I wasn't planning to think about shingles all week, but couldn’t avoid it. It started with an email from a close friend saying she had the painful skin rash, which is caused by the varicella-zoster virus. I winced, recalling my own bout of shingles, when I drove to and from work every day, steering with my right hand and holding the seat belt away from my torso with my left, because the pain from having the belt touch the rash on my rib cage was intolerable.
A day later, I came across a 2011 Institute of Medicine report on chronic pain. One of the leading causes? Post-herpetic neuralgia, the nerve pain that sometimes follows shingles, and which can last anywhere from weeks to years.
The shingles theme continued the next day when I saw my primary-care doctor for a routine annual physical. Along with the standard-issue recommendation about calcium for women my age, she told me I needed to have the shingles vaccine. When the FDA approved the vaccine in 2006, it was recommended for adults ages 60 and up. Last year, the FDA approved it for people ages 50 to 59. The FDA reports that approximately 200,000 healthy people in their 50s develop shingles every year, and the risk continues to rise as you age.
Shingles can affect people who have had chickenpox, which is also caused by the varicella-zoster virus, a type of herpes. For reasons no one understands, the virus never fully clears itself from your body after chickenpox, and can resurface as shingles decades later. In my case, the outbreak occurred more than 30 years after I’d suffered the splotchy, itchy spots of chickenpox as a child.
No one knows what triggers the dormant virus to rear its head again, although people with a suppressed immune system from chemotherapy or high doses of steroids are more vulnerable. Stress may also activate the hibernating virus, particularly in older adults, who sometimes develop shingles after the death of a spouse or another traumatic event.
The word shingles has nothing to do with roofing or signs, but comes from the Latin and French words meaning “belt” or “girdle.” That’s because the blistery rash generally appears in a band or strip on one side of the body or face. Sometimes the skin tingles, burns, feels numb or itches before the rash appears. And before the rash erupts you may feel generally unwell, with a headache or flu-like symptoms. Shingles does not produce a fever, however.
Having shingles is no joke. Not only can the rash be extremely itchy and painful, but if it occurs on the face, the risk of it spreading to the eye and causing blindness is especially worrisome. Tennis pro James Blake contracted severe shingles on his face following his father’s death in 2004. The infection caused temporary paralysis on one side of his face, affected his balance and blurred his eyesight. He recovered, but the illness sidelined him from the tennis court for months and his ranking dropped.
Shingles is treated with antiviral medication, and generally takes about a month to go away, unless lasting nerve damage occurs. The vaccine to prevent it is given in one shot (brand name Zostavax). Made from weakened varicella-zoster virus, the vaccine reduces the risk of infection by roughly 70 percent, according to the FDA.
Those unlucky enough to develop the infection even after receiving the vaccine will have a shorter, less painful bout of shingles, and are less likely to develop the lingering pain of post-herpetic neuralgia.
I thought I could get a pass on this vaccine because I’d already had shingles. Not so, my doctor told me. You can get it again, and your chances of another bout are roughly the same as contracting it the first time.
If you don’t have health insurance or if your plan will not cover the shingles vaccine, it costs $220 at RiteAid or Walgreens. Although that’s pricey, it seems worth it to avoid a month of pain that made wearing a seat belt excruciating.
