Q: If I never had chickenpox, do I need a shingles vaccine? I'll be 60 in January.
A: The shot you're talking about is an immunization against a virus called the varicella-zoster virus. This virus causes two common illnesses, and a few rare ones. The two common illnesses are chickenpox and shingles (also called "zoster").
The varicella-zoster virus usually enters our bodies in childhood when it often causes chickenpox. After the chickenpox ends, the virus stays in our bodies for the rest of our lives. Our immune system cannot kill it, so it just tries to keep the virus quiet. The virus lives inside nerves that lead to our skin. In most of us, it remains "asleep" and causes no problems. But sometimes, it "wakes up" and begins making copies of itself. That's when trouble can start.
When the virus wakes up, it can cause pain, itching, or a strange unpleasant sensation in a patch of skin. A few days later, that patch of skin starts to develop a rash. The skin turns red and tiny little blisters form. This condition is called shingles or zoster. The rash usually lasts no more than a few days, but sometimes the pain and discomfort can last longer.
Because you are 60, you probably have been infected with the virus. If you're not sure, a blood test can tell if you've been infected with the virus in the past.
There are two types of vaccines against varicella-zoster virus. The first is for people who've never been infected. This protects them against ever getting infected. Because you probably have been infected, this type of vaccine does not apply to you.
The second type of vaccine is for people who have been infected. The goal of this vaccine is to prevent shingles and a condition that can follow shingles called post-herpetic neuralgia. The U.S. Centers for Disease Control and Prevention recommend that most adults over age 60 get this shot. People who should not get the shot include those who've had a severe allergic reaction (anaphylaxis) to gelatin or the antibiotic neomycin and people who have an underlying medical condition or receive medical treatment that impairs their immune system.
You should probably talk to your doctor about getting the shingles vaccine. It's not perfect, but it definitely reduces your risk of getting shingles and post-herpetic neuralgia.
(Anthony L. Komaroff, M.D., is professor of medicine and editor-in-chief of Harvard Health Publications at Harvard Medical School.)
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