September 22, 2021

Shingles vaccination poses threat to patients with high shingles risk

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ShinglesBy Emma Rogers From Vaccine News

New research published in the BMJ on Wednesday revealed that those with the highest risk of shingles are not entitled to vaccination, due to safety concerns.

Shingles causes an acute painful rash and can eventually lead to a more serious complication called postherpetic neuralgia.

In order to determine if certain patients had an increased risk of developing shingles, the London School of Hygiene & Tropical Medicine tested a group of 144,000 U.K. adults diagnosed with shingles between 2000 and 2001 against a control group without shingles.

The study revealed that patients with conditions causing sever immunosuppression, such as HIV and leukemia, had the highest risk of shingles.

“This study has highlighted that patients arguably most in need of protection against shingles cannot currently benefit from vaccination,” Harriet Forbes, the study’s lead researcher from the London School of Hygiene & Topical Medicine, said. “The vaccine is live and there are concerns that giving it to patients with severe immunosuppression may cause a shingles episode. Alternative risk reduction strategies among these patients, for example the use of alternative vaccines, would help those at greatest risk of this disease and its complications.”

Other conditions shown to give patients an increased risk of shingles included rheumatoid arthritis, inflammatory bowel disease and chronic obstructive pulmonary disease. Asthma, chronic kidney disease, type 1 diabetes and depression were also shown to give patients a slight increase in shingles risk.


The shingles vaccine is currently licensed among individuals over the age of 50. PHOTO: shingles

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What is shingles? What causes shingles?

From Medical News Today

Welcome to the MNT Knowledge Center, your source for our most detailed content on specific conditions and subjects. Click through to Knowledge Center Home to read more.

What is shingles? What causes shingles?

Last updated on Tuesday 8 April 2014

Originally published on Tuesday 23 June 2009

Infectious Diseases / Bacteria / VirusesNeurology / NeuroscienceDermatologySeniors / Agingadd your opinionemailKnowledge Center


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What is shingles? What causes shingles?

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Shingles is an infection of a nerve and the surrounding skin surface that is supplied by the nerve, caused by the varicella-zoster virus. This is the same virus that causes chickenpox and can potentially present in anyone who has recovered from chickenpox, child or adult.1

There are an estimated 1 million cases of shingles each year in the US2 and almost 1 in 3 people may develop shingles.3

This Medical News Today information page will give you the essential details about shingles – describe what it is, what causes it, who gets the problem and the symptoms they have, how it is diagnosed, and offer an overview of treatment options for people with shingles.

You will also see introductions at the end of some sections to any recent developments that have been covered by MNT’s news stories. Also look out for links to information about related conditions.

Fast facts on shingles

1 in 3 people may develop shingles.

There are an estimated 1 million cases of shingles each year in the US.2

“Burden of illness” is double among individuals older than 70 compared to those 60-69 years old.4

Shingles in caused by the varicella-zoster virus – the same virus that causes chickenpox.

Shingles is a painful skin rash.

Older age and a weakened immune system present a greater risk for developing shingles.

Symptoms that accompany shingles may include headache, fever, nausea and body aches.

Shingles is often diagnosed by a doctor based on the appearance of the distinctive rash.

Antiviral and pain medication can be used to treat shingles.

Shingles can exhibit complications in some individuals; the most common is postherpetic neuralgia.

For some individuals, a vaccine is available to prevent shingles.

What is shingles?

Shingles is caused by the varicella-zoster virus – the same virus that causes chickenpox. Varicella-zoster virus belongs to a group of viruses called herpesviruses.5 All herpesviruses are able to hide in the nervous system after initial infection and then travel down nerve cell fibers to cause a renewed infection.

Varicella-zoster (shingles) virus belongs to a group of viruses called herpesviruses.

After recovery from chickenpox, the virus remains in the body and lies dormant in the central nervous system; which is made up of the brain and spinal cord. Nerves connect the central nervous system to the rest of the body and shingles occurs when the virus travels down nerve fibers causing a new infection.6

The blisters are usually limited to one or more bands, called dermatomes, on one side of the trunk, around the waistline, or clustered on one side of the face.7 Scientists now know that the shingles lesions correspond to a specific sensory nerve that exits from the brain or spinal cord.

The inactive virus may not cause problems for years, if ever. Shingles cannot develop as a secondary eruption if an earlier exposure to chickenpox has not occurred. Shingles is most common in people over the age of 50, about half of all cases occur in men and woman age 60 years and older. The risk of disease increases as a person gets older but the virus may reappear in people of all ages who have previously had chickenpox.4

Typically individuals will develop one episode of shingles in their lifetime. In some rare cases an individual may have a second or third episode.

The pain from shingles can be mild to severe including burning, shooting pain or itching generally on one side of the body, does not cross over the midline of the body and visualizes as a rash or blisters. This indicates the dormant virus has reactivated and traveled from the nerves along a path to the skin, causing inflammation along the way. This pain can sometimes last for months post healing.

Most adults with the dormant virus will never experience an outbreak of shingles unless an unknown trigger activates the virus.

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