SHINGLES: WHAT IT IS

Shingles – Or Herpes Zoster – Is caused by the varicella-zoster virus. This virus also causes chickenpox.

It is an infection that causes a painful or itchy rash on the skin and around the nerves. This rash may contain tiny fluid-filled sacs. It sometimes affects the eyes. It often occurs down one side of the body only. Other symptoms include headache, malaise, or a high temperature.

You may only suffer from chickenpox once, but the virus can lay dormant in the body for the rest of your life. If this virus is reactivated, it presents as shingles rather than a second incidence of chickenpox.

Growing older or having a weakened immune system both increase the likelihood of contracting shingles. Your immune system may be weakened if you are ill, run down, or have recently undergone medical treatment.

Whilst you are suffering from shingles, you may transmit chickenpox to others. However, you cannot catch shingles from those who have caught chickenpox or shingles.

Whilst the shingles vaccine does not protect you against chickenpox, it does reduce your risk of developing shingles.

SHINGRIX

Shingrix is a non-live shingles vaccination, manufactured by GSK and designed to be highly effective in providing protection against shingles (herpes zoster).

It can offer a protection rate of around 90% against the shingles infection, and it also boasts an 88% rate of efficacy against post-herpetic neuralgia – this is a painful, long-term condition, where the nerve endings remain painful long after developing shingles.

Shingrix is the most effective vaccine available on the market, and unlike its counterpart; the Zostavax vaccination, its efficacy does not decline with an increase in recipient age.

Subject to consultation, Shingrix is available to the following groups:

. Adults aged 18+ years, who may be at increased risk of developing shingles

. Adults aged 50+ years, to protect against both shingles and post-herpetic neuralgia (following shingles)

For more information on Shingrix, visit: https://www.medicines.org.uk/emc/files/pil.12054.pdf

INCLUSION

This vaccination allows for anyone over the age of 50 to be protected against shingles or post-herpetic neuralgia. It works by enhancing the body’s own immunity.

Two doses of this vaccine are delivered via intramuscular injection into the deltoid area. Dose two should be delivered two months after dose one, although it is possible to deliver the second dose at any point up to six months after the first injection.

PROTECTION AND BOOSTERS

Protection may be provided for up to 4 years following the second dose, but there is no data beyond this timeframe.

EXCLUSIONS

. Anyone under the age of 50

. Those who are currently pregnant or breastfeeding

. Those who are actively suffering from shingles

. Anyone who has suffered from an allergic reaction to the vaccination or any of its ingredients

. Those who are currently experiencing an illness resulting in a temperature of 38.5 degrees or above

SIDE EFFECTS

Localised possible reactions:

. A feeling of pain or soreness in the site where injected

. Swelling or redness

. Very rarely, swelling of the injected limb may occur

Generalised possible reactions:

. Feelings of nausea

. Gastrointestinal symptoms such as vomiting or loose stools

. Tiredness

. Headache

. High temperature

. Myalgia

There is no risk of transmission, as this virus does not contain a live virus component.

INTERACTIONS

Shingrix can be administered at the same time as other vaccinations.

ZOSTAVAX VACCINE

Zostavax contains a weakened dose of the varicella zoster virus. A large study on its efficacy was conducted, consisting of over 38,000 participants aged 60+ years old. The risk of contracting shingles was reduced by 51%. The risk of post-herpetic neuralgia was reduced by 67%. Those aged 70+ years demonstrated risk reductions of 38% and 66.8% respectively.

For patient information visit: https://www.medicines.org.uk/emc/product/6101/pil

For those who contract shingles after receiving the vaccination, it is a milder form with a shorter duration and less severe effects. The effects of the vaccine will be lifelong, and no booster immunisation is necessary.

INCLUSIONS

Anyone aged over 50 years old is eligible for the vaccination against shingles and post-herpetic neuralgia. It is provided in one dose, via an intramuscular or subcutaneous injection into the deltoid region.

The latest data suggests that the vaccination is effective for a period of around 5 years.

EXCLUSIONS

There are certain groups who are not eligible to receive a shingles vaccination. These include:

. Those who are pregnant

. Those currently suffering from an active shingles infection

. Those who are immunosuppressed, either because of disease, illness, or other medications

. Those who have a history of allergic reaction with the vaccine or one of its ingredients

. Those who are ill or who have a fever of 38.5 degrees Celsius or above

. Those who have Tuberculosis that remains untreated

SPECIAL CONSIDERATIONS

. This vaccine is not efficient at treating the symptoms of either pre-existing shingles or post-herpetic neuralgia. Its purpose is to reduce the incidence or likelihood of contracting the illness.

. Those who have contracted shingles more than twice over a one-year period should be assessed by a medical professional prior to vaccination.

. After an incidence of shingles, you should wait at least a year before being vaccinated. The body’s own immune response will be active after illness, and this could decrease the effectiveness of the vaccination.

. For those who are on either oral or injected antiviral medications such as Aciclovir, a period of 48-hours must be left after stopping medication and receiving a vaccine. This is to ensure that the vaccine has maximum effectiveness. For those who use topical only antiviral medications, this does not apply.

PREGNANCY

The shingles vaccine is not suitable for those who are pregnant. Pregnancy should be avoided until one month after vaccination.

BREAST FEEDING

The shingles vaccine is not suitable for those who are breastfeeding.

Harm to a lactating baby cannot be eliminated, as it is not known whether components of the vaccine can be transmitted via milk supply.

COMMON SIDE EFFECTS

. High temperature, or fever/chills

. Aches and pains in the joints or limbs

. Headaches

. Soreness, redness, or slight hardening of the skin at the site of the injection

. A haematoma caused by a broken blood vessel at the injection site

In less than 1 per 10,000 people who receive the vaccine, an illness similar to chickenpox, and/or the development of a chicken pox-like rash will occur.

A doctor should be contacted if any rash or illness similar to shingles or chickenpox develops, in order to assess whether this has been caused by the vaccine. A swab will be taken to determine the cause.

Transmission:

In clinical trials, there have been no documented cases of the shingles vaccine virus causing transmission to those who are not immune. However there have been rare events where the chickenpox vaccine virus has resulted in transmission, in isolated cases. Because of these circumstances, and the fact that the shingles vaccine contains the same virus at higher doses, it is recommended that close contact with the following groups is avoided for up to 6 weeks post-vaccination. This is especially important if a rash develops:

. Those who are immunosuppressed

. Babies aged from 0 – 28 days old, especially where their birth mothers have never suffered from chickenpox

. Those who are pregnant, especially where they have never suffered from chickenpox

INTERACTIONS

The shingles vaccine can be administered with the following vaccinations successfully:

. The seasonal flu jab / Influenza

. Travel vaccinations, with the exception of yellow fever (further details below)

. PPV-23 and other pneumonia vaccines

. The vaccine for Diphtheria, Polio, and Tetanus

For those requiring a yellow fever vaccine, it is recommended that there is an interval of 4 weeks left between this and the shingles vaccine. There is little known evidence about the interaction between these vaccinations, therefore a 4-week interval ensures optimum safety and efficacy.

Shingles / MMR Vaccinations:

Those who are seeking both shingles and MMR vaccinations can receive both on the same day, or a period of four weeks should be left between the two vaccinations.

AVAILABILITY

Check for availability at a branch close to you and book online, or call in and have a friendly chat. Our team can help book you in or deliver a same day service subject to availability.