shot (and so did I), but she came down with it not long after we attended a party with a good many young kids. Later we learned that several kids had chicken pox.

Anyway, my wife's case has been relatively mild, with a line of blisters from her spine to her side, just one line, and with an antiviral that has mostly disappeared. Her main and worst symptom was a deep ache, like many get with the flu.

I'm glad to say that she's up and about and even drove in the last two days.

 

[dann]

In related news:
Shingles vaccines may reduce dementia risk, two large new studies suggest

Post 68. It's what made me resurrect the thread.

 

[lionking]

Post 68. It's what made me resurrect the thread.

Yes I saw your post. Good news indeed.

 

[dann]

My wife has it right now. She did have the Shingrix shot (and so did I), but she came down with it not long after we attended a party with a good many young kids. Later we learned that several kids had chicken pox.

Anyway, my wife's case has been relatively mild, with a line of blisters from her spine to her side, just one line, and with an antiviral that has mostly disappeared. Her main and worst symptom was a deep ache, like many get with the flu.

I'm glad to say that she's up and about and even drove in the last two days.

You know that you're supposed to have two shots, don't you?

She may actually have been the one who infected those children and not the other way round:

Preventing the spread of shingles
You can’t give shingles to other people. But, other people can catch chickenpox from you if they haven’t had it before.
If you have shingles, you’re contagious until the last blister has dried and scabbed over.
To help prevent the virus being passed on:
Don’t
do not share towels or flannels
do not go swimming
do not play contact sports
do not go work or school if your rash is weeping (oozing fluid) and can’t be covered
Shingles (NHS)

I think many doctors aren't aware of this. I think I asked the doctor the first time if I should stay home from work and was told that shingles wasn't contagious, which may be a misunderstanding of the idea that you can't give shingles to other people. I did go to work, but my students were 16-19-year-olds, so I don't think I transmitted the infection to anybody.

Shingles is always only on one side of the body. The first time I had it, it was on the upper left side of the body, which made me think that I might have a heart condition. I still have two scars, which are only visible in the summer when I tan. The second time was on the left side of the head: ear, forehead and scalp. It can make you blind on one eye, but I didn't have any sequelae ... that I know of.

I would describe the pain as sharp (unlike blunt or dull) and nothing like the pain from the flu.


ETA: I looked up the price of Shingrix because I recently recommended the vaccination to my neighbor, who saw what dementia did to her mother. Since I got the second jab in March, the price has gone up by about 40-50%, quite a bit more than general inflation. I suspect that the weakening of the immunity caused by C19 may have increased the the demand.

 

[dann]

From WebMD:
If your immune system is healthy:
Your short-term chances of getting shingles again are very low. One study of people over age 60 found that only 1% got shingles again within about 3 years. Having shingles once lowers your chances of getting it a second time, at least for a while.
Over time, your chances of a second bout go up. Another study found that within 7 years, the odds of getting it again may be almost 6% in people 22 and older. That's about the same as the odds of getting shingles the first time.

True! It's not "incredibly rare." Both MikeG and I had it twice. I can't speak for him, but I am pretty sure that my cases were correctly diagnosed, and I have no reason to think that I am immunocompromised.

Can you get shingles more than once in your life?
More people are getting shingles these days, but experts still aren’t sure why. In the U.S., about 1 in 3 adults will get shingles in their lifetime.
Shingles was always thought to be a once-in-a-lifetime, bad-luck event. But studies have shown that around 6% of people will have shingles more than once. Shingles that happens again months or years later is called “recurrent shingles.”
Why You May Get Shingles More Than Once (GoodRx Health, July 27, 2022)

Besides recommending that people get the Shingrix jabs, I would also recommend that people make sure that their children and grandchildren get vaccinated against chicken pox. It isn't customary to do so in Scandinavia, but it may spare them from ever getting shingles.