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2.4: Zoster

  • Page ID
    38730
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    One of three adults over the age of 60 will get shingles. Shingles is caused by the same virus that causes chickenpox, but having had chickenpox does not provide immunity to shingles. Since 2006 the shingles vaccine known as Zostavax has been available. It reduces the risk of shingles by 51%.  There is collateral benefit from the vaccine as it reduces the risk of developing post-herpetic neuralgia by 67%.5 Post-herpetic neuralgia can be debilitating and there is no current treatment for this pain. 

    What to know in clinic:

    Recommended over age 60 by the ACIP

    Approved over age 50 by the FDA

    Very expensive so often insurance won’t pay until age 60

    Contraindicated in pregnancy, immunocompromised state, HIV (Remember, zoster is a live vaccine)

    If patients have had Zoster, they can and should still get the vaccine

     

    Adverse reactions: Occasional mild varicella like rash at the vaccine site 

    Contraindications: Known severe immunodeficiency, pregnancy

    Precautions: Recent receipt of antibody-containing blood product, history of thrombocytopenia or thrombocytopenia purpura, need for tuberculin skin testing


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