Rashes Not Roofs

Not These ...

Not These …

Imagine a submicroscopic life form that travels by air, attacking children and young adults with a nasty rash of itchy, raw pockmarks.   Although the rash and symptoms may disappear in matter of days, this organism hides in the facial and spinal nerves of the victim, lying dormant for years.   Then, when the victims’ immune systems weaken due to disease, medications or age, it awakens to cause a painful rash and, sometimes, lasting nerve pain.   The plot of some Sci-fi film like Andromeda Strain or a tale of genetic research gone bad like Outbreak?  Nope.  It’s the varicella zoster virus, the culprit behind Chickenpox.

So, why’s a sixty-nine year old guy in reasonably good health talking about a childhood disease? It’s that part about immune systems weakening due to age.  The painful rash is known as Shingles and it can bring pain from mild to excruciating, along with itching, fever and headache.  Interestingly, the rash generally occurs in a single band on one side of the body or face.  Extreme cases can affect one’s vision but the most common complication of shingles is a condition called postherpetic neuralgia (PHN).   People with PHN have nerve pain in the areas where they had the shingles rash, even after the rash clears up, sometimes for months.   According to the Center for Disease Control, about half of Shingles cases occur in men and women over sixty … and older adults are more likely to experience severe symptoms.  There is also evidence that the zoster virus is involved in about 25% of cases of Bell’s Palsy, a form of facial paralysis resulting from a dysfunction of nerves causing an inability to control facial muscles on the affected side.

At my senior assessment in December, my doctor asked me if I’d had Chickenpox as child and when I answered, Yes, he suggested I get the Shingles vaccine, known as Zostavax.  Today, I finally got around to it.  Zostavax is a live virus vaccine that must be kept refrigerated and used within 30 minutes of being removed from refrigeration.  It is also quite expensive.  With my Medicare HMO, it cost $95 but someone waiting at the pharmacy told me he paid $300.  Yikes.  My wife’s injection was covered completely by her Medicare Supplement.  As always, with my prescription I got an information sheet about the medication to read while I waited for my doctor to give me the injection.   It turns out that in clinical trails, Zostavax prevented shingles in about half of those tested.   However, it has also been shown to reduce the severity of cases and, in particular, reduce the occurrence of PHN, the post-rash pain, by 66%.   That’s not the sort of sure protection I’d hoped for but any medication involves a trade-off between protection and side affects.  According to a study on the effects of the vaccine on more than 190,000 patients published in the Journal of Internal Medicine, there is no risk of side effects beyond local reactions at the site of the injection.   So, I’m comfortable with my decision to be vaccinated.

Of course, if you’re making the same decision, you should talk to your doctor after reading a few articles on Shingles and the vaccine like the ones on www.cdc.gov and WebMD.  Let me know what you decide and why.

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One Comment on “Rashes Not Roofs”

  1. cherperz Says:

    I, am still on the fence when to be vaccinated. My husband and I talked to our health care provider when we got our flu shots last year and the shingles vaccine was $295.00 and none of it is covered by our insurance. It’s yet another thing we are dragging our feet on. We are still over 3 years from Medicare. We probably will just lump it and pay for it at some point.

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