Kicking off a monthly series of articles underwritten by Health Projects Center and Del Mar Caregivers on senior health, we discuss ways to minimize the risk of contracting the notoriously miserable shingles with currently available vaccines.
“Shingles can cause horrific pain, requiring multiple medications to keep it under control,” said Dr. Paul Percival of Hollister Family Medicine. “You can get shingles in the eyes and go blind from it. You can get it in your mouth or in your brain, which is a catastrophe. It can cause a stroke or damage to the spinal cord. I have had patients who suffered lifelong effects because their pain never went away. It can be life changing.”
Shingles has its origins in chickenpox, which is caused by the varicella-zoster virus and is usually acquired in childhood. Until recently, catching chickenpox was almost guaranteed. Approximately 95% of the U.S. population over 25 years old has had chickenpox—and that number approaches 99% for Americans over 40.
A chickenpox vaccine called Varivax has been available since 1995. Before vaccines became available, the U.S. averaged 4 million cases a year, but with a 90% effectiveness rate, vaccination has reduced, and may eliminate, this childhood disease.
Chickenpox infections usually resolve within a week or so, but the virus itself never goes away. It lays dormant in nerve tissue near the spinal cord, waiting for a trigger to bring it back to life as shingles.
“Shingles surfaces when your immune system becomes weaker as you get older,” said Andrea Zoodsma, director community services at Central Coast VNA & Hospice. “This weakening is a natural part of the aging process. In younger people, it usually happens during a stressful time. Again, stress causes your immune system to weaken and makes you susceptible.”
According to the Centers for Disease Control, there is a one-in-three chance of developing shingles for those who have had chickenpox. Those odds get worse after age 60, increasing to a one-in-two chance around age 85. Once a breakout occurs, there is very little to do besides ride out the pain until it resolves itself. And, having had shingles myself, I can testify that is a difficult experience to go through.
My shingles infection
In my case, I went to the doctor about a slight rash on my chest that was barely irritating, but she instantly diagnosed it as shingles. Insignificant as it seemed, it was already too late to do anything about it.
“Your first 72 hours after onset of symptoms is the golden period to treat it,” Percival said. “We can put you on antivirals that will reduce, but not eliminate, the chance that the shingles will get severe. If we miss the 72-hour window, the best we can do is treat the pain.”
I got the pain medication, but my doctor also told me to isolate myself because, during the onset of the infection, I would be capable of passing chickenpox onto anyone who had not had it before. Children are particularly vulnerable.
In my case, the small rash quickly spread across my upper chest and wrapped around to my back in a band as wide as my hand. It spread to my shoulder and neck until it finally stopped above my ear. As the infection progressed, the rash turned into large blisters that eventually burst, leaving very raw and tender skin.
There is no treatment for shingles beyond pain medication, cold compresses and lidocaine cream. Leaving the infected area open to fresh air can help with healing. I found that pouring Bactine liquid on the sores helped cool them.
Once the raw area scabbed over, the healing began. The process took three months from start to finish, and it was, to put it bluntly, hell. The pain was relentless, something the medication could not control. It was like being on fire.
Avoiding shingles
“People who are not vaccinated or don’t remember having chickenpox should get vaccinated,” Percival said. “In an adult, chickenpox can be terrible—much worse than if you have it as a child. People can die from it.”
For those who have had chickenpox, the chance of developing shingles can be mitigated with a vaccine called Shingrix, which is administered in two shots, two months apart.
“This new vaccine is amazingly effective,” Percival said. “There was a vaccine 10 years ago that was 50% effective. This one is 95% effective, and even if you end up in the 5% that still gets shingles, you get a much milder case.”
The vaccine is FDA-approved only for people over age 50 and is widely available from doctors and pharmacies. It’s effective for people who have never contracted shingles as well as those trying to stop a second outbreak, the doctor said.
For people under 65, the shots are usually covered by standard health insurance, but for those over 65, it can be more cost-effective to get the shots at a pharmacy.
“A shingles vaccination on your 50th birthday would be a great present to yourself,” Percival said. “And it becomes even more important as you get older. Shingles is something you definitely want to avoid if you can.”
BenitoLink thanks our underwriters, Health Projects Center and Del Mar Caregivers for helping expand our senior health coverage. Health Projects Center supports more reporting on senior health issues and solutions in San Benito County. All editorial decisions are made by BenitoLink.
Since 1988, Del Mar Caregiver Resource Center (CRC) has served families of persons living with neurological conditions such as Alzheimer’s Disease, Parkinson’s disease, Multiple Sclerosis, Stroke, Traumatic Brain Injury and other conditions that cause memory loss and confusion.