Parlez-en à votre pharmacien

novembre 7, 2019
Q:

I heard there is a new vaccine to prevent shingles. I had the older one. Do I need this one too?

A:

Great question. There is a relatively new vaccine used to help prevent shingles (herpes zoster). The latest vaccine is called Shingrix®, and it may help reduce the risk of shingles by roughly 90 per cent. The alternative, Zostavax, reduced the risk by roughly 50 per cent. The National Advisory Committee on Immunization (NACI) recommends that everyone over the age of 50 (with no contraindications) be offered Shingrix® to help prevent shingles, even if they have had the previous vaccine. To answer your question, you don’t have to get the new vaccine, but based on the evidence, you should consider Shingrix® to give you the best protection you can receive.

Shingles is a tingling, painful rash, usually on one side of the body, caused by the chicken pox virus (varicella). After having the chicken pox or having been exposed to it, the virus sticks around living in nerve cells of your body. The virus is kept dormant by your immune system, but at times when the immune system is compromised by stress, illness or medication, etc., the virus can resurge and travel along a nerve to where the nerve ends on the skin where it can erupt in a rash capable of spreading chicken pox (by direct contact) to anyone who has not had chicken pox. Shingles can occur in many places on the body, the most concerning of which is on the face and around the eye. Loss of vision or facial paralysis can occur in this situation.

Rates of shingles are increasing, and now we expect one in three people will have shingles in his/her lifetime. The age where risk significantly increases is somewhere between age 50-60, and it continues to increase as you get older with half of those over 85 having been affected. These are the age groups of most concern as complication rates are higher with older people.

The most common complication of shingles is lasting pain (mild to severe) for one to two months after the outbreak. This is called Post-Herpetic Neuralgia (PHN) and is caused by damage to nerve cells as shingles erupts. PHN can range from mild to tingling burning sensation to a severe pain described as similar to thorns or barbed wire burning and scratching the skin. To make matters worse, many patients, especially older patients with weakened immunity, can have pain that lasts into the year range. At 85, my grandfather seemed like he would never slow down, but he got shingles and with it, came severe pain. The way he walked changed, the normal day-to-day exercise was put on hold until the pain subsided. Unfortunately, the pain took almost 18 months to subside, leaving him without the independence he had before shingles. I often tell this story when people ask me if I believe the vaccine is worth it.

If you are over 50 talk to your pharmacist as two injections of Shingrix® can help reduce the chance of having shingles by 90 per cent in your life. New Brunswick pharmacists can prescribe certain vaccines like Shingrix®. Shingrix® is a two-dose vaccine with a second dose being administered two to six months later. If you have any questions on Shingrix®, or other recommended vaccines, ask your pharmacist for help.

Jared Mactavish (BSc., Pharm) is a pharmacist at Guardian Pharmacy in Hampton and St. Stephen. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.