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Monday, June 14, 2021

Shingles slumbers in every third person: Do you belong to the risk group?

It should be your next step to cut your risk for shingles.

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Manish Saini
Manish works as a Journalist and writer at Revyuh.com. He has studied Political Science and graduated from Delhi University. He is a Political engineer, fascinated by politics, and traditional businesses. He is also attached to many NGO's in the country and helping poor children to get the basic education. Email: Manish (at) revyuh (dot) com

Many things about Shingles remain a mystery, in which the herpes zoster virus affects the nerves and causes pain, usually involving the chest wall.

It causes a burning or stabbing sensation in the area where the shingles outbreak first occurred. And once the skin rash resolves, a chronic pain syndrome called postherpetic neuralgia (PHN) can sometimes develop.

Around every third person gets shingles at least once in their life, an infectious disease that is anything but harmless. It is triggered by varicella-zoster virus (VZV), which is known to cause chickenpox. 

After the infection – mostly in childhood – some of the pathogens withdraw into nerve nodes and “slumber” there, well guarded by the immune system. 

Certain factors, such as a weak immune system with advancing age, but also stress and everything that demands the immune system, the viruses can become active again and lead to shingles (herpes zoster).

Shingles can be dangerous – a risk for the heart and brain too

Apart from the fact that the rash and nerve pain in the acute stage are extremely uncomfortable in some sufferers, risky complications are possible, which sometimes last:

  • Up to 20 percent still have massive nerve pain (post-zoster neuralgia) months after the disease.
  • The risk of stroke and heart attack is increased by more than half in the first few weeks after shingles.
  • In the case of shingles of the eye (ophthalmic zoster), visual impairment may occur.
  • Dizziness and hearing loss can also occur when the ear is affected (herpes zoster oticus).

And not everyone who has had shingles before is safe from re-infection. 

Around six percent of those affected get sick a second time, as a study shows.

Vaccination against shingles from the age of 50

It is, therefore, safest not to get shingles in the first place. That is easy to say, but difficult to implement. After all, more than 90 percent of the over-50s had chickenpox in their childhood and thus carry these “zombie viruses” that can be reactivated at any time. 

The risk of reactivation can be significantly reduced by a WHO-approved vaccine with a so-called adjuvanted subunit dead vaccine.

The serum is a substance containing a specific surface protein of the virus. It stimulates the immune system to develop and maintain special anti-virus agents. This allows varicella in the nerve nodes to be permanently controlled. The reactivation and thus a herpes zoster infection is prevented in this way in the vast majority of cases.

The vaccine is available as a powder plus solvent, and the serum is produced from it shortly before the injection. The dead vaccine does not contain preservatives, such as thiomersal.

Approved in 2017, according to CDC, the Shingrix® vaccine series offers you maximum protection against both shingles and its potential complications. Scheduled two to six months apart, Shingrix is given as a series of two shots.

This is how effectively the vaccine protects against shingles

Various studies that closely examined the effects of the dead vaccine confirm that it is highly effective:

  • Herpes zoster was prevented by 92 percent in 50 to 69 year olds
  • 90 percent of those over the age of 70

Simply calculated for the general population, this means that with vaccination only three out of 100 adults will develop zoster in the course of their life, without vaccination at least 33.

The vaccine is injected twice, at least two to a maximum of six months apart. The full effect is only possible with the second vaccination. Incidentally, patients with immunodeficiency also build up protection against zoster through the vaccination.

Refreshment of the zoster vaccination – how long the protective effect lasts

The effect of the vaccination lasts for years. Studies show that vaccination protection decreases slightly after four years; further studies are still ongoing. In this context, effects on T cells and antibodies have been proven for nine years.

Experts believe that there is immunity at least for this period. Whether a booster vaccination will be necessary later is still the subject of investigations – the dead vaccine has only been on the market since 2018.

Vaccine reactions: These side effects are possible

No effect without side effects, this also applies to the zoster vaccine. Because when vaccinated, the reaction shows that our immune system reacts to the serum and thus builds up future protection against infection. The following vaccination reactions occur relatively often with inactivated vaccines:

  • Local reactions such as pain at the injection site in almost ten percent of those vaccinated; Chickenpox-like, limited rash at the injection site in 0.1 percent.
  • Systemic reactions such as a mild fever, fatigue, headache, and muscle pain can also occur.

However, these vaccine reactions usually subside within one to three days.

Who should get vaccinated against zoster

Experts generally recommend the dead vaccine to all people aged 60 and over to protect themselves from herpes zoster, its possible complications and consequences.

Because shingles can be particularly dangerous for people with certain chronic diseases.

The risk group includes patients with

  • Diabetes mellitus
  • chronic obstructive pulmonary disease or bronchial asthma
  • chronic renal failure
  • rheumatoid arthritis
  • inflammatory bowel disease
  • congenital or acquired immunodeficiency or immunosuppression
  • HIV infection
  • systemic lupus erythematosus

According to Cleveland Clinic, if you are age 60 or over and have not had shingles, talk to your doctor about getting the shingles vaccine. Not only will it reduce your risk of developing shingles, but if you do develop shingles, you’ll be more likely to have a mild case.

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