From Our 2012 Archives
Risk of Shingles Recurrence Is Low
Study Questions Immediate Need of Vaccine Following a Bout of Shingles
By Denise Mann
Reviewed by Laura J. Martin, MD
June 5, 2012 -- A new study offers encouraging news for people who have recently experienced a painful bout of shingles.
For most people, the risk of having shingles recur after the initial occurrence is fairly low. The study appears online in the Journal of Infectious Diseases.
What Is Shingles?
Anyone who has had chickenpox can get shingles. People older than 50 and people with a weak immune system are at higher risk. The new study only looked at otherwise healthy individuals with a well-functioning immune system. The findings may not apply to people who are immunocompromised.
"The incidence of recurrence is low -- especially the short-term incidence," says researcher Hung-Fu Tseng, PhD, MPH. He is a research scientist at the department of research and evaluation at Kaiser Permanente's Southern California Department of Research & Evaluation in Pasadena.
Once a person develops shingles, their body's immune system develops memory of the exposure that helps with the immune response if the virus reactivates. "Having shingles boosts immunity against the virus. There is probably no immediate urgency to get the vaccine right after you have shingles," Tseng says.
Tseng and colleagues mined electronic health records of more than 6,000 people with a recent history of shingles. They charted less than 30 recurrent cases in an average of two years of follow-up.
The risk was similar among people who had, or had not, received the vaccine after their bout of shingles.
Nineteen people per 10,000 who had received the shingles vaccine had a shingles recurrence. In those who had not received the vaccine, recurrence occurred in 24 people per 10,000.
The CDC recommends this vaccine for all people aged 60 and older, including those with a history of shingles.
May Change Treatment Plans
The new findings may change how Bruce Hirsch, MD, approaches people with shingles. Hirsch is an infectious disease specialist at the North Shore University Hospital in Manhasset, N.Y. "This study provides new information about the nature of shingles," he says. "I am not going to give the shingles vaccine to individuals who had a recent history of shingles."
In these cases, "the immune system can see the virus, and it is similar to getting the vaccine," Hirsch tells WebMD.
For people who currently have shingles, early treatment with an antiviral medication can help shorten the duration of the virus, and possibly lessen the pain associated with it.
The first step is to determine why someone has shingles. "It can be a sign that immune system is weakened," he says.
SOURCES: Bruce Hirsch, infectious disease specialist, North Shore University Hospital, Manhasset, N.Y. Hung-Fu Tseng, PhD, MPH, research scientist, department of research and evaluation, Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, Calif. Tseng, H.F. The Journal of Infectious Diseases, 2012, study received ahead of print.