If you are at least 50 years old, shingles can be prevented by vaccination | Canadian Medical

If you are at least 50 years old, shingles can be prevented by vaccination

Article

29. 01. 2015

Shingles (Herpes zoster) is a dreaded disease which occurs more frequently as the patient gets older. The disease causes severe pain in areas where large red spots occur. These spots are caused by the chickenpox virus, which many people have undergone when they were young.  The virus attacks the dorsal root ganglia, i.e. the nerve endings, where it then rests in a latent form. In some cases, the virus rests dormant throughout the entire life. In other cases, the virus resurfaces and is the culprit behind shingles.

The risk of shingles increases four-fold after the age of 50

Cellular immunity is to blame for the outbreak. In case it is weakened, it is unable to control the occurrence of latent viruses which reside inside the body. In the case of chickenpox, the virus then resurface and since cellular immunity no longer functioned correctly, the virus travels to tissues previously affected by it. However, not all parts of the body where the virus manifested itself earlier in life are affected.  Usually, the virus resurfaces on the shoulders, the neck or the waist.

With people older than 50, the risk of shingles occurring increases two to four-fold. This is connected to the fact that with growing age, the immune system and general cellular activity weaken. The occurrence of shingles is also affected by other factors such as a woman’s menopause - shingles is more commonly observed in women than men. The disease is also affected by genetic predisposition, by using immunosuppressants or by various diseases of the immune system.

The Zostavax vaccine prevents shingles

Thanks to medical progress, it is now possible to vaccinate against shingles with the Zostavax vaccine. It took 15 years to introduce the vaccine against chickenpox. During its testing, further attention was paid to also treating recurrent infections with the help of the same vaccine to prevent shingles. As part of this research, it became clear that the concentration of the vaccine virus had to be increased ten-fold when compared to the amount needed to vaccinate against chickenpox alone. Such a high concentration is responsible for increasing the amount of antibodies and increasing specific cells of the immune system. This further leads to an increase in cellular immunity.

Vaccination significantly decreases the possibility of shingles occurring in the 50-79 age group. People below the age of 60 have a 72% rate of protection and people over 70, a 74% rate of protection. With people over the age of 80, the protection rate decreases to 56%.

Recurrences of shingles are not common, but certainly possible. With about 4% of patients, shingles occurs again within a period of six years. It is therefore important to vaccinate against it even after it occurs, and at least within six months of the infection. Recurrence with people younger than 70 is lower by 61% following vaccination. With people older than this, such good results were not recorded. When an older patient undergoes shingles, cellular immunity is increased in a similar manner to having been vaccinated. As a result, vaccination would not have any positive impact.

Since 2006, vaccination has been available in the EU

The application of the vaccine is entirely safe. In one single case, a patient underwent a mild occurrence of shingles and a mere two cases exhibited mild cases of chickenpox. No other patients had similar symptoms. People who are sensitive towards gelatin or neomycin cannot use this vaccine. However contact dermatitis to neomycin is not an obstacle. Patients with cellular immunodeficiency can also experience serious limitations. Such patients are not vaccinated at all or only under specific circumstances.

Since 2006, the vaccine has been registered in the EU, the United States and Australia. It was introduced to the Czech market in 2014. It is the first available vaccine capable of protecting from recurrent infections, or more specifically, shingles. Vaccination is only intended for people over the age of 50, i.e. people whose immune system is undergoing a natural deterioration.

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