Shingles Vaccination Program

National Shingles Vaccination Program

 

Shingles, also known as Herpes Zoster is a painful blistery skin rash due to reactivation of the Varicella Zoster virus, the virus that causes chickenpox.

The rash of shingles is painful. The rash may take many weeks to settle. Once the rash settles, the patient may suffer with pain for many weeks.

The National Shingles Vaccination Program sponsored by the Australian Government commenced on 1 November 2016.

A single dose of Zoster Vaccine(Zostavax®) will be funded on the National Immunisation Program for all adults 70-79 years of age.

People who are not eligible to receive the free vaccine as part of the National Immunisation Program can purchase the vaccine in the private market.

What causes Shingles?

As we have said, shingles is caused by the same virus that causes chickenpox. So you can only get shingles if you have had chickenpox in the past. A person who has never had chickenpox can catch chickenpox from someone who has shingles.

After a person has chickenpox, the virus becomes dormant (that is, remains inactive) within certain nerves in the body. If the virus becomes active again, in these nerves many years later, shingles will occur. When reactivated, the virus multiplies and spreads along the nerves. As the virus spreads along the nerves it has been occupying, the area of skin supplied by the nerve becomes painful and the rash develops in this region.

It is not understood what triggers the chickenpox virus to become active again and cause shingles. It is thought that possibly a temporary decrease in the immune system may play a role. People who have cancer, or whose immune system is weak, or people who take medicines which depress the immune system are at risk of getting shingles.

Shingles commonly occurs in people over the age of fifty, but it can occur in younger people.

One in three people will develop shingles in their lifetime. The older a person becomes the higher the risk of developing shingles and neurological complications from the disease.

Symptoms of Shingles

The first symptom of shingles is usually an intense pain, burning or tingling sensation which occurs on one side of the body. This may be associated with feeling unwell or having a fever. After two to three days, a painful red rash appears on the skin, often distributed in a band across one side of the body and it doesn’t cross the midline.

The rash is initially red, it may then form small swellings of fluid-filled blisters. The fluid in these blisters then becomes cloudy and they break open and become dry and crusty. The blisters usually take about four to five days to come out, and the crusty rash may take five to six weeks to fade.

Treatment of Shingles

Shingles is best treated with anti-viral medications which must be started within seventy two hours of the rash appearing for them to be most effective. These agents will shorten the duration and decrease the severity of the infection.

People who are treated with antiviral agents usually reduce the risk of continuing pain after the rash has settled.

The patient will generally require over the counter pain relieving medication and topical lotions may be useful in drying the lesions out.

The patient should avoid scratching the lesions because they become infected and scar. Occasionally, infected lesions may require treatment with oral antibiotics.

Complications of Shingles

Younger people who experience shingles rarely develop complications. Shingles in older people can resolve without complications, but about fifty percent may develop severe pain in the distribution of the affected nerves known as post-herpetic neuralgia. This is a debilitating painful condition sometimes making it difficult for people to carry out their activities of daily living.

Post-herpetic neuralgia may not respond to simple analgesics and may require treatment with alternative medications including anticonvulsants or antidepressants, topical anaesthetics and other creams containing Capsaicin.

Shingles may infect the eye and can result in temporary or permanent loss of sight in the affected eye. If shingles involves the ear, it may affect hearing or balance.

Prevention of Shingles

As we have discussed the vaccine Zostavax® can help prevent shingles. The vaccine reduces the chance of getting shingles, but it is still possible to catch shingles even if vaccinated. However for those who are vaccinated and do get shingles, vaccination will reduce the pain associated with shingles and can help prevent post-herpetic neuralgia.

The Australian Government is funding a free single dose of Zoster Vaccine (Zostavax®) on the National Immunisation Program for all adults 70-79 years of age. Strictly speaking the program is for people aged 70 with a five year catch up program for people aged 71-79 years old until 31 October 2021.

People who are not eligible to receive the free vaccine as part of the National Immunisation Program who would like to be vaccinated can purchase the vaccine in the private market. The doctors at Rose Bay Family Medical Centre will provide a prescription for patients after discussing suitability for vaccination with the patient. The approximate cost of Zostavax® is $210 from most chemists.

Side Effects of Vaccination for Shingles

The shingles vaccine is safe most people including those with chronic disease. People who have a weakened immune system are not able to have the vaccine. Your general practitioner will be able to guide you.

Vaccination is still recommended for people who have already had shingles in the past. However vaccination should not occur within twelve months of an episode of shingles.

The most common side effects of shingles vaccination are mild and occur around the injection site and include redness or swelling or pain. Occasionally an itch or rash may occur. Headache has also been reported.

The Australian Immunisation Register

The Australian Government commenced the Australian Immunisation Register in September 2016 expanding on the Australian Childhood Immunisation Register and seeking to record all vaccines administered throughout a person’s life.

So your shingles vaccination either as a private vaccine or sponsored under the National Immunisation Program will be recorded by the Australian Immunisation Register.

Please talk to your doctor today about vaccination for shingles.

*The information given in this article is of a general nature and readers should seek advice from their own medical practitioner before embarking on any treatment.