AgingSkinNet Article
Shingles: More Common with Age
CDC recommends shingles vaccine for adults 60+

Vaccinations are not just for children and world travelers. Adults need booster shots for some common vaccines such as the one for diphtheria and tetanus. A booster reminds the immune system how to fight the disease. A few vaccines are recommended specifically for older adults. One of these is the vaccine for shingles.

About Shingles
Your doctor may call shingles:

  • Herpes zoster

  • Zoster

Shingles is a disease that causes a rash and often painful blistering on the skin. After the skin clears, some people continue to experience severe pain that can last for months or even years.

Early diagnosis and treatment of shingles may reduce and actually prevent the risk of complications such as long-lasting severe pain.

According to the Centers for Disease Control and Prevention (CDC), about 1 million cases of shingles occur in the United States each year. More than half of the people who develop shingles are over 60, and nearly 50% of complications from shingles arise in older adults.

One serious complication that can occur is called post-herpetic neuralgia (PHN). About 1 in 5 people will develop PHN, which can cause excruciating pain for weeks, months, or even years after a bout with shingles.

Other serious complications from shingles are rare and include eye problems and possible blindness if shingles develops near an eye, hearing loss, pneumonia, and inflammation of the brain (encephalitis). All of these complications can be excruciatingly painful.

Shingles on the face can cause blindness or deafness

Shingles rash

If shingles develops, see a doctor immediately. On the face, shingles can involve the eyes and may lead to blindness. Hearing loss also can occur.

Shingles usually causes a rash followed by blisters. This 78-year-old man has a severe case on his chest.

Long after the rash and blisters clear, shingles can cause debilitating pain that can last for months or even years.

(Photos used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides)

What the Vaccine Does
To prevent shingles in Americans who are most susceptible, the CDC now recommends the shingles vaccine for people 60 years of age and older. Clinical trials have found that the vaccine:

  • Reduces the risk of developing shingles. In one study that enrolled 38,546 adults who were 60 years of age or older, the adults who received the vaccine reduced their risk of getting shingles by more than 50%.

  • Reduces the risk of complications if shingles develops. In the study mentioned above, some adults who received the vaccine developed shingles anyway at a later time. These adults had fewer cases of PHN than those who did not receive the vaccine. Cases of PHN were reduced by 66.5%.

Vaccine Recommended if No History of Chicken Pox
While only people who have had chicken pox can develop shingles, the CDC recommends that people 60 years of age and older receive the shingles vaccine — even if they do not recall having had chicken pox. The CDC cautions that many people had a mild case of chicken pox and simply do not remember. This puts them at risk for developing shingles.

Why Age Increases Risk of Shingles
As we age, our bodies become more susceptible to many diseases. Anyone who has had chicken pox has a 10% to 30% lifetime risk of developing shingles. By 85 years of age, this risk increases to 50%.

This increased risk may be due to a weakening of the immune system that happens as we age. Others factors that weaken our immune system include having certain diseases such as cancer or HIV/AIDS, many of the treatments for cancer such as chemotherapy, and medication taken to prevent rejection after an organ transplant.

Speak with Your Doctor
Vaccinations are important at all stages of our lives. If you cannot remember the last time you received a booster shot or are wondering if you should get the shingles vaccine, speak with your doctor. Some people should wait to get certain vaccines, and others should not receive specific vaccines. Discussing vaccinations with your doctor will let you know if and when you should receive certain vaccines, including the one for shingles.

More Information
To learn more about shingles including the signs and symptoms, treatments, and possible complications, see the American Academy of Dermatology’s pamphlet “Herpes Zoster.”

Advisory Committee on Immunization Practices (ACIP). “Recommended adult immunization schedule: United States, October 2007-September 2008.” Ann Intern Med 2007; 147: 725-9.

Centers for Disease Control and Prevention. “CDC Recommends Shingles Vaccine.” Press release issued May 15, 2008. Last accessed February 10, 2009.

Hicks LD, Cook-Norris RH, Mendoza N et al. Family history as a risk factor for herpes zoster: a case-control study. Arch Dermatol 2008; 144: 603-8.

Oxman MN, Levin MJ, Johnson GR et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005; 352: 2271-84.

All content solely developed by the American Academy of Dermatology

The shingles vaccine has been studied in clinical trials, and findings from these trials have led to the following:

• May 2006 - The U.S. Food and Drug Administration (FDA) approves the vaccine.

• May 2008 - The Centers for Disease Control and Prevention (CDC) recommends the vaccine for adults aged 60 and older.





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Page last updated 2/27/09

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