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July 22, 2024
What you need to know about shingles
By Anna Sharratt
About one in three Canadians will get shingles. But timely treatment can lessen symptoms, and a vaccine can help prevent it.
December 2014 was anything but festive at our house. In the last week of school before the holidays, my son brought home chicken pox. Worse, he gave it to my husband, who had somehow spent a chicken pox-free childhood in the 70s.
Chaos ensued. For weeks, my husband sported dozens of itchy blisters, a fever, shortness of breath and fatigue. He was in agony. After the worst was over, he went for the doctor for a follow-up visit. More bad news: Having had chicken pox, he was more likely to develop shingles. That’s a painful rash caused by the same virus, herpes zoster, as chicken pox. Once you’ve recovered from chicken pox, the virus can lurk quietly in your body for years. That’s until age or a health problem weakens your immune system, letting the virus flare up as shingles. Let’s just say my husband is now weighing getting the shingles vaccine.
Odds are good that he – and many of the rest of us – will get shingles. “About one in three Canadians will get shingles,” says Toronto family doctor Dr. Vivien Brown. “By the time they reach about 80, 50% of average Canadians will have had an episode,” she says.
Most at risk:
- women
- people with a family history of shingles
- diabetics
- patients taking statin drugs
- people with chronic obstructive pulmonary disorder.
Though young people can get shingles, “the greatest risk factor is age,” says Brown. “The older you are, the more likely you are to have shingles and to have a more severe case.”
What are the symptoms of shingles?
Shingles is no picnic. It can cause severe pain that sufferers often mistake for a muscular condition. It can cause tingling, itching and then a painful rash that can occur anywhere on the body (more commonly on the torso). Usually located together in one strip, the fluid-filled blisters resemble chicken pox blisters. Until the blisters dry up and scab over, you’re infectious. You can give another person chicken pox – not shingles – if they haven’t yet had it. And, as with chicken pox, the blisters can scar.
The condition can be serious. Complications include post-herpetic neuralgia, where your nerve fibres become inflamed and cause burning pain. “The neuralgia can wax and wane, but it can go on for years,” says Dr. Frank Martino. Martino is former family medicine chief and current president and CEO of William Osler Health System in Brampton, Ontario.
Martino adds that shingles can also affect the cornea, causing vision problems.
Plus, there’s a cardiovascular element. Research has shown that having had shingles significantly raises your chance of having a stroke or coronary heart disease. About 20 people in Canada die of shingles every year, according to Health Canada.
What is the treatment for shingles?
Doctors treat shingles by trying to reduce the severity of symptoms. According to Martino, no topical ointment works magic. The usual battery of calamine lotion and baking soda can offer some relief, however. Antihistamines can help with itching as well. So can pain medications, from over-the-counter drugs such as acetaminophen and ibuprofen, to doctor-prescribed narcotics.
If your doctor diagnoses you with shingles, your best bet is doctor-prescribed antiviral drugs. These can help reduce severity if you take them within the first 72 hours, says Martino. Better still, says Brown, is to try to prevent shingles in the first place, with the shingles vaccine.
What is the shingles vaccine?
According to the Canadian Immunization Guide, the recommendation is that all adults that are 50 years or older without contraindications receive 2 doses of the shingles vaccine.
SHINGRIX is the only vaccine the Canadian government has authorized for use. You get the shot in two doses, two to six months apart. Some provinces provide the vaccine free to certain age groups. Your workplace benefits plan or your personal health insurance plan may also cover the cost. If you have to pay for it, expect a cost of about $150 to $190 per dose.
The vaccine doesn’t offer 100% protection, but it comes close. In clinical trials, SHINGRIX was shown to be more than 90% effective at preventing shingles for people 50 years of age and older.
The vaccine is similarly effective in preventing post-herpetic neuralgia. Effectiveness is somewhat lower if your immune system is compromised, depending on your underlying condition.
Medical experts recommend avoiding the shingles vaccine if you :
- have had a life-threatening, allergic reaction to any part of the vaccine
- are pregnant or breastfeeding
- are now sick with another illness
If you’ve never had chicken pox, you can’t get shingles. But you may have been exposed to the virus without developing the disease. If you want to avoid chicken pox now and shingles later, get the varicella vaccine (to prevent chicken pox) – not the shingles vaccine. The varicella vaccine won’t prevent shingles. And having shingles once doesn’t mean you can’t get it again.
If you’re considering the vaccine, talk to your doctor.
Martino feels the vaccine is a good idea. He’s familiar with the secondary infections that can develop after shingles. These are often serious infections of the skin that require antibiotics. “I think the vaccine is great,” he says.
Brown agrees. She hopes that the 73% of Canadians over 50 who haven’t already had the shots get vaccinated.
“When we think about the cost of the vaccine, let’s remember the cost of going without it,” she says.
This article is meant to provide general information only. It’s not professional medical advice, or a substitute for that advice.
