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 are 2 types of herpes zoster vaccine in Thailand which are:

1. Zoster vaccine live (ZVL) This vaccine is used in adults 50 years and older. Dosage of vaccine is a single 0.65-mL dose subcutaneously. 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.
2. Recombinant zoster vaccine (RZV) This vaccine is given as a 2-dose series (0.5 mL each) intramuscularly. It can be used in:

• Adults 50 years and older: The second dose administered 2 to 6 months after the first dose. For this group, the vaccine is more than 90% effective at preventing shingles and PHN.
• Adults 18 years and older who have or will have weakened immune systems because of disease or therapy: The second dose administered 1 to 2 months after the first dose. For this group, the vaccine is 68-91% effective in preventing shingles, depending on the condition that affects the immune system.

The fully effect of herpes zoster vaccine is 4 weeks after getting a shot of zoster vaccine live, or after getting both shots of recombinant zoster vaccine, and it may last long for 10 years. Now, there is no data available about booster dose of both vaccines.


 

Who should get the herpes zoster vaccine?

Adults 50 years of age and older should get the herpes zoster vaccine, even they are not having chickenpox before. Adults 18 years and older who have weakened immune systems because of disease or therapy should also get 2 doses of recombinant zoster vaccine, as they have a higher risk of getting herpes zoster and related complications.

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

• People who have severely weakened immune systems (not suitable for live-attenuated zoster vaccine)
• People who have history of severe allergic reaction to any component of the vaccine
• People who are currently have herpes zoster
• Pregnant women

 

What is the possible side effects of herpes zoster vaccine?

The most common side effect is pain, redness, or swelling at injection site. Other common side effects are tiredness, muscle pain, headache, shivering, fever, stomach pain, and nausea.

 

 

How long should patients who previously had herpes zoster wait before receiving the herpes zoster vaccine?

People who previously had herpes zoster should wait at least 6 months after an episode of herpes zoster before receiving the vaccine.

 

If you already received live-attenuated zoster vaccine, how long should you wait before receiving recombinant zoster vaccine?

The minimum interval between zoster vaccine live and recombinant zoster vaccine is 2 months. If you would like to get the recombinant zoster vaccine, you still need to receive 2 doses of the vaccine.

 

See Shingles Vaccine Package, Click