How To Prevent Shingles

Shingles is extremely common, but also relatively preventable. It is caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Like chickenpox, shingles can start with pain, tingling, or itching of your skin. However, in the case of shingles, these symptoms are followed by a painful rash, usually on one side of the body, often the face or torso. You may also get fever, headache, chills, and upset stomach.

Chickenpox is what happens the first time you get the varicella-zoster virus. When you recover, the virus isn't completely eliminated from your body. Some of it stays in your nerve cells. When that virus becomes reactivated, you get shingles. Reactivation occurs when the virus moves from the nerve cells, where it has been lying dormant, to the skin, where it causes a rash. Most people get shingles only once. However, some people get shingles multiple times.

The medical term for shingles is herpes zoster, or sometimes just zoster. Herpes zoster is not the same thing as herpes—the infection caused by the herpes simplex virus resulting in genital herpes and/or cold sores.

Here's what to know about your risk of developing shingles, its potential complications, and and how to prevent it.

Who Is Most at Risk?

Everyone who has had chickenpox can get shingles. The vast majority of people in the United States who were born before 1980 (more than 99% of them) have had chickenpox. You may even have had chickenpox but don't remember it.

The Centers for Disease Control and Prevention (CDC) estimates that one out of three people in the U.S. will develop shingles. Every year, the disease affects an estimated one million people in the U.S.

Shingles can happen at any age, but is more common after we reach the age of 50 years. Our chances of getting it go up as we age. In fact, about half of people aged 80 years and older have had shingles. The reason age is a factor has to do with our immune systems.

The immune system's T cells are responsible for controlling the varicella-zoster virus, which is lying dormant in the nerve cells. As we age, our immune system slows down and we have fewer T cells. With fewer T cells around to control the virus, the virus can reactivate.

Other health factors can affect a person's T cells as well. They include chemotherapy drugs, drugs that prevent rejection after organ transplantation, and certain infections like HIV. There is also some evidence that emotional stress and physical trauma may cause the virus to reactivate as well.

In general, these people have a greater risk of developing shingles:

• Those who have a poorly functioning immune system: Several medical conditions can affect a person's immune system, including leukemia, lymphoma, and HIV. Shingles is actually rather common in people with HIV and can be dangerous.
• Those who are taking drugs that prevent the immune system from working properly: These drugs can include steroids and drugs given to patients after organ transplantation.
  

Genetics

It's unclear whether or how genetics plays a role in shingles. Having a first-degree relative (such as a parent or sibling) with shingles increases your risk slightly. Remember, though, that shingles is relatively common, especially among older adults. It is unknown whether there is actually a familial connection.

People of non-Hispanic white ancestry are more likely than people of African-American ancestry to develop shingles. Compared to people assigned male at birth, people assigned female at birth are also at higher risk of developing shingles.

How To Reduce Risk

Fortunately, shingles and its complications can be prevented through vaccination. A chickenpox vaccine has been in use in the U.S. since 1995, and the first shingles vaccine was introduced in 2006. Although it is still too early to tell, we may see the number of shingles cases decrease as the people who received these vaccines age.

More effectively, a shingles vaccine marketed under the name Shingrix is a highly effective recombinant vaccine that can protect against shingles and its complications. The CDC recommends this vaccine for these two groups of people:

• Adults aged 50 years and older (no maximum age limit)
• Adults aged 19 years and older who have a weakened immune system due to disease or treatments for other conditions that affect the immune system

Shingrix is administered in two doses. It is more than 90% effective at preventing shingles. In people aged 50 to 69 years who have healthy immune systems, Shingrix was 97% effective in preventing shingles. In people 70 years and older, Shingrix was 91% effective. In adults with weakened immune systems, Shingrix ranged from 68% to 91% effective, depending on the underlying condition.

Should You Get the Shingles Vaccine?

Reasons to and not to get vaccinated depend on a variety of factors, including your age, whether or not you have had chickenpox, and your current health status.

Reasons to get vaccinated include:

• You've had chickenpox, the chickenpox vaccine, or shingles.
• You got the Zostavax shingles vaccine, which was available until November 18, 2020, and was found to not be as effective as Shingrix.
• You don't recall having chickenpox.

Reasons not to get vaccinated include:

• You have shingles at present.
• You are sick or have a fever.
• You had an allergic reaction when you got a previous dose of the shingles vaccine.
• You are currently pregnant.

If you're thinking about getting the Shingrix vaccine, you may want to check in with your health insurance provider. Medicare Part D and some private plans may cover some or all of the cost of the vaccine.

Discuss With Your Healthcare Provider

If you notice signs and symptoms of shingles, like a painful, blistering rash, talk to a healthcare provider right away. They can prescribe medication that acts in multiple ways. Treatment can reduce symptoms (including pain), shorten the time you have shingles, and lower your risk of developing other health problems.

Timing is important here. That's because the medications are most effective when you get them within three days after the rash first appears.

Also, take note that the virus that causes shingles can spread when someone has blisters. You can't give someone else shingles, but you can give someone chickenpox if that person hasn't had it before.

The treatments you can get from a healthcare provider can help prevent serious and long-lasting complications. It is important that you seek medical attention if you think you have shingles.

A Quick Review

Shingles is characterized by a painful, itchy rash that is most likely to show up on one side of the body, usually the torso or face. Anyone who has had chickenpox can get shingles. The older you are, the more likely you are to get it. Getting the shingles vaccine is a safe and easy way to prevent the disease and its potentially serious complications.

Talk to a healthcare provider if you're interested in getting the shingles vaccine. Remember that if you have symptoms of shingles, the sooner you get medical help, the less likely you are to develop long-lasting complications.