The shingles vac­cine is not for ev­ery­one

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff AskDr.K

You’ve writ­ten about who should get the shingles vac­cine, and why. Are there any groups of peo­ple who should not get the shingles vac­cine?

I’m glad you asked be­cause, yes, there are groups of peo­ple who should not get the vac­cine.

Shingles is a painful skin rash, of­ten with blis­ters, that lasts from two to four weeks. Its main symp­tom is pain, which can be quite se­vere. For some peo­ple, the se­vere pain of shingles con­tin­ues long af­ter the rash clears up. Called pos­ther­petic neu­ral­gia, this condition can last for months, or even years. It can be quite de­bil­i­tat­ing.

Shingles is caused by the vari­cella zoster virus (VZV), the same virus that causes chick­en­pox. VZV qui­etly re­mains in your body af­ter you re­cover from chick­en­pox, but it can re­ac­ti­vate and cause shingles many years later.

Most adults age 60 years and older should get a vac­cine called Zostavax. The vac­cine helps pre­vent shingles — and it de­creases the risk of post-her­petic neu­ral­gia if shingles does oc­cur. The vac­cine is also ap­proved for peo­ple 50 and over. Peo­ple gen­er­ally should get the shingles vac­cine even if they have al­ready had shingles: The vac­cine will re­duce the risk of get­ting shingles again.

The shingles vac­cine con­sists of ac­tual liv­ing vari­cella zoster virus that has been greatly weak­ened. The weak­ened virus stim­u­lates the im­mune sys­tem the same way in­fec­tion with the reg­u­lar virus would. How­ever, the virus has been so weak­ened that it can­not cause prob­lems in peo­ple with healthy im­mune sys­tems.

Still, some peo­ple should not get the shingles vac­cine or should wait. This in­cludes:

• Any­one who has had a se­vere al­ler­gic re­ac­tion to gelatin, the an­tibi­otic neomycin, or any other com­po­nent of the shingles vac­cine. Tell your doc­tor if you have any se­vere al­ler­gies.

• A woman who is preg­nant, or might be preg­nant. Women should not be­come preg­nant un­til at least four weeks af­ter get­ting the shingles vac­cine. That’s be­cause preg­nant women have a some­what weak­ened im­mune sys­tem.

• Any­one with a moder­ate or se­vere ill­ness (in­clud­ing a tem­per­a­ture of 101.3 de­grees F or higher) should wait un­til they re­cover be­fore get­ting the vac­cine. The vac­cine is less ef­fec­tive when given to some­one who is sick with an­other in­fec­tion.

• A per­son who has a weak­ened im­mune sys­tem, and there­fore might be made sick by the virus in the vac­cine. Peo­ple with weak­ened im­mune sys­tems in­clude those:

• with HIV/AIDS or an­other dis­ease that affects the im­mune sys­tem;

• re­ceiv­ing treat­ment with drugs that af­fect the im­mune sys­tem (for ex­am­ple, pro­longed use of high-dose steroids);

• re­ceiv­ing can­cer treat­ment such as ra­di­a­tion or chemo­ther­apy;

• who have can­cer af­fect­ing the bone mar­row or lym­phatic sys­tem, such as leukemia or lym­phoma.

Shingles is no fun — and pos­ther­petic neu­ral­gia can be very de­bil­i­tat­ing. So the shingles vac­cine has been a very good thing for most peo­ple, but not for all.

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