Health and Me

Rachel V Thomas

Shingles Can Strike More Than Once, Vaccination Offers Protection, say experts

<a href="https://www.healthandme.com/health/shingles">Shingles</a>, caused by the reactivation of the varicella-zoster virus (the same virus that causes <a href="https://www.healthandme.com/health/chickenpox">chickenpox</a>), can strike more than once, especially in older adults and people with weakened immune systems. Vaccination against the virus is the most effective way to prevent shingles and related complications, said health experts as part of the <a href="https://www.healthandme.com/health/shingles">Shingles</a> Awareness Week.

The World Health Organization estimates that over 90 percent of individuals worldwide are infected with the varicella-zoster virus, indicating a high susceptibility to shingles. 

Health experts explained that the varicella-zoster virus remains dormant in the nerves of the body after an attack of chickenpox. 

Dr. Monica Mahajan, Senior Director – Internal Medicine, Max Multi Speciality Centre, Panchsheel Park, told HealthandMe that the virus can remain in an inactive state for two to five decades, or even longer. 

When the immunity decreases, the virus can re-activate to cause shingles. The most common symptoms include a rash with sharp, shooting, or stabbing nerve pain.

While it is rare, shingles can recur as one episode of the disease doesn’t grant lifelong immunity. 

“It is possible to get shingles infection more than once. An episode of shingles may not give lifelong immunity to the disease. Although it is a rare occurrence, people who have had shingles once can get it again. But those who get vaccinated after the first attack of shingles can prevent the second attack,” Dr. Mahajan said. 

The common manifestation of shingles is a painful blister-like rash, which usually occurs only on one side of the body or face. 

It is followed by post-herpetic neuralgia -- a nerve pain that arises in the areas where the rash was located, which often lasts for months or years after the rash has cleared up.

“It is severe and excruciating and is sometimes described as a pain that is worse than chronic cancer pain,” Dr. Chandani Jain Gupta, Dermatologist &amp; Aesthetic Physician, Elantis Healthcare, New Delhi, told HealthandMe. 

Dr. Gupta noted that shingles can also affect the eye, impacting the patient's ability to see. 

Other less frequent complications of shingles are secondary bacterial infections of the rash, pneumonia, blindness, hearing loss, and neurological complications involving the brain. Fatigue, fever, and sensitivity to touch are other potential complications due to shingles. 

As longevity increases, the phenomenon of ‘immunosenescence’ becomes more common. This means that as we age, our immunity declines, and this process generally starts at the age of 50 years. 

"As life expectancy is increasing, more and more people live well beyond the age of 50 years. These people have lowered immunity and are at a higher risk of developing shingles," Dr. Mahajan said. 

People who suffer from conditions such as diabetes, HIV, cancer, and patients with kidney or liver transplants are also at a higher risk of shingles because of lower immunity. 

Patients who are on certain drugs called the ‘immunomodulators’ (used for conditions like arthritis, lupus, and some skin diseases) that reduce immunity are also more vulnerable to shingles. 

<h2>How Do Vaccinations prevent Shingles? When to Get It</h2>

While some anti-viral medicines can reduce the intensity of the rash and the pain, these are effective only when given within three days of the first symptom. Despite medications, the outcome is not satisfactory in most patients. 

But shingles can be prevented with vaccination. 

<ul><li>Adults 50 and older: The CDC recommends that all healthy adults aged 50 years and older receive two doses of the shingles vaccine. The second dose is typically given 2 to 6 months after the first.</li></ul><ul><li>Adults 19 and older with weakened immune systems: If you are 19 or older and have a compromised immune system due to disease (like cancer or HIV) or treatments (like chemotherapy or immunosuppressive drugs). The second dose can be given 1 to 2 months after the first.</li></ul>In addition to vaccination, one could reduce their risk of acquiring shingles by maintaining a well-balanced diet, managing one's stress level, getting enough sleep, and managing pre-existing health conditions.

Health Conditions A-Z

health

shingles

Chickenpox

rash

shingles awareness week

nerve pain

varicella zoster virus

neuralgia

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Shingles, caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox), can strike more than once, especially in older adults and people with weakened immune systems. Vaccination against the virus is the most effective way to prevent shingles and related complications, said health experts as part of the Shingles Awareness Week.  The World Health Organization estimates that over 90 percent of individuals worldwide are infected with the varicella-zoster virus, indicating a high susceptibility to shingles.  Health experts explained that the varicella-zoster virus remains dormant in the nerves of the body after an attack of chickenpox.  Dr. Monica Mahajan, Senior Director – Internal Medicine, Max Multi Speciality Centre, Panchsheel Park, told HealthandMe that the virus can remain in an inactive state for two to five decades, or even longer.  When the immunity decreases, the virus can re-activate to cause shingles. The most common symptoms include a rash with sharp, shooting, or stabbing nerve pain.  While it is rare, shingles can recur as one episode of the disease doesn’t grant lifelong immunity.  “It is possible to get shingles infection more than once. An episode of shingles may not give lifelong immunity to the disease. Although it is a rare occurrence, people who have had shingles once can get it again. But those who get vaccinated after the first attack of shingles can prevent the second attack,” Dr. Mahajan said.  How Do Shingles Disrupt Life?  The common manifestation of shingles is a painful blister-like rash, which usually occurs only on one side of the body or face.  It is followed by post-herpetic neuralgia -- a nerve pain that arises in the areas where the rash was located, which often lasts for months or years after the rash has cleared up.  “It is severe and excruciating and is sometimes described as a pain that is worse than chronic cancer pain,” Dr. Chandani Jain Gupta, Dermatologist & Aesthetic Physician, Elantis Healthcare, New Delhi, told HealthandMe.  Dr. Gupta noted that shingles can also affect the eye, impacting the patient's ability to see.  Other less frequent complications of shingles are secondary bacterial infections of the rash, pneumonia, blindness, hearing loss, and neurological complications involving the brain. Fatigue, fever, and sensitivity to touch are other potential complications due to shingles.  Who Is At Risk Of Shingles?  As longevity increases, the phenomenon of ‘immunosenescence’ becomes more common. This means that as we age, our immunity declines, and this process generally starts at the age of 50 years.  "As life expectancy is increasing, more and more people live well beyond the age of 50 years. These people have lowered immunity and are at a higher risk of developing shingles," Dr. Mahajan said.  People who suffer from conditions such as diabetes, HIV, cancer, and patients with kidney or liver transplants are also at a higher risk of shingles because of lower immunity.  Patients who are on certain drugs called the ‘immunomodulators’ (used for conditions like arthritis, lupus, and some skin diseases) that reduce immunity are also more vulnerable to shingles.  How Do Vaccinations prevent Shingles? When to Get It While some anti-viral medicines can reduce the intensity of the rash and the pain, these are effective only when given within three days of the first symptom. Despite medications, the outcome is not satisfactory in most patients.  But shingles can be prevented with vaccination. Adults 50 and older: The CDC recommends that all healthy adults aged 50 years and older receive two doses of the shingles vaccine. The second dose is typically given 2 to 6 months after the first.Adults 19 and older with weakened immune systems: If you are 19 or older and have a compromised immune system due to disease (like cancer or HIV) or treatments (like chemotherapy or immunosuppressive drugs). The second dose can be given 1 to 2 months after the first.In addition to vaccination, one could reduce their risk of acquiring shingles by maintaining a well-balanced diet, managing one's stress level, getting enough sleep, and managing pre-existing health conditions.