Is Shingles Prevention Possible? Is There a Shingles Vaccine?
Prevention of shingles in people who have contracted chickenpox is difficult, since the factors that trigger reactivation are not yet defined. However, if a person is never infected with the virus, shingles will not develop. Furthermore, there are at least two methods that are currently used to reduce the incidence of shingles.
First, the VZV vaccine, otherwise known as the chickenpox vaccine, may decrease the incidence of shingles by enhancing the immune system's ability to fight off VZV (about 70%-90% effective) or keep this virus inactive. This vaccine is usually administered to children, but the immunity may decline in about 15-20 years. The single-dose vaccine dose is given to babies 12-18 months of age. Most vaccine side effects, if they occur, are mild and range from a rash, skin redness, and swelling to small chickenpox lesions, usually at the injection site. Boosters of this vaccine for use in adults are now being investigated and may help prevent shingles in the future.
Further, there are vaccines to prevent shingles. The first of these is a live attenuated (weakened) virus vaccine called Zostavax that has been in use since 2006. The U.S. Centers for Disease Control and Prevention (CDC) states that adults 60 years of age and older may receive this vaccine. It is most effective in the 60- to 69-year-old age group; its efficacy in older patients becomes less as the age of the patient increases. The vaccine is not given to patients with ongoing shingles disease because it is only effective in preventing or reducing complications of the disease (PHN) before the virus is reactivated. The vaccine is composed of attenuated live chickenpox virus. People who obtain the vaccine should avoid contact with individuals who may be susceptible to viral infections, especially after just receiving the vaccine. Side effects of the vaccine are usually mild and confined to the injection site. These include erythema (skin redness), pain or tenderness of the site, swelling, and itching (in about one person in three who obtains the vaccine).
Shingrix (recombinant zoster vaccine, RZV) is the vaccine the CDC currently recommends as the preferred shingles vaccine. Two doses about 2-6 months apart are more than 90% effective in preventing shingles and PHN, and it is recommended for use in people 50 and over. Side effects of Shingrix may occur and last about 2-3 days and may include redness and swelling at the inoculation site. Some individuals may experience muscle pain, headache, shivering, fever, stomach pain, and nausea.
Varicella zoster immune globulin (VZIG or ZIG) can be used to passively prevent VSV infection, but it is used rarely and only in special cases (for example, newborns, pregnancy, immune-compromised patients). Currently, there are no data that suggest that VZIG prevents shingles.
Home remedies for shingles are mainly concerned with reducing the pain caused by this disease. Cold compresses (some containing aluminum acetate), colloidal oatmeal baths, starched baths, and some topical creams may help reduce pain for some people. Loose-fitting clothing may help reduce pain as clothing that touches or rubs sensitive skin areas can be painful.