Herpes zoster, or shingles, is caused by the same virus that causes chickenpox . After an episode of chickenpox, the virus becomes dormant in the body. Herpes zoster occurs as a result of the virus re-emerging after many years.

The cause of the re-activation is usually unknown, but seems to be linked to aging, stress or an impaired immune system. Often only one attack occurs, without recurrence.

If an adult or child is exposed to the herpes zoster virus and has not had chickenpox as a child or received the chickenpox vaccine, a severe case of chickenpox may develop rather than shingles.

Herpes zoster can be contagious through direct contact to an individual who has not had chickenpox, and therefore has no immunity. Herpes zoster may affect any age group, but it is much more common in adults over 60 years old, in children who had chickenpox before the age of one year, and in individuals whose immune system is weakened. The disorder is common, with about 600,000 to one million cases in the U.S. per year.

Most commonly, an outbreak of shingles is localized and involves only one dermatome. Widespread or recurrent shingles may indicate an underlying problem with the immune system such as leukemia, Hodgkin's disease and other cancers, atopic dermatitis, HIV infection , or AIDS . People whose immune systems have been suppressed because of organ transplant or treatment for cancer are also at risk.

Recently,the Advisory Committee on Immunization Practices (ACIP), a federal panel of immunization experts, has recommended people age 60 and older receive a new vaccine to prevent herpes zoster, or shingles, a condition that often leads to debilitating chronic pain.

The ACIP to the Centers for Disease Control and Prevention (CDC) voted to recommend a newly licensed zoster vaccine, Zostavax manufactured by Merck, to protect against shingles be given to all people age 60 and older, including those who have had a previous episode of shingles.

“Vaccines aren’t just for kids anymore – and this vaccine represents an important medical breakthrough aimed at improving health in older people,” said Dr. Anne Schuchat, Assistant Surgeon General and director of CDC’s National Center for Immunizations and Respiratory Diseases. “These vaccine recommendations address a health problem for people age 60 and older. It has been tested and has been found to be safe and effective in providing protection against shingles and associated chronic pain.”

Zostavax, the only zoster vaccine on the market, was studied in approximately 38,000 individuals throughout the United States who were age 60 years and older. Half received the vaccine and half received a placebo. Study participants were followed for an average of three years to see if they developed shingles and, if they did, how long the pain lasted. Zostavax reduced the occurrence of shingles by about 50 percent and post herpetic neuralgia (pain persisting after an episode of shingles) by 67 percent.

While the ability for the vaccine to prevent shingles declined with age, the risk of chronic pain among those older vaccinated persons who still developed shingles was lowered. The most common reported side effects in vaccine recipients were mild, such as reactions at the injection site and headache.

Varicella zoster virus (VZV) causes varicella, or chickenpox and becomes dormant within the nerves following exposure or a case of chickenpox. It can reactivate later in life to cause shingles. About 25% of people develop zoster during their lifetime, and there are about one million cases of shingles per year. The risk is highest in the elderly, and it increases with age starting at around 50 years. Shingles often causes chronic pain, and the risk of suffering chronic pain increases with age, starting at 60 years. Shingles is much less contagious than chickenpox.

The ACIP, consisting of 15 members appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP become CDC policy when they are accepted by the director of CDC and are published in CDC’s Morbidity and Mortality Weekly Report (MMWR).

"Older people should take zoster vaccine(Zostavax) for Herpes zoster / shingles"   User Opinions

June Morrison :   I have read the US trial results. It leaves no doubt that the vaccine should be available to over-60s (who have had chickenpox/varicella)

Susan :   When I read the AOL article about this vaccine being available, I said, "At last". At my annual physical I requested the vaccine and received it. Intermed submitted the bill, $172.00, to my AARP Supplemental health plan and while I hope they will pay for it, it is worth it to me to cough up the cost out of my own pocket. I've seen the agony people have endured battling Shingles!!!!!!!!!! and I don't want it.

dukejeanne@aol.com :   I contacted shingles in 2001. I still have post shingles or Hepetic Neuralgia a a result. I have it on the left side of my head. It is very painful and sometime unbearable. I take Neurontin, that helps to dull pain, somewhat. I also have Emphyema and take advair and prednisone for breathing.Do my exercise every day, very important My advice would be take the vaccine of course with your doctors approval. I am 79 yrs old. I think when I was diagnosed with Emphysema the stress may have affected my immune system. This is only one person's opinion.Accept the thing you cannot change. Change the things you can. Have the wisdom to know the difference. with love, Jeanne

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