CDC touts new shingles vaccine as more than 90 percent effective

December 11, 2017 GMT

OMAHA, Neb. - Maybe you’ve heard of shingles, that ghost of chicken pox past that’s undoubtedly hiding in your nervous system, waiting for a chance to make a comeback with a blistering rash and persistent nerve pain.

Shingles and chicken pox are both caused by the same virus, varicella zoster.

Maybe you’ve heard of, or even gotten, the shingles vaccine, which is intended to head off that comeback. That shot, Zostavax, was recommended for people age 60 and over. It reduces the risk of developing shingles by 51 percent, according to the federal Centers for Disease Control and Prevention.

Now, however, there’s a new vaccine, approved in October by an advisory committee to the CDC. That one, called Shingrix, is recommended for people age 50 and older. And this new one is more than 90 percent effective.

The best news, said Dr. Rudolf Kotula, an infectious disease physician with Methodist Physicians Clinic in Omaha, is that the new vaccine remains more than 90 percent effective even as people age. The older vaccine’s effectiveness drops off significantly over the decades.

“If you are 80, it’s still more than 90 percent effective to prevent shingles, which is amazing,” he said.

That’s important, because the risk of developing shingles also increases with age. While it can occur at any age, the risk begins to rise at age 50 and increases at age 60. About half of all cases occur in people age 60 or older. And one in three people will get it, to the tune of a million cases a year in the United States.

And though recommendations haven’t been written yet, Kotula said he expects Shingrix to be available even to those with compromised immune systems, a group that includes a significant number of older people. That’s because Shingrix is formulated from a killed version of the virus, while the older version of the vaccine is based on a weakened live virus.

People with immune systems compromised by anything from cancer treatments to HIV are more vulnerable to shingles.

Some people with shingles might have no symptoms other than itching, Kotula said. The virus usually appears as a rash or blisters on one side of the body.

But the blisters can become painful, and they can spread. And it can lead to complications, the most common of which is nerve pain, or post-herpetic neuralgia, which can be severe and debilitating. While it usually resolves in a few weeks or months, the CDC said, the pain can persist for years.

Shingles also can lead to serious complications involving the eyes. Very rarely, it can lead to pneumonia, hearing problems and brain inflammation.

Despite all that, only 30 percent of those age 60 and older have been immunized, Kotula said.

“I look at it as a very inexpensive way to prevent illness,” he said.

As yet, the new vaccine isn’t available to the public. Kotula estimated it will be sometime early next year. It will be a two-shot course with the doses two to six months apart. The reason for the second dose, Kotula, said is to generate a strong, long-lasting immune response.

In fact, the earlier vaccine, Zostavax, was approved by the U.S. Food and Drug Administration for people age 50 and older. But the CDC did not recommend routine use in people 50 to 59, noting that people who got it before age 60 might not be protected later in life, when the risk of developing shingles is greater.

According to the CDC, the new Shingrix vaccine, developed by drugmaker GlaxoSmithKline, is recommended for adults who previously have gotten the earlier vaccine.

Kotula said the cost of the new vaccine has been estimated at about $300 for the two-shot course. It likely will be covered by insurance, he said, but that may take some time.

“I’m very thrilled that this vaccine is available,” Kotula said. “It took almost 20 years to develop it.”