Q. I have been seeing more and more information about the shingles vaccine in the news. What is shingles?
A. Shingles (or herpes zoster) is a painful skin rash that usually appears in a band, a strip, or a small area on one side of the face or body.
Q. What causes shingles?
A. Shingles occurs when the virus that causes chickenpox becomes active (reactivates) again in your body. After you get better from chickenpox, the virus “sleeps” (is dormant) in your nerve roots. In some people, it stays dormant forever. In others, the virus “wakes up” when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this happens, but after the virus becomes active again, it can only cause shingles, not chickenpox.
Q. How do I get shingles?
A. Shingles is caused by the varicella zoster virus (VZV), which is the same virus that causes chickenpox. Anyone who has had chickenpox can develop shingles because VZV remains in the nerve cells of the body after the chickenpox infection clears. Anyone who has had the chickenpox vaccine can also develop shingles, but it occurs less frequently in these people. Many people have had chickenpox but were not or are not aware of it, or don’t remember it. Almost everyone born in the US before 1980 has had chickenpox.
Q. Can I catch shingles from someone who has it?
A. You cannot catch shingles from someone else who has shingles. However, fluid from shingles blisters is contagious and can cause chickenpox (but not shingles) in people who have never had chickenpox and who have never gotten the chickenpox vaccine. If you have never had chickenpox and have never gotten the chickenpox vaccine, avoid contact with people who have shingles or chickenpox.
Q. How do I know if I have shingles?
A. Shingles happens in stages. At first you may have a headache and be sensitive to light. You may also feel like you have the flu, but not have a fever. Later, you may feel itching, tingling, or pain in a certain area. That’s where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash, and some do not get a rash at all. If you have any of these symptoms, you should contact your doctor right away to determine if you have shingles.
Q. Is there a treatment for shingles?
A. Shingles can be treated with medication, including antivirals, as well as medication for pain. Starting antiviral medication right away can help your rash heal faster and be less painful. If you think you may have shingles, contact your doctor right away.
Q. How do I know if I need the shingles vaccine?
A. The Centers for Disease Control recommends the shingles vaccine for people 60 years old and older to prevent shingles, regardless of whether they remember having had chickenpox or not. The effects of shingles can become increasingly severe with age. The shingles vaccine is a one-time vaccination and there is no maximum age for getting the shingles vaccine. Studies show that more than 99% of Americans born before 1980 have had chickenpox, even if they don’t remember getting the disease, so almost all people 60 years and older have already had chickenpox. However, because the vaccine’s effect wanes over time and the risk of shingles is higher at an older age, the CDC does not recommend routine vaccination for people age 50-59. Response to the vaccine appears best at age 60-69; therefore, it would be ideal to receive the vaccine during that period.
There are some people who should NOT get the shingles vaccine.
Q. When should I get the shingles vaccine?
A. The decision on when and whether or not to get vaccinated should be made with your health care provider.
Q. Can I still get the vaccine even if I have already had shingles?
A. Even if you have had shingles, you can still receive the shingles vaccine to help prevent future occurrences of the disease. In general, a person should wait until after the shingles rash has healed before getting the shingles vaccine. Otherwise, there is no specific time interval that you must wait after having shingles before receiving the shingles vaccine.
Q. Is the shingles vaccine covered by my insurance?
A. Insurance coverage for the shingles vaccine can sometimes be confusing. Many insurance providers do not cover the shingles vaccine for people younger than age 60. In the event that you would like to pay for the vaccine out-of-pocket, the cost is approximately $250, but it can vary. If you have Medicare insurance coverage and have a pharmacy benefit included (usually known as Medicare Part D), the vaccine is covered under the pharmacy benefit and your doctor will need to write a prescription for you to fill at a pharmacy. You can either receive the vaccination by a pharmacist, if he or she is certified to do so, or you may need to bring the vaccine back to your doctor’s office for administration. Many of our Atrius Health medical offices also have a pharmacy on the premises to facilitate the process. If you do not have Medicare insurance but have commercial insurance coverage, then your doctor can administer the vaccine in any of our offices without writing a prescription. If you are unsure about coverage of the vaccine, it is best to contact your insurance provider to confirm prior to getting the vaccination.