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Vaccine needed, even after shingles

I am a 78-year-old woman. I had chicken pox when I was 8 years old. I had shingles when I was 57 and also at 60. Do I need to have a shingles shot?

The short answer is yes. Zostavax is the vaccine given to older adults to prevent shingles. Shingles is a painful, blistery rash caused by the reactivation of the same virus that causes chicken pox. If you have been exposed to or had chicken pox as a child, you would be at risk for getting shingles.

According to the Centers for Disease Control, about one-third of the U.S. population will get shingles. Of those who do, about one-third will have serious complications like persistent nerve pain or visual and hearing impairment. The risk of getting shingles increases after age 50, although it can happen at any age.

The Federal Drug Administration has approved Zostavax for all adults age 50 or older. Its effectiveness appears to decline with age, because of waning immune responses in older adults.

Overall response rates reveal a decrease in the incidence of shingles by 50 percent. From age 70 to 79, it was 40 percent less common as compared with a placebo, but the decrease in chronic nerve pain was better at 67 percent. The duration of effectiveness is not known, but patients have maintained immunity after being followed for four years.

If you already had a case of shingles recently, your own natural immunity has been boosted, and the vaccine will not improve it further. I would recommend getting Zostavax two to three years after the natural case of shingles, although I have heard you can wait up to five years.

Zostavax is more expensive than other adult vaccines, so check with your insurance first to see whether it is a covered benefit.

Dr. Lenora Hirschler is a family medicine physician with Parkview Physicians Group in Ligonier. “Ask the Doctor” is a health column by doctors from Parkview Physicians Group. Send questions to Terri Richardson at The Journal Gazette, 600 W. Main St., Fort Wayne, IN 46802, or email Please put “Ask the Doctor” for the subject line.