Shingles Vaccine – should you or shouldn’t you?

by Dr. Michael Contreras

Every unvaccinated patient that I have seen with a new shingles outbreak has told me emphatically they wish they had opted to get vaccinated.   We are fortunate to now have a vaccine that can effectively reduce the risk of getting shingles.  Zostavax was the first vaccine approved by the FDA in 2006 for patients older than 60, and in 2017 Shingrix was approved for patients older than 50.

Shingles, also called herpes zoster, is a painful viral infection caused by reactivation of the chickenpox virus that lays dormant in nerve roots after the initial chicken pox infection.  People affected by the chickenpox virus in their past are all at risk for developing the painful shingles breakout that brings many patients into our office for treatment.   The risk for developing shingles increases with age because of age-related weakened immunity, and 50% of people older than 85 will have shingles, and one of every 3 people who are unvaccinated will eventually develop shingles.

The lesions of shingles appear as red bumps, clusters of blisters, and red patches in a segmental distribution, usually only on one side of the body.   While pain, sometimes prolonged even after the rash goes away, is a dreaded symptom, there are other more dangerous potential outcomes.  For example, involvement of the facial areas around the eye can cause visual loss due to scarring of the eye.

Treating shingles early, within 72 hours of shingles onset, can reduce the pain and duration of the shingles lesions.  Unfortunately, patients are often not aware that they have shingles within this short period of time.  Even if treated early, patients are at risk of developing a prolonged pain syndrome called post-herpetic neuralgia.

Despite the fact that the shingles vaccine is effective, only 30% of patients older than 60 had received the vaccine by the end of 2015.   As Dermatologists who see patients suffering with shingles, we want to educate our patients on the current vaccine recommendations and review the potential associated risks.  Our goal is to increase the rates of vaccination.

Should I get Shingrix or Zostavax?

  • Shingrix, the newest vaccine, is 90% effective in preventing shingles and post-herpetic neuralgia.  Additionally, Shingrix does not lose effectiveness in people over age 70 like Zostavax does.  Shingrix is a dead version of the virus, while Zostavax is a live virus.   Although it requires 2 doses (2-6 months apart), I advise patients to maximize efficacy with the Shingrix vaccination.

Who should get the shingles vaccine?

  • The CDC recommends healthy adults 50 or over get the Shingrix vaccine.  Patients receiving immunosuppressive medications (such as biologics for psoriasis) are also potentially eligible to have Shringrix vaccination since it is not a live virus.

What side effects are associated with the Shingrix vaccine?

  • Some patients have reported skin rash, joint pain, flu-like symptoms, headaches, and fatigue lasting 2-3 days.  These reported side effects are minimal compared to the devastating symptoms people with a shingles outbreak may endure.

 

What if I already had the Zostivax vaccine?  Should I get the Shingrix vaccine?

  • Yes.  The Shingrix vaccine is significantly more effective.  It is also likely that the protective effect of the Shingrix vaccine will last longer than Zostivax.  You should wait at least 2 months before receiving Shingrix after Zostivax.

Should I get the Shingrix vaccine if I already had shingles?

  • Yes, you can still get shingles again, so vaccination is still advised.

What is the cost for the vaccines?

  • The shingles vaccines are covered differently than influenza and pneumococcal vaccines.  The cost to patients is variable depending on their insurance coverage, and co-pays are sometimes a barrier to getting the vaccine.   Shingrix:  $290 (includes the required 2 doses); Zostivax:  $230 for single dose.
  • Both drugs are covered under Medicare under Medicare Part D (co-pay price depends on tier within individual part D plan).  The Affordable Care Act (ACA) requires that vaccines are treated as preventative care meaning cost is typically low for privately insured patients.
  • Keep in mind that coverage may be better when the vaccine is administered at a pharmacy or at physician offices with a pharmacy onsite.

At AboutSkin in Greenwood Village and Lone Tree in the Denver area we are a team of only board-certified dermatologist MDs.  We have same day appointments available if you or someone know you has new lesions suspicious for shingles.

Denver's Best Dermatologists

American Academy of Dermatology American Society for Dermatologic Surgery
Dr. Joel Cohen

Dr. Joel Cohen

As director of AboutSkin Dermatology, the nationally renowned Dr. Cohen oversees the practice.

Dr. Michael Contreras

Dr. Michael Contreras

With AboutSkin Dermatology since 2010, Dr. Contreras provides medical, cosmetic, and surgical services.

Dr. Samantha Stoler

Dr. Samantha Stoler

Dr. Stoler has provided medical and surgical services at AboutSkin Dermatology since 2011.

Dr. Stephen C. Ho

Dr. Stephen Ho

Dr. Ho joined AboutSkin Dermatology in 2012, and provides medical and surgical services.

Dr. Scott Walter

Dr. Scott Walter

With AboutSkin Dermatology since 2017, Dr. Walter provides medical and surgical services.

Dr. Jade Fettig

Dr. Jade Fettig

Dr. Fettig came to AboutSkin in 2019 after completing her Boston University residency.

Dr. Joel Cohen

Dr. Joel Cohen

Read More

As director of AboutSkin Dermatology, the nationally renowned Dr. Cohen oversees the practice.

Dr. Michael Contreras

Dr. Michael Contreras

Read More

With AboutSkin Dermatology since 2010, Dr. Contreras provides medical, cosmetic, and surgical services.

Dr. Samantha Stoler

Dr. Samantha Stoler

Read More

Dr. Stoler has provided medical and surgical services at AboutSkin Dermatology since 2011.

Dr. Stephen C. Ho

Dr. Stephen Ho

Read More

Dr. Ho joined AboutSkin Dermatology in 2012, and provides medical and surgical services.

Dr. Scott Walter

Dr. Scott Walter

Read More

With AboutSkin Dermatology since 2017, Dr. Walter provides medical and surgical services.

Dr. Jade Fettig

Dr. Jade Fettig

Read More

Dr. Fettig came to AboutSkin in 2019 after completing her Boston University residency.

Patient Testimonials

This office is WONDERFUL. Dr. Cohen is literally world famous and totally down to earth, and teaches folks all over the globe about skin cancer surgery, botox, restylane, juvederm...

Google Review

— M.S

Before & After Photos

Before & After Photos

Television APPEARANCES

Denver CBS Denver The Doctors 2 Colorados News

FOLLOW US ON SOCIAL MEDIA


Stay up to date on the latest AboutSkin Dermatology & DermSurgery, PC happenings by following us on Facebook, Twitter, Instagram, and more.

CONTACT OUR OFFICE

security code

GREENWOOD VILLAGE OFFICE


MAIN OFFICE

5340 South Quebec St.,
Ste. 300
Greenwood Village, CO 80111

South Entrance

Monday-Friday: 8am – 5pm

Phone No.: (303) 756-7546

Fax: (303) 756-7547

AboutSkin Dermatology & Derm Surgery

SKY RIDGE MEDICAL CENTER


10099 Ridge Gate Parkway, Ste. 490
Lone Tree, CO 80124
Conifer Building

West Parking Lot

Monday-Friday: 8am – 5pm

Phone No.: (303) 756-7546

Fax: (303) 799-4696