shingles shot

The point of that column was that the newer study reaffirmed information from the drug company Merck, whose data showed that the vaccine seemed to protect people about 50 percent of the time from a shingles attack. The newer study showed better protection into higher ages

This is not a movie sequel like “The Son of Shingles Vaccine” or “Herpes Zoster II.” The inspiration for it was a phone call from a mighty fine internist who had read the column (and fine not just because he read the column).

He has been a passionate advocate for the vaccine since its release and shared with me some personal patient numbers he had collected (as well as anyone can in a busy practice, doing it all oneself).

Admitting that all patients may not have been included, he said only two had experienced shingles in the group who received the vaccine. The numbers for a group that had not had the shot were a bit sketchier, but several more of those he contacted had been zapped by zoster. That would lend weight (non-calorically for a change) to the argument for getting the “shingles shot.”  To date, no real problematic adverse reactions have come from it, after millions of administrations.

He also made me aware of an article I’d not read yet. It was from a clinical research group headed by Dr. Barbara Yawn at Olmsted Clinic. (Not to say her papers induce drowsiness). They have done other population studies of the Olmsted County populace because it seems to be rather indigenous and not too migratory. The article reported shingles recurrences in a base of 1,669 people. These folks had had documented shingles during a prior study that had tried to calculated the frequency of shingles in that group.
This study lasted as long as 12 years for some individuals. In doing chart reviews, the defined diagnostic criteria were the same and were pretty strict for both studies. In the 1,669 people from the first study, 95 had 105 recurrences. Six people had two recurrences, and two had three recurrences (bummer!).

The encore presentation was anywhere from 96 days up to 10 years after the original shingles. In 45 percent they popped out in a different body region than the first. In roughly 25 percent, the shingles virus was documented by lab test as the true culprit, which is an important point.

The recurrence rate here of 6.2 percent is higher than rates reported in other studies with much smaller patient numbers. It seemed that a worse history of pain with the initial episode was a slight predisposition to a recurrence, although not absolutely.

What the authors tried to point out was that second zoster eruptions are more common than has been thought and taught for eons. This, in turn, runs contrary to the conventional intuitive wisdom that having shingles boosts your immunity toward the virus to protect you against recurrences. It also leads to the idea that perhaps a shingles shot should be offered to people who have already had shingles to try to prevent another potential bout of it. How ’bout that?

Like everything in this business of biology, it seems maybe it requires “further research” — and it does. The idea sounds great, but the proof is in the pudding, here the shooting and the following for many years to track the real results.

The other snag in such studies is that what looks and acts like the shingles virus can uncommonly be the cold-sore virus, which is a kissin’ cousin. You can get blistery rashes from that in other places than around mouth, which is the stereotypical area. The culture of the blister fluid clinches the right culprit.
To shoot, or not to shoot — that is the question. The answer isn’t totally clear yet. But these two pieces of information would lend credence to the advisability of doing it.

Even then, there are no guarantees here for preventing shingles. It is a lot easier to nail shingles down on a roof than it is on a body, eh?