In the U.S., one in three people in their lifetime will be infected with shingles, a virus that can cause severe burning pain and a blistering rash. While the rash from shingles may disappear after a few weeks, for some individuals the debilitating pain can persist for months or years. This condition is called postherpetic neuralgia. Despite the widespread prevalence of shingles, and the potentially devastating long-term complications, vaccination rates to protect individuals from the virus remain lower than expected.
Since 2006, a shingles vaccine, Zostavax, has been approved for individuals 60 years or older, which is the age group most likely to be infected by shingles. Given in a single dose, the vaccine provides protection for approximately five years, and though it does not fully prevent the disease, the vaccine has been found to reduce the occurrence of shingles by 50% and decrease the likelihood of postherpetic neuralgia by 66%. The vaccine was most effective in individuals between the ages 60 and 69.
While the risk of shingles for some patients is not a strong enough motivator to receive the vaccine, the threat of postherpetic neuralgia should be. Postherpetic neuralgia impacts the nerve fibers and skin, and results in intermittent or constant pain that can interfere with an individual’s daily activities, including even minimal exercise and sleeping. For some, even the touch of clothing on the affected skin is too painful. Postherpetic neuralgia occurs in 10 – 20% of individuals with shingles, and the likelihood increases with age as well as the severity of the initial shingles case and other chronic illnesses impacting immunity.
Currently, there is no treatment that reliably relives the pain associated with postherpetic neuralgia. In many cases it takes a unique combination of medications, customized per patient, and usually only solved through a trial of different medications, topical creams, and herbal remedies. Although an effective treatment for those suffering from the complication is eventually found in most cases, many doctors believe, “prevention is the best treatment.”
For adults nearing 60 years old, a discussion about shingles and the risk of postherpetic neuralgia is essential. The vaccine offers prevention against the virus and against a debilitating condition.