Tag: Shingles

  • What Is The Best Shingles Vaccine?

    What Is The Best Shingles Vaccine?

    Let’s explore a topic we are often asked about, shingles vaccines. Specifically, Shingrix and Zostavax. Understanding these vaccines is crucial. Shingles, is a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. It affects many people, particularly as they age.

    Shingles: A Brief Overview

    Shingles, or herpes zoster, manifests as a painful rash. The rash usually follows the path of a single nerve group. It’s a consequence of the reactivation of the dormant varicella-zoster virus in the body. While not generally fatal, shingles can lead to serious complications like post-herpetic neuralgia, a severe chronic pain condition.

    Shingles Vaccines: Zostavax and Shingrix

    • Zostavax: This was the go-to shingles vaccine for many years. It’s a live attenuated vaccine, meaning it uses a weakened form of the live virus. Zostavax effectively reduced shingles cases but less so in those over 70. Also, it couldn’t be used in immunocompromised individuals.
    • Shingrix: The newer player in the field, Shingrix is an inactivated recombinant vaccine. It contains only a part of the virus, making it safe even for those with weakened immune systems. Its efficacy surpasses Zostavax, offering better protection against shingles, even in older adults.

    Comparing Effectiveness

    • Efficacy Over Time: Shingrix has shown higher and longer-lasting effectiveness compared to Zostavax. This is particularly so in the older population.
    • Safety for Immunocompromised Individuals: Unlike Zostavax, Shingrix is suitable for those with compromised immune systems.
    Dosage and Side Effects
    • Shingrix requires two doses, spaced 2-6 months apart, while Zostavax was a single dose.
    • Side Effects: Shingrix may have more frequent mild side effects. But these are generally short-lived and manageable.
    Recommendations for Those Vaccinated with Zostavax
    • Given Zostavax’s reduced effectiveness over time, it’s recommended that individuals previously vaccinated with Zostavax consider getting re-vaccinated with Shingrix.
    My Perspective

    Given the higher efficacy and broader suitability of Shingrix, it stands out as the preferred choice for shingles vaccination. Remember, shingles is not only painful but can also lead to debilitating long-term complications. Consider that one in three people may develop shingles in their lifetime. Thus, opting for the most effective vaccine available seems a prudent choice.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

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    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

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  • How You Can Avoid Shingles

    How You Can Avoid Shingles

    If you’ve had a friend or relative who has had shingles, then you will be familiar with just how uncomfortable it is. It can affect up to 1 in 4 people and is more likely in people aged over 50, although it can occur at any age. 

    The first thing people tend to notice when they have contracted shingles is not the rash but the pain. This can be burning, dull or electric shock-like. Shortly afterwards the characteristic rash develops. This affects only one side of the body and occurs in a band. The rash itself looks rather like the chickenpox rash except that is localised to one area. This is because shingles affects a nerve that supplies the skin and it usually only affects one nerve at a time. The pain and rash occur in the area of skin that is supplied by the affected nerve. 

    How Does It Occur?

    Many people (doctors included) still struggle to get their heads around how shingles occurs. To have shingles you have to have had chickenpox. The chickenpox virus, also known as the varicella-zoster virus, then lies dormant in one of the nerve endings in our skin. Precisely what causes the reactivation of the virus resulting in shingles is not known. However, it is thought that the risk is increased as our immune system wanes with age. Stress, or another recent illness, may also cause this dip in our immunity allowing shingles to strike. 

    Thankfully, there’s now a simple way to prevent shingles

    There is now a vaccine that can prevent shingles. Zostavax can be given to adults over 50. It is a live vaccine but the virus has been altered so that it does not cause illness. Instead, it primes the immune system to prevent shingles. Because it is a live vaccine it can’t be given to people who have problems with their immune system. While the vaccine does not prevent all cases of shingles it is very effective and in those who do get shingles despite the vaccine, it is likely to reduce the severity and complications. 

    For adults who have never had chickenpox, it is sensible to have the chickenpox vaccine. The two doses given a month apart are about 90% effective in preventing chickenpox. 

    Can someone else catch shingles from me?

    People who have never had chickenpox can contract chickenpox from the shingles rash but you can’t pass shingles onto someone else. The shingles rash is contagious until the blisters start to scab over so it’s best to keep away from pregnant women, children or anyone with a weak immune system if you have it. 

    Brisk Treatment Means Faster Healing

    If you have any of the tell-tale symptoms of shingles such as burning or gnawing pain in a band or the classic rash you should arrange to quickly see your doctor. Antiviral medication such as Aciclovir can be used to help quicker healing and reduce the risk of complications. Antivirals work best if given within 72 hours of the onset of the rash which is why it is important to let your doctor know quickly if you suspect something is wrong. The medication is particularly important to give to people with shingles who are over 50, have the rash near the eye or on an arm or leg, have severe pain or have low immunity. 

    With regard to shingles, prevention is better than cure. So if you’re over 50, think about getting the vaccine. And if you do think you may have shingles see your doctor quickly, as the earlier you start treatment the better.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides