Each year, it’s estimated that millions of Americans are affected by shingles, and one in three Americans will have shingles in their lifetime according to the Centers for Disease Control and Prevention (CDC). In 2006 the first shingles vaccine, Zostavax, was approved for use and was more recently replaced by Shingrix as the CDC-recommended vaccine for adults 50 years of age and older.
Despite the prevalence of shingles and development of Shingrix, the CDC reports that only 33.4% of adults 60 years and older have received the shingles vaccine. A CDC study also found that coverage among adults aged 50 to 59 is only around 6%. These low rates of vaccination uptake and age disparities may be attributed to low rates of adult vaccination overall, a misunderstanding of who should receive the vaccine, or lack of awareness of available preventions. The current health risks associated with COVID-19 further emphasize the need for patients to utilize all preventative measures available, including vaccines, to maintain their overall wellbeing.
By educating patients on the effects of shingles and who needs the vaccine, providers can improve shingles vaccine uptake and ensure that their patients are protected against this painful disease.
According to the Mayo Clinic, shingles is a viral infection that causes a painful rash, fever, headache and fatigue, among other symptoms. This disease is caused by the varicella-zoster virus—the same virus that causes chickenpox. Contrary to popular myth, people of any age who have had chickenpox are at risk of getting shingles at some point in their lifetime, and the risk increases as people age.
There is no cure for shingles, but an antiviral medication may be prescribed to treat shingles and shorten the length and severity of the illness. A vaccine is the only way to confidently prevent shingles. The CDC recommends all adults 50 years and older get two doses of Shingrix, a recombinant zoster vaccine, which is than more than 90% effective at preventing shingles.
Although the shingles vaccine is a powerful prevention tool against shingles, some older patients may feel that they aren’t at risk of having shingles, or won’t benefit from the shingles vaccine. By better understanding patients’ motivations, providers can answer questions and provide clarity around the vaccine.
The risk of shingles increases with age. While children and young adults can get shingles, it’s most common amongst adults 50 years and older, and the Immunization Action Coalition reports that about half of all cases occur among people age 60 years or older.
While most patients will only experience shingles once, it is possible to have occurrences of the disease in the future. The CDC recommends that patients receive the Shingrix vaccine even if they have had shingles in the past.
The National Foundation for Infectious Diseases estimates that 98% of Americans have had chickenpox, even if they don’t remember it, and are at risk of shingles. It is likely that any patient over 50 years old has had chickenpox and is at risk for shingles.
The CDC recommends that healthy adults 50 years and older receive the Shingrix vaccine even if they received the Zostavax vaccine previously, because Shingrix provides stronger protection against shingles. If a patient recently received the Zostavax vaccine, they should wait at least eight weeks before receiving the first dose of the Shingrix vaccine.
It’s unknown if certain factors, such as stress, can trigger the varicella-zoster virus to reactivate, causing shingles. According to the National Institute of Neurological Disorders and Stroke, the immune system helps to keep the virus dormant but, when weakened, can allow the virus to resurface. As patients age, their immune systems can weaken, putting them at a higher risk of shingles and other illnesses.
Many opportunities exist for providers to engage patients in a dialogue about the shingles vaccine, including during a scheduled well visit or when patients receive their influenza vaccination in the fall. By making it a regular practice to discuss and recommend the shingles vaccine, providers can ensure their patients are protected against this painful virus.