CDC Recommends Shingles Vaccine for Those Over 60

THURSDAY May 15, 2008 -- All adults aged 60 and older should be vaccinated against shingles, a condition that can cause debilitating chronic pain, the U.S. Centers for Disease Control and Prevention recommended on Thursday.

This new recommendation replaces the agency's provisional recommendation, made in 2006, after the ZOSTAVAX vaccine was approved by the U.S. Food and Drug Administration.

"The publication of these guidelines will give an impetus to the use of shingles vaccine," said Dr. William Schaffner, chairman of the Department of Preventive Medicine and a professor in the Division of Infectious Diseases at Vanderbilt University School of Medicine and vice president of the National Foundation for Infectious Diseases.

In addition, it may get health insurance companies to start covering the cost of the vaccine, Schaffner said. "Also, it will give physicians some stimulus to use this vaccine more extensively than they have to date," he said.

The new recommendation was published in the May 15 online edition of the Mortality and Morbidity Weekly Report.

Schaffner thinks getting vaccinated is very important. "There are about 1 million cases of shingles that occur each year in the United States," he said. "Half of these occur in people aged 60 and older."

Moreover, 50 percent of those who live to 85 will have shingles, Schaffner said. "Shingles is very common and ranges from mild to very severe and disabling," he said.

However, people who have an immunodeficiency disease should not be vaccinated, Schaffner added.

In evaluating the vaccine, known as ZOSTAVAX and manufactured by Merck & Co., researchers found that for those aged 60 and older, the vaccine reduced the occurrence of shingles by about 50 percent. For those aged 60 to 69 years old, the vaccine reduced the occurrence of shingles by 64 percent.

"The vaccine is about two-thirds effective," Schaffner said. "It will prevent about two-thirds of the cases of shingles and its consequent pain syndrome. Like most vaccines, it's not perfect, but it offers the promise of reducing the risk and occurrence of shingles by two-thirds, and that's not bad."

One drawback to the vaccine is its cost, which is about $150, Schaffner noted. In addition, the vaccine may not be covered by private insurance. For Medicare patients, it is currently covered under the Part D drug benefit, so its cost will vary by provider.

Schaffner hopes that the new CDC recommendation will make the vaccine more available.

Shingles is caused by the chickenpox virus, known as varicella zoster, which remains dormant in the body after being infected. Shingles causes blisters, which develop on one side of the body, including the face, and can cause severe pain that can last for weeks, months or years.

One potential consequence of shingles, if it appears on the face, is loss of some vision or blindness, should the virus infect the eye, Schaffner noted. Shingles can also result in hearing loss.

While mild cases of shingles usually disappear within a few weeks, severe cases can cause pain that lasts for years. This long-term nerve pain, called post herpetic neuralgia, is described as burning, stabbing, throbbing or shooting pain.

More information

For more information on shingles vaccine, visit the U.S. Centers for Disease Control and Prevention.

Posted: May 2008


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