During a stressful and emotional month in 2017, Carol Opie of Portland, Ore., woke up to find her left side numb, from butt to torso.
“That’s when I thought, ‘Ugh, I think I have shingles,’ ” Opie recalls. Soon, the blisters appeared. “It’s very painful, and it wiped me out. It’s difficult to sleep,” says the 48 year-old ceramicist. “The nerve pain moved around. Anywhere I had the nerve pain, I felt like the muscles under that area had been punched really hard. I was surprised by the amount of muscle pain.”
More than 1.2 Americans get shingles annually, according to the Centers for Disease Control. It’s caused by the varicella-zoster virus — the same virus that causes chicken pox — and can infect anyone who’s previously had chicken pox. The virus lurks dormant, in nervous tissue near the brain and spinal cord, and can be reactivated at any time as shingles.
It’s not entirely clear what reactivates varicella-zoster, but health experts say you’re more at risk if you have cancer, HIV or an otherwise compromised immune system, take long-term steroids, are over 50, under stress or have had a physical trauma. Typically, the older the victim, the more severe the symptoms.
However, medical professionals have high hopes for a new vaccine called Shingrix. “I do think this is a breakthrough vaccine,” says Dr. Amesh Adalja, an infectious disease physician and the senior scholar at the Johns Hopkins Center for Health Security. “I hope to see the general public embrace it. I think that it can really have a huge impact on the incidence of shingles.”
The CDC now recommends that people over 50 with normal immune systems be vaccinated with Shingrix. But beware: The FDA only approved Shingrix late last year. Some healthcare organizations might still be using the older, less-effective Zostavax, which went into use in 2006. Adalja advises that patients ask for the newly approved version of the CDC-recommended vaccine.
Shingrix offers a higher level of protection against shingles than Zostovax and is longer-lasting. However, it’s also likelier to cause side effects, such as injection site pain, muscle aches, fatigue and headaches. And since it’s a two-dose vaccine, people might have to weather the side effects twice. If you have a compromised immune system, talk with your doctor about which vaccine is right for you.
Despite the possibility of side effects, many people who’ve endured shingles say trying the new vaccine is worth it. Joanne Bourgeois, a retired schoolteacher in Louisiana, got a severe case of shingles even though she’d been vaccinated with Zostavax — at an out of pocket cost of $150. “Horrible! Miserable! Extremely painful!” she recalls of the disease. “I had lesions that were on the brink of being treated as wounds.” That was in 2012, and she says she still has occasional itching along the nerve paths.
The CDC recommends getting Shingrix even if you’ve received the Zostavax vaccine in the past, and even if you’ve already had shingles. While people only get chicken pox once, unfortunately, you can get shingles multiple times, which 51-year-old Mary Chong found out last year.
A graphic artist in Toronto, Canada, Chong attributes her first case of shingles at age 24 to stress. “I was planning our wedding and we were renovating our house and living in it at the same time,” she says. Her second bout came on at age 50. Both cases involved lots of lesions, burning and nerve pain, but the second time the pain lasted longer. “The burning felt like after you burn yourself on a pan in the oven,” she says.
Those who do develop shingles and get lesions on their scalp or face are advised to visit their eye doctor because of the risk of infection, inflammation, secondary glaucoma and other issues. “Having taken care of perhaps 10,000 different patients with shingles over my 30-year career, I have unfortunately witnessed the havoc that can be wreaked upon the human eye by shingles,” says Dr. Alan Mendelsohn, an ophthalmologist in Miami, Fla. The sooner oral antivirals are started the better, Mendelsohn says, to prevent scar tissue and damage to critical structures of the eye.
The good news is that you can’t get shingles if you haven’t had chicken pox, and thanks to vaccination, the number of cases of chicken pox has dropped drastically in the past 20-some years. Before 1995, when the chicken pox vaccine was licensed, there were about 4 million cases of chicken pox in the United States per year. Since then, the number of cases has fallen more than 90 percent, according to the Immunization Action Coalition.
But for those who came of age before 1995, the shingles vaccine could save many people from excruciating pain and permanent eye damage, Adalja says. “This is all solely going to be dependent upon vaccine uptake,” he adds. “So if the vaccine is well-embraced and uptake is very high, I do think shingles will be something that is not as common.”
