Should You Get the Shingles Vaccine at 50?

Weighing the Decision to Pay for Early Shingles Vaccination

herpes zoster
Shingles on the Back.

It's hard to quantify just how much disease prevention means to any individual person. Shingles (AKA herpes zoster) is an exquisitely painful condition, the pain of which can linger for years in the form of postherpetic neurlagia. Now is $200, the going rate for a shingles vaccination, worth it?

The answer to this question really depends on you.

Medicare Part A and B don't cover the cost of shingles vaccination; nevertheless, most individuals would gladly spend $200 to avoid the pain and suffering of a future shingles infection.

Maybe you have had shingles or know somebody who has had this illness; it's no fun.

However in terms of public health, the value of this vaccination is based on other things including its cost, efficacy, or ability to prevent disease, and how long the vaccination lasts.

What's Shingles?

Whether you remember it or not, at one point in your life you've most likely had chickenpox, which is caused by the varicella-zoster virus. About 99 percent of all people have had chickenpox before.

Decades after an initial bout of chickenpox, varicella zoster can reemerge or reactivate resulting in shingles, or herpes zoster. When varicella zoster reactivates it affects nerve cells that distribute along a dermatome, or specific area of skin.  Often, people with herpes zoster infection experience infection along dermatomes in the face, head, arms, legs, back and so forth.

Check out these pictures of shingles.

Shingles usually affects older people, and people who have weakened immune systems.

The first phase of shingles is often marked by both localized, or dermatomal pain, along with more generalized pain and discomfort like headache, muscle pain, photophobia and so forth. After a couple of days, this severe pain evolves into both pain and vesicular rash, which can last up to 2 weeks.

Many people who come down with shingles experience complications. For example, about 10 percent of affected people develop postherpetic neuralgia or persistent pain, such as burning, stabbing or itching that can be aggravated by light touch. Of note, postherpetic neuralgia can also present as other types of sensory disturbance including numbness or paresthesia. Postherpetic neuralgia can last for several months.

As with any virus for which there exists a vaccination, the best way to deal with shingles is to get the shingles vaccination in the first place. Even if you've had shingles before, you can still get vaccinated with the shingles vaccine to prevent future infection.

More About the Shingles Vaccine

In 2006 the FDA approved the shingles vaccine, or Zostavax, for people aged 50 years and older. However, the CDC recommends that people older than 60 receive the vaccine.

In clinical trials, the overall efficacy of the shingles vaccine at preventing an attack of herpes zoster is 51 percent, and the efficacy of the vaccine preventing postherpetic neuralgia is 67 percent. In other words overall, the shingles vaccine reduces the chance of you developing shingles by about half and the chance of you later developing postherpetic neuralgia by about two-thirds.

Of importance, the shingles vaccine is most effective in people aged 60 to 69 years old, with an efficacy equal to 64 percent. In people aged 70 and older, the vaccine is about 34 percent effective.

Many insurers cover the cost of the shingles vaccination for people 60 years and older. If you're in your 50s, you can still get vaccinated but will likely have to shell out about $200. 

The shingles vaccine is not a one-in-a-lifetime deal. Once you're immunized, you should be protected from infection for about 5 years. After 5 years, you'll need to get vaccinated again.

After looking the efficacy, cost and length of protection conferred by the shingles vaccine, the federal government figured that adults aged 60 and older experience the most benefit from receiving the shingles vaccine.

Thus, the CDC recommends that people aged 60 and older receive the vaccination.

Please keep in mind, however, the government develops policies for the masses not for individuals. If you're aged 50 or older and want to possibly avoid a future bout with shingles--or have a history of immunocompromise--discuss vaccination with your physician. After all although $200 is bit pricey, it's a small price to pay to avoid pain of shingles and postherpetic neuralgia. Just remember that once you get vaccinated, you need to get vaccinated again every 5 years.

Selected Sources

Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. Chapter 124. Zoster. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. eds. The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013. Accessed February 19, 2016.



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