The shingles vaccine approved last fall is highly effective, but older adults seem reluctant to get it.
For older adults, the risk of developing shingles increases with age. Other factors, including immune problems and developing chicken pox early in life, also increase the risk.
But should you get vaccinated to protect yourself from shingles if risk factors aren’t present?
If you’re under the age of 50, you’re probably fine. But if you’re over 50, the answer from health professionals is an unequivocal yes.
Shingrix, a new shingles vaccine introduced last fall, is effective and increasingly covered by insurance providers, so experts say getting vaccinated is a no-brainer.
They say it’s a pronounced improvement over Zostavax, the previously recommended shingles vaccine.
It’s prompted some medical professionals this month to publicly encourage older adults to get the vaccine.
One of them is Dr. Jennifer Carandang, an internal medicine specialist at University Hospitals Avon Family Practice in Ohio.
“Zostavax is a live vaccine, which is a lot different from the Shingrix vaccine,” Carandang told Healthline.
“Zostavax is about half as effective as Shingrix and it also was not approved to prevent postherpetic neuralgia, which is a complication of shingles, whereas the new Shingrix vaccine is,” she added. “This is why we prefer Shingrix over Zostavax now.”
A nasty, persistent condition
Dr. Navjot Jain, an internal medicine specialist at The Ohio State University Wexner Medical Center, says shingles is an offshoot of the chicken pox virus.
While many people have experienced chicken pox and therefore have the dormant virus, those who experienced chicken pox before they were 18-months old are considered to be at a higher risk.
“Basically, shingles is the activation of the varicella zoster virus, which causes chicken pox,” Jain told Healthline. “Herpes zoster, which causes the vesicular rash associated with shingles, is a reactivation of the varicella zoster virus.”
Even after the initial painful rash caused by shingles dies down, the aftereffects can be even worse.
“The most common thing that we see after shingles is something called postherpetic neuralgia, which is nerve pain that can last for months, typically 90 days or more, and sometimes for several years,” said Jain. “It’s excruciating pain at the site of where the patient would have previously had the shingles rash.”
The agony of postherpetic neuralgia is often enough to convince patients to get vaccinated against shingles, says Jain.
“A lot of times, when I introduce the idea of getting the shingles vaccination to my patients, I ask them first if they know of anyone who’s had it. Most people will say yes and they’ll talk about how debilitating it was for that particular person,” said Jain. “So, a lot of times I’ll ask them about it just to help them understand how common it is. If they haven’t been associated with someone who’s had it before, I usually explain to them how painful it can be and how debilitating it can be.”
There’s also the fact that a subtype of shingles, herpes zoster ophthalmicus, occurs in about 15 percent of shingles cases. In rare cases, says Jain, this can lead to vision loss.
Why not get the vaccine?
Shingrix is a marked improvement over its predecessor, more than 90 percent effective in preventing against the shingles virus.
Health professionals, from family doctors to the Centers for Disease Control and Prevention (CDC), recommend that most people over the age of 50 get vaccinated.
Yet only about a third of people over the age of 60 got the vaccination in 2016.
So what’s stopping people?
One issue might be cost for people who aren’t sure whether their insurance will cover the immunization.
“Shingrix costs about $280 for both shots and Medicare Part D, which some people 65 and over have, will cover that cost,” said Carandang. “But individually it’s best to talk to your insurance company.”
Carandang also points out that even for those with a high deductible plan, some providers will still cover the cost of the shots for the sake of health maintenance.
Jain adds that more insurers are covering the cost of Shingrix, even for patients who’ve already been vaccinated with Zostavax, simply because the new vaccination is so much more effective.
Another reason some people may be hesitant about getting vaccinated stems from the side effects of getting these shots.
“The side effects of getting the Shingrix vaccine can include muscle aches, fatigue, and headaches,” said Carandang. “These are common and they can happen with pretty much any vaccine.”
While the pain from getting injected may be a deterrent, the potential pain that could come with a shingles infection can be worse.
About a third of people will develop the shingles virus at some point in their life, so experts say it’s worth it to get the Shingrix vaccine.
“A lot of times, people get really concerned about having a vaccine because of the side effects, but with the Shingrix vaccination, it’s usually fairly minimal,” said Jain. “I would really urge them because this vaccine is so effective, that it’s in their best interest to get it.”