Shingles vaccines, chickenpox, Shingrix

This is from New England Journal of Medicine's Journal Watch.

https://blogs.jwatch.org/hiv-id-obs...he-shingles-vaccine-answered-here/2019/10/14/

October 14th, 2019
Common Questions About the Shingles Vaccine — Answered Here!

Here’s an interesting email from my friend and ID-colleague Dr. Carlos Del Rio (shared with his permission):

Went Tuesday to see my PCP for a routine visit and had my second dose of Shingrix that day. I had gotten my first dose about 3 months ago and had severe chills and even a fever of 38.5 after the first dose. With the second dose the response was not as severe but did have chills and rigors for about 18 hrs. Stupid of me, but the next day I went to get my labs checked, and everything was fine except my HS-CRP which was 14.72 (nl < 10 and in the past I had been < 1.0).

Anyway…..Shingrix is a good vaccine but it is a tough one to take and really gives you a nice TNF storm!

The rest is at the link.

 

Is there any suggestion whether the shingles vaccine is recommended for PWMECFS? My MECFS physician was not recommending this vaccine to their patients, but I do not know of any evidence that suggests that the new vaccine (or even the old one) is harmful to PWMECFS. Any thoughts about this?

 

I've been advised that it's fairly unlikely I'd get shingles a second time, so it's one vaccine choice I don't have to make (unless the advice has changed by the time I get to 70).

Mine only got diagnosed because I happened to have an appointment at the surgery to have stitches removed. There was a little rash going in a line across my back, which I realised was a bit tender when the nurse got the GP to examine it, but I had no other symptoms. I don't think I'd have known I'd had it otherwise.

The only difficult bit was when someone else developed it a few weeks later, and we had to try and convince two particular colleagues that shingles itself isn't transmissible. We'd both checked that people in our respective offices had definitely had chickenpox before continuing going in to work with it...we never quite convinced them that we weren't spreading a shingles epidemic, though!

 

In Canada SHINGRIX is a two-dose vaccine.

 

Shingrix is expensive (new, more effective than Zostavax) and because of its effectiveness (maybe because of the adjuvant?-- which is the chemical that prods your immune system into action) side effects of the vaccine can be strong: sore arm, muscle aches, fever, etc. This means the immune system is activated (a good thing).

Probably the UK will get on board with Shingrix when the price drops (generic comes out).

 

https://www.gsk.com/en-gb/media/pre...st-shingles-in-adults-aged-50-years-and-over/

 

Good to be reassured by the effectiveness and safety findings.
I'm about to take the huge financial plunge and have the two Shingrix vaccinations. The protection from both infection and post-herpetic neuralgia is far superior.

According to nps.org.au, the older vaccine, Zostavax, is only 51% effective at preventing infection and 67% effective at preventing post-herpetic neuralgia.

In Australia Zostavax is free for over 70s but Shingrix isn't. Shingrix will cost me about $560 (about £315) for the two injections.

The lifetime risk is 22% for men and 32% for women. I assume that's 32% of only those who have had chicken pox. It's quite common anyway. Big decision.

 

My province's immunization program transitioned from Zostovax to Shingrix vaccine a couple of years ago. Seniors ages 65 to 70 years will get the two dose Shingrix for free. So I'm waiting five years until I'm eligible.

 

I had my first Shingrix vaccination last week. For the first time ever I had a reaction to a vaccine, not counting sore arms. I felt very unwell for about 15 hours then I was fine. No big deal but it was a surprise.

After just noticing this new thread - https://s4me.info/threads/zoster-as...increased-stroke-risk-2022-bubak-et-al.31053/ - I'm glad I made the decision to go with Shingrix.

 

My second Shingrix vaccination was completely uneventful - not even a particularly sore arm. Despite the eye-watering AUD$570 price tag I feel relieved to have potentially saved myself from the worst of yet another nasty disease.

 

New long-term data show Shingrix continues to provide high protection against shingles in adults aged 50 and over for more than a decade.

• End-of-trial data show 79.7% efficacy in participants aged 50 years and over, six to 11 years after vaccination1
• Vaccine efficacy remains high at 82.0% at year 11 after initial vaccination1
• No new safety concerns were identified during the follow-up period
PDF

 

I think I got shingles 4 days ago just below my left shoulder. The pain is excruciating when I move a certain way. It feels like an ice pick is stuck in that area. I just noticed this morning that there is a rash in that area.

I don't think that this is the usual place to get shingles?

 

I think you can get it more or less anywhere.

One of mine was between my neck and shoulder and the other on my lower back, and my friend got it across one side of her forehead. We seem to have got off quite lightly, as the shingles vaccines were much more uncomfortable than the actual condition. Her poor husband got it in the genital area, which he said he couldn't recommend at all.

I hope you feel better soon!

 

If you Google shingles on shoulder, I think you will find some photos of it in that location. I had it on my head. I had no idea you could get it there either!
Hope you feel better soon. I felt a bit unwell for a couple of weeks. Blisters lasted about a month.