About a third of people in the United States will develop shingles, yet only 31.6% of adults are estimated to have received their recommended vaccinations. With adult immunization rates declining in the wake of COVID-19, the risks of contracting or spreading vaccine-preventable diseases is more prominent. Providers play an important role in educating patients on the risks, symptoms, and best prevention methods for shingles.
What Are the Risks of Shingles?
Shingles is a viral infection that causes a painful rash, and originates from the varicella-zoster virus—the same virus responsible for chickenpox. If you’ve previously had chickenpox, the virus lives in your body for the rest of your life and can potentially be reactivated as shingles. There is a higher risk of reactivation for patients with weakened or vulnerable immune systems, with nearly 30% of shingles-related hospitalizations involving immunosuppressed patients.
While the virus remains dormant for the majority of people, research shows that it can be activated in nearly a third of Americans at some point of their life. Shingles is rarely fatal but can have serious symptoms including blisters on the skin, shooting pain, and tingling or itching of the skin. More severe shingles cases can lead to postherpetic neuralgia (PHN), a debilitating pain where the rash occurred.
Shingles Prevention and Vaccine Recommendations
Preventing a varicella-zoster infection through vaccination is the first line of defense in protecting against shingles. The varicella vaccine is recommended to children starting at 12 months old in a two-dose series, and reduces the risk of developing shingles later in life by up to 78%.
The original shingles vaccine, Zostavax, was licensed for use by the FDA in 2006 and widely administered until 2017, when the more effective Shingrix vaccine was introduced to the market. Shingrix provides patients with up to 97% immunity against shingles and is now the sole vaccine approved for the disease in the U.S.
Our knowledge about shingles has evolved with the development of new vaccines. While shingles is typically activated in older adults, the virus has become more prevalent among younger and middle-aged adults over the past several decades. The CDC recommends two doses of Shingrix to all healthy adults 50 and older—even those whose received the Zostavax vaccine or have already contracted shingles.
mRNA-based Shingles Vaccine
Messenger RNA (mRNA) technology played a prominent role in combatting COVID-19 and has the potential to treat or prevent numerous harmful diseases and conditions, including shingles. Unlike traditional vaccines that use a weakened or dead form of the virus, mRNA vaccines use messenger proteins to elicit an immune response that produces antibodies that defend the body when faced with the real virus. Earlier this year, Pfizer and BioNTech began development of a mRNA shingles vaccine, with trials set to start before the end of 2022.
While adult vaccinations may have declined during the pandemic, the benefits of receiving recommended vaccines has not changed, and it is important to engage in dialogue with your patients about their immunization schedule. Routine check-ups or flu shots can be a great opportunity to review your patient’s vaccine history and help prevent the spread of shingles.