Shingles vaccine is recommended beginning at age 50

Dear Dr. Roach: I’m writing in regard to your recent column about a 56-year-old person, recommending he or she wait till 60 for the shingles shot. In 2010 I was 56 and was told by my insurance company that they would not cover the shot till I was 60. Unfortunately, that year I suffered a shingles attack that started on the back of my head and moved into my left eye. I spent an extremely painful and stressful year, not being able to see well and going through medical treatments. My cornea was permanently damaged, and each time I have tried to stop the eyedrops I am taking, the blurriness returns. So, I have told all my friends and family to get the shingles shot as soon as possible.

— G.J.

The column was about a person nervous to get the shot during the coronavirus pandemic. I said it was OK to wait because the risk of serious complications of shingles at age 50 is low.

However, the risk of complications from shingles is not zero. I do recommend the vaccine starting at age 50, but the older a person is, the greater the risk of shingles complications, and thus the more benefit they are likely to get from the vaccine.

Dear Dr. Roach: I am 87 and have heart disease. I take atorvastatin and aspirin. Is it dangerous for me to get a flu shot?

— J.B.

It’s more dangerous for you NOT to get a flu shot than it is to get one. Although there are risks to the flu shot, they are small and almost always involve symptoms that last a day or two at the most. Even though the flu shot is “only” about 50% effective, that means a lot less flu, and flu in an 87-year-old person with heart disease can be fatal. This year in particular, we want to keep people with flu out of the hospitals because of COVID-19, and the single best way to do that is through flu shots.

Dear Dr. Roach: Years ago, you discussed tramadol as a cough suppressant. I have had a chronic cough for years, and my family doctor at the time told me to take tramadol. I have been taking it for about 10 years. My new family doctor doesn’t want to give it to me. What can I do?

— ANON.

Tramadol is an opiate medication that can be dangerous if misused. Physicians need to be cautious about prescribing it. Like essentially any medication, it can be abused.

However, you have a 10-year safety record with the medication. I hear frequently from people who have had years or decades of chronic cough with extensive evaluations that failed to make a diagnosis or find an effective treatment. For this small number of people, I think that low dose tramadol is safe and effective. I think it’s unfortunate you can’t get the medication from your new doctor. I suggest you consult a pulmonary specialist, who might find alternate treatment or decide the benefits of tramadol outweigh the risks.