The shingles vaccine in people who have had shingles
Shingles is a painful skin disease that can be prevented with a vaccine, but is the vaccine beneficial if you have already had the disease?
What is shingles and how does the vaccine work?
In people who have had chickenpox, the varicella-zoster virus that caused it remains in the body in nerve cells but is dormant, kept in check by your immune system, so you are unaware of it. A weakened immune system – either through illness or simply because it doesn't work as well as you get older– may allow the virus to emerge. If it becomes active again, it emerges as a painful skin rash that starts as a burning sensation in the skin and progresses to fluid-filled blisters. These blisters often burst and turn into sores before healing. This reactivation of the virus is known as herpes zoster – or shingles. About 20% of people who have had chickenpox will develop shingles. In England and Wales, it is estimated that more than 50,000 cases occur annually in people 70 years old and older.
Shingles can be painful, with some people experiencing pain years after the rash has healed, which is known as postherpetic neuralgia (PHN).Shingles can cause complications that affect the eyes or other organs and cansometimesbefatal.
The shingles vaccine, Zostavax, contains a live but weakened version of the varicella-zoster virus responsible for causing chickenpox. The virus is too weak to cause shingles but stimulates the body's immune system to respond to the virus and produce more antibodies against the virus. The extra antibodies help to boost the immune system and keep the virus dormant. If you do develop shingles despite having been vaccinated against shingles the symptoms will be milder, with less chance of PHN. As with any vaccine, the shingles vaccine can have some side effects, but in general it is well tolerated.
Who should have the shingles vaccine?
The NHS now provides the vaccine to anyone at the age of 70 and in a catch-up programme to people who are 78, plus people who missed the start of the programme up to the age of 80.
Shingles is not generally as severe in the 50 to 69 year-old age group, In addition, researchers do not yet know for how long the vaccine offers protection, but they currently believe it works for at least 5 years, though follow-up is continuing. The vaccine is less effective in people over the age of 80. By giving the vaccine to people who are 70, it provides protection when the vaccine can be the most useful.
Only one dose of the vaccine is needed and it is given as an injection under the skin (subcutaneous) in the upper arm. The shingles vaccine can be given at any time of year, and it can be given at the same time as the influenza (flu) vaccine as long as a different injection site is used.