Be ready to mingle, free of shingles

Shingles is a viral infection of the nerve and surrounding skin, also known as herpes zoster. It is caused by a reactivation of the varicella-zoster virus, the same virus that causes chickenpox.

Some of the symptoms of shingles are similar to the symptoms of chickenpox. They include a high temperature or fever, a headache and a characteristic rash which can be painful or itchy.

While you will usually only get chickenpox once in your life, the virus that causes it remains in your body. If it becomes active again at a later date, it causes shingles rather than chickenpox.

Your risk of getting shingles increases with age and you are more likely to get it if your immune system is weakened, for example due to illness or a medical procedure. While you can’t catch shingles from someone with chicken pox or shingles, you can pass on the chickenpox virus while you’re experiencing a bout of shingles.

The shingles vaccine protects against shingles and effectively reduces your risk of developing the condition. It is possible to develop shingles even if you have had the vaccine. If this happens, your symptoms should be milder and pass quicker as a result of the vaccination. The shingles vaccine is not designed to protect against chickenpox.

The good news is, protection has never been easier. Health Plus Pharmacy make the shingles vaccination convenient and accessible for all the community in Cardiff and Pontypool. Book an appointment with your local Health Plus Pharmacist to keep you safe.

What are shingles?

Shingles is a painful rash that develops on one side of the face or body. The rash consists of blisters that typically scab over in 7 to 10 days and fully clears up within 2 to 4 weeks.

Shingles symptoms

Before the rash appears, people often have pain, itching, or tingling in the area where it will develop. This may happen several days before the rash appears.

Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. Shingles on the face can affect the eye and cause vision loss. In rare cases (usually in people with weakened immune systems), the rash may be more widespread on the body and look similar to a chickenpox rash.

Other symptoms of shingles can include:

• Fever
• Headache
• Chills
• Upset stomach

Shingles risk

It’s estimated that around one in every four people will have at least one episode of shingles during their life.

Most people who get shingles will have it only once. However, you can get the disease more than once.

Your risk of getting shingles increases as you get older. The most common complication of shingles is postherpetic neuralgia (PHN), which is severe pain in the areas where the shingles rash occurred.

About 10 to 18% of people who get shingles will experience PHN. The risk of PHN also increases with age.

Children can get shingles, but it is not common.

Causes of shingles

Shingles is caused by the reactivation of the varicella-zoster virus, which is the virus that causes chickenpox.

After you have had chickenpox, the varicella-zoster virus lies dormant (inactive) inside your body. It can become reactivated at a later stage and cause shingles.

It is not known exactly why the virus is reactivated, but it is linked to having lowered immunity (protection against infection and diseases).

Your immunity to illness and infection can become lowered if there is a problem with your immune system (the body’s natural defence system). This can happen as a result of:

• old age – as you age, your immunity may decrease, and shingles most commonly occurs in people over 70 years old
• physical and emotional stress – the chemicals released by your body when you are stressed can prevent your immune system working properly

• HIV and AIDS – people with HIV are much more likely to get shingles than the rest of the population because their immune system is weak
• recently having a bone marrow transplant – the conditioning you require before the transplant will weaken your immune system
• recently having an organ transplant – you may need to take medication to suppress your immune system so your body accepts the donated organ
• chemotherapy – chemotherapy medication, often used to treat cancer, can temporarily weaken your immune system

However, young people who appear otherwise healthy can also sometimes develop shingles.

Is shingles contagious?

It is not possible to catch shingles from someone else with the condition, or from someone with chickenpox.

However, it is possible for someone who has never had chickenpox to catch it from someone with shingles, as the shingles blisters contains the live virus.

In the UK, chickenpox is so common during childhood that 9 out of 10 adults have already had it and will not be at risk from someone with shingles.

Catching chickenpox

The blisters that develop as a result of shingles contain virus particles. If you have not had chickenpox before, you can catch it from direct contact with the fluid from the blisters of someone who has shingles, or from something that has the fluid on it, such as bed sheets or a towel.

If you have shingles, you are contagious until the last blister has scabbed over. This will usually occur after about 10 to 14 days.someone with shingles.

Preventing the virus spreading

If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.

You should also avoid work or school if your rash is weeping (oozing fluid) and cannot be covered.

Chickenpox can be particularly dangerous for certain groups of people.

If you have shingles, avoid:

• women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
• people who have a weak immune system, such as someone with HIV or AIDS
• babies less than one month old, unless it is your own baby, in which case your baby should have antibodies (proteins that fight infection) to protect them from the virus

Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.

The shingles vaccine is suitable for adults 50 years and above; adults 18 years and above who are at increased risk of shingles; adults who have either had chickenpox or have received the chickenpox vaccine in the past.

If you have neither had chickenpox nor the vaccine, you are not at risk of developing shingles and the vaccine won’t be suitable for you. In this case, you could benefit from the chickenpox vaccine.

You will be unable to have the shingles vaccination if you have had one or more episodes of shingles in the last 12 months.

The vaccine is not suitable for you if you are pregnant or trying for a baby. You need to use contraception for at least 4 weeks after having received the vaccine. The vaccine is not advised for breastfeeding women.

The vaccine also won’t be right for you if you have certain medical conditions or are taking certain medications. This may be the case if you are taking medicines that affect your immune system or if you have recently taken medication for herpes.

The nurse or pharmacist will check your medical history and ensure the vaccine is safe and beneficial for you before administering the injection.

If you are ill on the day of your appointment, you need to reschedule.

About the shingles vaccination

The shingles vaccination we use is called ‘Shingrix’, which is a new adjuvanted, non-live recombinant shingles vaccine. Two doses of Shingrix provides more than 90% protection against shingles and postherpetic neuralgia (PHN), the most common complication of shingles.

You will just need one course of the shingles vaccine. You won’t need any boosters.

Shingrix reminds your body about the virus that causes shingles. This helps your immune system (the body’s natural defences) stay prepared to fight the virus and protect you against shingles and its complications.

How long will the shingles vaccine protect me for?

It’s difficult to be precise, but research suggests the shingles vaccine will protect you for at least 5 years, probably longer.

How the shingles vaccine is given

The shingles vaccine is given as an injection into a muscle (usually in the upper arm).

You will receive 2 injections 2 months apart. If flexibility in the vaccination schedule is necessary, the second dose can be administered between 2 and 6 months after the first dose. Based on your medical condition, your doctor may also recommend that you receive the second injection 1 month after the first injection.

You will be informed when you should come back for the second dose of the shingles vaccination.

Make sure you finish the complete vaccination course. This will maximise the protection offered by the shingles vaccine.

The shingles vaccine can be given if you have already been vaccinated with a live attenuated herpes zoster vaccine. Speak to your doctor or pharmacists for more information.

Side effects of the shingles vaccination

Like all medicines, this vaccine can cause side effects, although not everybody gets them.

Side effects reported during clinical trials with Shingrix:

Very common

(these may occur with more than 1 in 10 doses of the vaccine):

• headache
• stomach and digestive complaints (including nausea, vomiting, diarrhoea and/or stomach pain) • muscle pain (myalgia)
• pain, redness and swelling where the injection is given
• feeling tired, chills, fever

Common

(these may occur with up to 1 in 10 doses of the vaccine):

• itching where the injection is given (pruritus)
• generally feeling unwell

Uncommon

(these may occur with up to 1 in 100 doses of vaccine):

• swollen glands in the neck, armpit or groin
• joint pain

Most of these side effects are mild to moderate in intensity and are not long-lasting.

Immunocompromised adults aged 18-49 years may experience more side effects compared to immunocompromised adults aged ≥ 50 years.

Adults aged 50-69 years may experience more side effects compared to adults aged ≥ 70 years.

Side effects reported after the marketing of Shingrix:

Rare

(these may occur with up to 1 in 1,000 doses of the vaccine)

• allergic reactions including rash, hives (urticaria), swelling of the face, tongue or throat which may cause difficulty in swallowing or breathing (angioedema)