Vaccinate against varicella to prevent chickenpox in childhood, shingles later in life
One in three adults will experience herpes zoster varicella virus, better known as shingles, the Centers for Disease Control and Prevention (CDC) reports. The virus also causes chickenpox, formerly a common childhood illness, and remains in the body throughout a person’s lifespan. It reappears with distinct symptoms later in life as shingles, an illness known for its painful rash and fever. A weakened immune system, even from everyday triggers like stress, contribute to the likelihood of reactivating the dormant virus.
Although most patients experience temporary symptoms, nerve pain known as postherpetic neuralgia, and vision loss can last for years after initial recovery. My own experience with shingles was certainly unpleasant and I remember related details now more than a decade later. I was going through a stressful time at work and at home. My first symptom of shingles was fatigue. I noticed myself just getting unusually tired, with pain in my stomach and midsection. I made a doctor’s appointment to get checked for what I assumed was an ulcer.
Over the weekend before my appointment, I noticed a painful rash near my spine, with purple lines reaching around my right side, but I thought it might be poison ivy.
At the appointment, my doctor and I discussed the stomach pain I was experiencing but those symptoms just didn’t match up for an ulcer. As an afterthought, I showed my doctor the rash and he instantly recognized it as shingles. He said I was actually lucky, as I had caught the disease just a few days into the rash. I learned later antivirals are sometimes only considered effective in the first three days after the onset of symptoms. While I was grateful to get a swift diagnosis and treatment, I was still in pain and felt extremely ill.
The pain got progressively worse, even though I was taking prescription pain medication. The telltale shingles rash took three days or so to stop spreading but the most significant symptom was the lingering postherpetic neuralgia. I still have nerve pain from my stomach to my leg.
The varicella vaccine and who is vulnerable to shingles
CDC data confirms more than 99% of Americans born before 1980 have had chickenpox, which makes Baby Boomers, Gen X and some Millennials at risk for shingles. The varicella vaccine protects against chickenpox and shingles but it did not become part of the routine childhood immunization schedule until 1995. Physicians have described vaccines as the single most important milestone for public health, as they are safe and effective, the best way modern medicine offers to prevent illness.
A combination vaccine known as the MMRV vaccine is often administered to prevent measles, mumps, rubella and varicella. The varicella vaccine can also be given as a two-dose series for children between 12 and 18 months of age or at older ages for those who were not vaccinated in early childhood.
Fewer deaths, better outcomes
The U.S. Department of Health and Human Services lists the varicella vaccine as 90% effective, with better outcomes for breakthrough cases. In fact, the CDC reported important declines in fatal occurrences of the virus after the vaccine became widely available: “In children and adolescents less than 20 years of age, varicella deaths declined by 99% during 2012-2016 compared with 1990-1994.”
Additionally, the CDC and other global health agencies recommend two doses of the shingles vaccine, known as Shingrix, after age 50, even if the individual has already had shingles.
CDC Shingrix information: How well does Shingrix work? Source: https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html
In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles; in adults 70 years and older, Shingrix was 91% effective.
In adults 50 years and older, Shingrix was 91% effective in preventing postherpetic neuralgia; in adults 70 years and older, Shingrix was 89% effective.
In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition.
In people 70 years and older who had healthy immune systems, Shingrix immunity remained high throughout 7 years following vaccination.
Protect yourself and others
I was not yet eligible for the shingles vaccine that was on the market because of my age when I got shingles, in my late 40s. I did get the Shingrix vaccine later to prevent a recurring case but I would encourage any parent considering the varicella vaccine to do their part and prevent chickenpox during childhood. I do recall having that itchy, uncomfortable experience when I was 5, as most children did then, but not every child does survive chickenpox. We have to remember that. People can die of shingles, too, especially as they get it when they’re older and less able to recover.
Help keep your child from suffering unnecessarily at any age by getting the varicella vaccine while they’re young. What I would say to any parent is talk with your doctor if you have concerns but know vaccines are safe and effective. Immunize to protect those you love, the weak, the strong, just for humanity. Prevent illness before it starts.
Where to get vaccinated Find local resources here.
Ron Kroening is president and CEO of the Tulsa Area Immunization Coalition.