Defeating Shingles
November 10, 2017 5:16 PM   Subscribe

Good news for people who've had chicken pox. Shingrix, the new shingles vaccine prevents more than 90 percent of shingles cases, even at older ages. It will start shipping this month.

"Almost all older Americans harbor the varicella zoster virus that causes shingles; they acquired it with childhood chickenpox, whether they knew they had the disease or not.

The virus stays dormant until, for unknown reasons, it erupts decades later. The risk rises sharply after age 50.

Shingles is hardly a minor menace. “A million cases occur in the United States each and every year,” Dr. Schaffner said. “If you’re fortunate enough to reach your 80th birthday, you stand a one-in-three to one-in-two chance of shingles.”

Preventing the great majority of these cases — along with the risk of lingering and debilitating nerve pain, called postherpetic neuralgia — would represent a major advance in public health."
posted by storybored (38 comments total) 35 users marked this as a favorite
 
As someone who got shingles at the age of 14, I don't know if it would be worse at 50, but I think this is some awesome news.
posted by motioncityshakespeare at 5:26 PM on November 10, 2017 [6 favorites]


I wonder if it helps with people who have recurring shingles and who are well under 50. Time will tell! Thanks for sharing. It's been debilitating in a way I can't describe. My mother keeps telling me "Oh parenting is just really hard, it's normal to be tired" and I'm like mom... I'm not TIRED I'm in excruciating debilitating pain. It's taken me four years to get back to being able to work a full work day and even then still hurting. I've known a number of people who had shingles only once and did not get postherpetic neuralgia but if you get that and if you have recurring issues it can really be life and function altering and is not considered a "real" disability at present.
posted by xarnop at 5:26 PM on November 10, 2017 [10 favorites]


I've had chicken pox twice, once at 7 and then again at 13. I'd been dreading the possibility of getting shingles and having it be incredibly severe, so this is great news.
posted by GameDesignerBen at 5:39 PM on November 10, 2017 [3 favorites]


So why won't Medicare cover this? That seems astonishingly short-sighted.

But anyway, it's good news! I wonder why they're advising that people wait until they're 50. I know someone who got shingles in her mid-40s, and it was really awful.
posted by ArbitraryAndCapricious at 5:41 PM on November 10, 2017 [2 favorites]


Medicare won't cover this, because Republicans.

PREEXISTING CONDITION!
posted by BlueHorse at 5:50 PM on November 10, 2017 [1 favorite]


TOO FUCKING LATE.

You kids are so bloody spoiled.
posted by srboisvert at 5:55 PM on November 10, 2017 [1 favorite]


As a shingles haver, I want as many other people to never have to experience that so this is great news. It's bullshit if Medicare won't cover it, but I have to think they will eventually because of the cost benefit.
posted by MCMikeNamara at 5:56 PM on November 10, 2017 [5 favorites]


Oh thank god. I had chicken pox twice as a kid, and shingles in my twenties. I have been dreading my upcoming late middle age, because I watched my aunts really struggle with shingles as they grew older.
posted by Malla at 6:34 PM on November 10, 2017


My doctor told me this was close to market when I had my checkup last month. He told me to wait, and I’m looking foreword to getting it (as much as anyone looks forward to an injection or two).
posted by lhauser at 6:38 PM on November 10, 2017


This is great news. Chicken pox haver at 17, and I just turned 50 this year. (More fodder for Cortex's evil data mining!) Now to hope I can get it through Medicaid...
posted by Samizdata at 6:54 PM on November 10, 2017


So why won't Medicare cover this? That seems astonishingly short-sighted.

According to the article, Medicare covers both the old and new vaccines under Part D.
posted by Thorzdad at 7:14 PM on November 10, 2017 [3 favorites]


the overwhelming number of shingles cases are very self-limited if caught and treated. The bad ones are almost always in elderly or cases where someone ignored the rash until it was too late to treat effectively and at that point you're at the mercy of the neural inflammation that inevitably occurs. And those cases can be horrible for the victim.

The advice I give to all my patients, vaccinated or not, is that if you have a painful rash anywhere, even one or two marks, get to any urgent care immediately and at least ask to consider treatment. The meds for this are extremely safe. Waiting more than a couple days is where things go off the rails.

Weird to think a generation of kids will never be exposed to chicken pox like us olds.
posted by docpops at 7:28 PM on November 10, 2017 [15 favorites]


I've had chicken pox twice, once at 7 and then again at 13

I didn't know that was possible. How awful.
posted by thelonius at 7:41 PM on November 10, 2017 [1 favorite]


Weird to think a generation of kids will never be exposed to chicken pox like us olds.

Not that I blame my parents, but as far as I know a chicken pox vaccine was available in the early 80s, which is when it would have been useful to me, but people just didn't get it. My kids are all immunized, but both my wife and I got some form of shingles (in both cases blamed on stress) when we were younger.
posted by Literaryhero at 7:54 PM on November 10, 2017


I had a really mild case of shingles some years ago, and it truly sucked. This is great news and I’ll be talking to my doctor about it.
posted by Dip Flash at 8:02 PM on November 10, 2017


The chicken pox vaccine wasn't available until the 2000s, but there was an immuoglobulin available .

I had it because I was immuosurpressed as a kid because they were afraid that chicken pox would develop in my lungs when my brother got it. This was 1990.

I ended up getting a couple pox, and never developed immunity. But I also ended up having the vaccine twice as an adult because the first time I took the vaccine my titers still came back negative.
posted by AlexiaSky at 8:04 PM on November 10, 2017


Medicare doesn't cover drugs until they are approved for commercial use outside of drug trials. If it isn't on the formulary for part D it could be that it hasn't caught up with the drugs classification change yet.
posted by AlexiaSky at 8:08 PM on November 10, 2017


Part D does cover it. But not everyone has part D, and part D is complicated. It could be free through Part B, the way the flu shot is.
posted by ArbitraryAndCapricious at 8:12 PM on November 10, 2017


Weird to think a generation of kids will never be exposed to chicken pox like us olds.

It's still an open question in the medical community as to whether those kids will grow up to simply never have any risk of shingles, or will develop shingles as older adults, or will have weaning immunity from their childhood vaccines and end up with primary varicella infection as an adult (which can be really nasty) or some other variation somewhere in the spectrum. We can guess based on what's biologically plausible, but we don't have anyone who's old enough yet to observe reality.
posted by telegraph at 8:19 PM on November 10, 2017 [2 favorites]


There's a vaccine available on the NHS, but only if you're 70 or 78.

Speaking as someone who had chicken pox at 27 (and cried to AskMe about it), I'm going to be there the damn second I turn 70.
posted by Katemonkey at 9:00 PM on November 10, 2017


> Weird to think a generation of kids will never be exposed to chicken pox like us olds

My daughter was vaccinated for chicken pox but still got it, just three years ago. Her case was very mild, because of the vaccine (or at least this is what her doctor thinks; we didn't do any testing to confirm that it was actually chicken pox). We're a long way still from it being wiped out.
posted by The corpse in the library at 9:33 PM on November 10, 2017


I cede not an inch to anyone in my loathing for Republicans' efforts to kill me by crippling our health care system, but c'mon people, RTFA: "Once the C.D.C.’s director endorses the committee’s recommendations, and the agency publishes them, insurers — including Medicare and Medicaid — will start covering the vaccine."
posted by twsf at 10:07 PM on November 10, 2017 [1 favorite]


Thanks, just emailed my doctor.
posted by matildaben at 10:16 PM on November 10, 2017


I caught chicken pox for the first time when I was 22 and got very lucky that I was vigilant, got the proactive treatment immediately and was still quarantined for a week.

I developed shingles when I was 37 or so and was in the middle of a bunch of stress, including a new job and a horribly taxing commuting. Of course they were right around my waist, right where my jeans hit. My wife was surprised when I called her in tears about the pain.

So yeah, you got a way for me not to feel that red hot needley stupidity again? I'm your huckleberry.
posted by drewbage1847 at 11:22 PM on November 10, 2017 [1 favorite]


When I checked with a pharmacist a couple of years ago, the Shingles shot was $400.00.
Maybe the new shot will be more reasonably priced.
posted by Cranberry at 12:19 AM on November 11, 2017


Hopefully something will be done about the cost other than making it another unaffordable version of unobtanium. Several years ago I tried to get vaccinated and it wasn't covered (thus would be full price); didn't get vaccine but did get shingles the next year.
posted by mightshould at 2:37 AM on November 11, 2017


The chicken pox vaccine wasn't available until the 2000s, but there was an immuoglobulin available .

The chicken pox vaccine has been available since 1984.
posted by Literaryhero at 5:56 AM on November 11, 2017


Got shingles while my newborn was in the NICU, and it was not a proud time for me as a father: First, I was just unimaginably exhausted--moreso than my wife who'd just gone through labor and a full week of basically zero sleep due to round the clock nursing and the fact of the NICU. I couldn't function. Wife understandably thought i was a craven weakling. i mean, so did i. Then, once i was diagnosed, i had to quarantine myself for another week, while she sobbed and the baby cried upstairs. (Then a relative had a psychotic break and the cops shot tear gas through the windows and trashed the apartment. had to break into the apartment to rescue the pets--with shingles.) Shingles hurt! my insides felt like they had been beaten with a crowbar. Then a couple years later i got hand-foot-mouth from the baby and...it was worse, actually. Seven months later, my toenails are still falling out. SPOILER ALERT DON'T REPRODUCE.
posted by Zerowensboring at 6:24 AM on November 11, 2017 [8 favorites]


Wow, this is great news. I just watch a friend in his mid-40s suffer for 4 months with terrible symptoms. Now 2 years later, he still has nerve pain in the area he had the rash. Yes, this is anecdotal evidence but seeing it firsthand is quite alarming. I will be getting this vaccine.
posted by Muncle at 7:11 AM on November 11, 2017


Never had Chicken Pox despite my mother making me sleep in my brother's room when he got it as a kid. She wanted to get it all over with at the same time assuming the whole time I would get it sooner or later. Then, when I was 41, I was exposed through my kids. Doctors all telling me not to get chicken pox as an adult! I spent 3 days chasing my tail trying to find a pediatrician that would give me, at 41, the shot. Shots suck, but easily the greatest tradeoff of all time to get pricked with a needle in exchange for avoiding a debilitating, maybe life threatening, condition.

But now all this talk about chicken pox has put the Armour Hot Dogs song into my head. Terrible earworm to have.

Hot dogs
Armour hot dogs
What kind of kids eat Armour hot dogs?
Fat kids
Skinny kids
Kids who climb on rocks
Big kids
Little kids
Even kids with chicken pox
Eat hot dogs
Armour hot dogs
The dogs kids love to munch.
posted by AugustWest at 7:12 AM on November 11, 2017 [1 favorite]


Yeah, this is news. I've just got over a bout (skin still feels weird but no pain) and shingles is not fun at all even if the case I had was probably pretty mild in the scheme of things. The scab-like things are strange too -- it's like pieces of glass embedded in you.
posted by hawthorne at 7:19 AM on November 11, 2017 [1 favorite]


I'm in my early 60's. I've got the Zostavax vaccination. I'll see how well it does me before going for Shingrix. I've gotten little flareups that I've ascribed to poison ivy or some other irritant, but after looking at pictures of shingles online, I wonder now if those were small shingles flareups?
posted by King Sky Prawn at 7:57 AM on November 11, 2017


I had shingles earlier this year and caught it early enough that it was easily treated...and it was still agony. I’m only 39. Glad to see there’s some progress in this area.
posted by okayokayigive at 9:12 AM on November 11, 2017 [1 favorite]


I have shingles right now and I hope nobody has to deal with this ever again.
posted by azarbayejani at 10:57 AM on November 11, 2017 [2 favorites]


The scab-like things are strange too -- it's like pieces of glass embedded in you

Thank you for this comment: that was my experience too, but I wasn't sure I wasn't exaggerating things in retrospect.

When I was scratching out the last of those they were so flat, hard and sharp-edged one of them embedded itself in the quick under my fingernail.

I don't know, the first effort to meet any success in protecting people from smallpox wasnt Jenner's development of a cowpox based vaccine, it was crumbling up scabs of people who'd recovered from smallpox and inoculating with that. I've seen texts of letters in which the writer refers to an included harvest of such scabs meant to help the recipient protect themselves and their family.

I feel compelled to wonder whether (trigger warning) eating those 'shingles' would confer any degree of immunity to shingles or chickenpox.
posted by jamjam at 9:03 PM on November 11, 2017


AugustWest:

The old songs really are the best songs.
posted by Chitownfats at 1:42 AM on November 12, 2017


I've had chickenpox twice, once at 7 and then again at 13.

Count me as another person who didn't know that you could get chickenpox twice, GameDesignerBen. That couldn't have been fun. I had it once -- when I was 13, in 1978 -- and that was bad enough. I will definitely be seeking out the Shingrix shot.

I missed three weeks of school, spiked a fever of 104 and scratched my way to a couple of truly stunning scars.

The upside of the pock marks: They fascinate my nieces, ages 13 and 11. Because the vaccine has been available since 1984, none of their classmates has had chickenpox -- and I'd bet that the same is true of their younger teachers.
posted by virago at 9:03 PM on November 12, 2017


We're eagerly awaiting more info on the use of this with the immunosuppressed. My wife has been on some chemical or another to treat an obscure eye condition (inner punctate choroiditis if you care) for well over a fifteen years now and they've all been immune suppressing to varying degrees. Now it's Humeira, but while she was on another drug commonly used for transplant patients she had a pair of shingles eruptions. The old vaccine was live so no good for her use.

Here's hoping this gets good results for the immunosuppressed/compromised and that our insurance will pick up the tab even though she's not 50 for quite a while. If not we'll probably tighten our belts elsewhere and just pay, which thankfully we can probably do. It's horridly unfair that folks who aren't so fortunate will likely be left out.
posted by phearlez at 12:10 PM on November 15, 2017


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