Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.
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I am often asked by elder persons whether or not they should
take the herpes zoster (“shingles”) vaccine. Up until this point, I have been
answering “yes” based on my own experience, but now there is some data to
support this recommendation.
In the article, “Herpes Zoster Vaccine in Older Adults and the Risk of Subsequent Herpes Zoster Disease,” Hung Fu Tseng and his colleagues reported their findings in the Journal of the American Medical Association (JAMA 2011;305[2]:160-161). They evaluated the risk of herpes zoster after persons received the vaccine in a general practice setting.
In a retrospective (looking back at a cohort of patients from medical records) study, the researchers compared information about 75,761 vaccinated persons with 227,283 patients who were not vaccinated. Both the vaccinated and non-vaccinated groups were made up of people in the same age range. The outcome measure of the study was incidence of herpes zoster infection.
The vaccine works. The number of herpes zoster cases among vaccinated individuals was 828 in 130,415 person-years, and for unvaccinated persons was 4606 in 355,659 person-years. In other words, the number of cases was 6.4 per 1,000 person-years in the vaccinated group versus 13 per 1,000 person-years in the unvaccinated group. From a practical standpoint, that is a huge difference. Importantly, a very painful manifestation of herpes zoster, ophthalmic (affecting the eye) herpes zoster was less likely among vaccine recipients.
The conclusion is that among persons with normal immune systems who are “community dwelling” and aged 60 years or older, the herpes zoster vaccine is quite effective. For persons in this group who will be travelers or outdoor recreationalists, perhaps without prompt access to medical care if afflicted by shingles, vaccination makes good sense.
