What is herpes zoster?

 Herpes Zoster (Shingles), also known as shingles, is one of viral infection caused by varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the varicella zoster virus stays inactive in the body. The virus can reactivate later if your body and immune systems are weak, causing herpes zoster.

 

What are the symptoms and complications from herpes zoster?

Classic symptom is a group of painful blister skin rash. Beside the rash, herpes zoster can also cause fever, headache, chills, or upset stomach. The most common complication of herpes zoster is a condition called postherpetic neuralgia (PHN). People with PHN have severe pain in the areas where they had the rash, even after the rash clears up. The pain from PHN may be severe and debilitating, but it usually resolves in a few weeks or months. Some people can have pain from PHN for many years and it can interfere with daily life.

 

What about the transmission of herpes zoster?

Herpes zoster is a communicable disease as the blisters that form contain fluid with the varicella zoster virus. Herpes zoster can occur in young people, but some people are at greater risk than others such as people who have age of 50 and above, or people with weakened immune systems.

 

How to prevent herpes zoster?

The easiest way to prevent herpes zoster is always make yourself healthy. Moreover, vaccination for Herpes Zoster is available. You can consult with your healthcare professional about herpes zoster vaccination.

 

What is herpes zoster vaccine?

There is only one type of herpes zoster vaccine available in Thailand, which is a live, attenuated varicella-zoster vaccine.

From randomized controlled trial study showed that efficacy for prevention of herpes zoster is 69.8% and efficacy for prevention of PHN is 66.5% in age 50-59 years old. While in age 60 years and older, the efficacy is 51% for prevention of herpes zoster and 39% for prevention of PHN.

Dosage of vaccine is a single 0.65-mL dose subcutaneously. The fully effect of vaccine is 4 weeks after getting a shot and it may last long for 10 years. Now, there is no data available about booster dose of this vaccine.

 

Who should get the herpes zoster vaccine?

All adults 50 years of age and older, especially who are above 60 years old, should get the herpes zoster vaccine, even they are not having chickenpox before.

 You should come to consult with your healthcare professional because herpes zoster vaccine may have some limitations. For example,

• People who have history of anaphylactic/anaphylactoid reaction to gelatin, neomycin or any other components of the vaccine
• Pregnant women
• People who are immunodeficient or immunosuppressed due to disease or therapy such as primary or acquired immunodeficiency states, AIDS or other clinical manifestations of infection with human immunodeficiency viruses, leukemia, lymphoma or other malignant neoplasms affecting the bone marrow or lymphatic system, and immunosuppressive therapy

 

What is the possible side effects of herpes zoster vaccine?

The most frequent side effect is pain or swelling at injection site (>10%).
Other common side effects are headache, fever, shivering, stomach pain, and nausea (1-10%).
 

 

Reference

1. Centers for Disease Control and Prevention. Shingles (Herpes Zoster). Available from: https://www.cdc.gov/shingles/hcp/clinical-overview.html [Assessed 20 July 2022].
2. Zostavax^® [package insert]. USA: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc; 2019. Available from: https://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi2.pdf [Assesses 23 July 2022]
3. Centers for Disease Control and Prevention. Shingles (Herpes Zoster). Available from: https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/index.html [Assessed 20 July 2022].
4. The Immunization Action Coalition. Recombinant Zoster (Shingles) Vaccine: What You Need to Know. Available from: https://www.immunize.org/vis/zoster_recombinant.pdf [Assessed 22 July 2022]
5. Janniger c., et al Herpes Zoster: Practice Essentials, Background, Pathophysiology [Internet]. Emedicine.medscape.com. 202. Available from: https://emedicine.medscape.com/article/1132465-overview#showall [Assessed 21 July 2022]
6. Hales, Craig M., et al. "Update on recommendations for use of herpes zoster vaccine." MMWR. Morbidity and mortality weekly report 63.33 (2014): 729.