What You Need To Know About The Shingles Vaccine and Your Coverage

Dr. Geoff Swanson, Senior Medical Director of Select Health Idaho, is a family medicine physician. He provided direct patient care for over 20 years and treated many patients with shingles.

Shingles is a painful rash that comes from reactivation of the chicken pox virus. Most older adults, even if they cannot remember it, have been infected with chicken pox. Some younger adults have been vaccinated for chicken pox as a vaccine has been available since 1995.

The chicken pox virus, part of a larger family of viruses known as herpes viruses, has an interesting way of “hiding out” from our immune systems within our nerve roots. Occasionally, during times of stress or other immunosuppressants, the virus “reactivates” and spreads out from the nerve root into the skin and associated tissues that are supplied by that nerve. This causes, in the early stages, odd itching type sensations, followed by pain, and then a blistering rash that looks just like the chicken pox rash except its extent is usually limited to the skin supplied by an individual nerve root. The rash and the condition are called shingles. According to the CDC the shingles rash typically develops on one side of the face or body. The rash consists of blisters that typically scab over in 7 to 10 days and fully clears up within 2 to 4 weeks.

Before the rash appears, people often have pain, itching, or tingling in the area where it will develop. This may happen several days before the rash appears.

The risk of shingles goes up with age and is most common in those over the age of 60. In most people, the rash is short-lived, however, in some cases, the location of the rash is dangerous. For example, getting shingles near the eye can potentially affect your vision and has been known to cause blindness. In some cases, people get what is called Post Herpetic Neuralgia, meaning that pain persists in the affected nerve long-term.

"What is the typical course of a shingles flare-up?"

Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. Shingles on the face can affect the eye and cause vision loss. In rare cases (usually in people with weakened immune systems), the rash may be more widespread on the body and look similar to a chickenpox rash.
Other symptoms of shingles can include:

• Fever
• Headache
• Chills
• Upset stomach

PREVENTION

In the United States, the Centers for Disease Control and Prevention (CDC) suggests that adults 50 and older get a shingles vaccine called Shingrix. The agency also suggests Shingrix for adults 19 and older who have weaker immune systems because of diseases or treatments. Shingrix is suggested even if you've already had shingles or the older vaccine, Zostavax. Shingrix is given in two doses, 2 to 6 months apart.

According to medicare.gov, Medicare prescription drug plans (Part D) usually cover all commercially available vaccines needed to prevent illness, like the shingles shot. You can now get more vaccines under Part D at no cost to you.