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Why the Elderly Need Vaccination Against Shingles

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Vaccines are an effective preventative means of combating various infectious and non-transmittable diseases. Although they’re most commonly administered to children who haven’t developed immunities to potentially harmful diseases, other population groups also benefit from receiving vaccinations for specific ailments. In particular, elderly individuals may be able to enjoy drastically improved health outlooks after they’re given shingles vaccines.

What Do Vaccinations Do?

Vaccines are injections or oral treatments designed to increase patient immunity to target diseases.[1] When people respond well to such treatments, their immune systems will develop a heightened ability to recognize and fight similar incursions should they occur in the future.

Common vaccines include treatments for various forms of influenza, measles, polio and other diseases that once ravaged larger segments of the global population. Many vaccines are created using killed forms of viral agents that can’t actually infect patients yet include the toxins or surface proteins needed to prompt the immune system to produce antibodies.

What Is Shingles?

Shingles is the common name for a disease that medical science refers to as herpes zoster or simply zoster. This ailment occurs when the virus that causes chickenpox, or varicella, becomes reactivated.

The varicella-zoster virus, or VZV, remains in the body in a dormant state following a chickenpox infection. It’s most commonly located in an area at the base of the spinal column known as the dorsal root ganglia. When VZV exits dormancy later in life, patients experience shingles.

Who’s In Danger?

According to the U.S. Centers for Disease Control and Prevention, shingles can manifest in anyone who has had chickenpox or received a vaccine for it.[2] Although most people only experience it once, it may occur in multiple bouts throughout someone’s lifetime.

What Are the Effects?

Shingles sufferers typically exhibit localized zosters. These are rashes in specific dermatomes, or areas of skin that are supplied by distinct spinal nerves. In most cases, rashes show up on the trunk of the body and remain localized on either the right or left side.

Around one-fifth of individuals exhibit rashes that spread to multiple dermatomes. Such symptoms are more prevalent in those who already possessed weak immune systems before getting shingles.

Diverse Complications and Outcomes

Herpes zoster rashes can cause significant discomfort in the form of tingling, itching or pain. In some cases, patients notice these feelings many days before they actually observe rashes appearing. Headaches, sensitivity to bright lights and general sensations of discomfort have also been observed.

Like many diseases characterized by rashes, shingles often results in the development of transparent blisters or sacs on affected skin. Although these often heal within a few weeks, they might lead to permanent scars and noticeable blemishes.

Lesions and blisters can also become infected by Staphylococcus or Streptococcus bacteria. Some patients suffer nerve palsies, acute eye complications and inflammatory diseases that impact the brain, lungs or other organs.

Why Is Shingles Such a Concern Among Elderly Populations?

The elderly experience a number of factors that heighten the importance of herpes zoster control:
PHN and Serious Pain

The most common negative outcome associated with herpes zoster is known as post-herpetic neuralgia, or PHN. This condition is known for causing lasting pain in the spots where the rash formerly was, and such feelings can sometimes persist for years.

Herpes zoster patients are more likely to develop PHN as they grow older, and the pain they experience can also increase in severity and duration. The CDC says that at least 13 percent of people over the age of 60 who contract shingles also come down with PHN.

High Occurrence Rate

Another important fact to remember is that shingles is highly prevalent among the elderly to begin with. For instance, the CDC estimates that 50 percent of people who reach the age of 85 will develop the disease at some point in their lives. Shingles can also be transmitted by direct contact until the blisters start to harden and crust over, which could increase the risk for elderly individuals whose acquaintances have contracted the disease.

Unclear Causes

It’s also worth noting that scientists are as-yet uncertain what causes VZV reactivation. They do know, however, that some 20 percent of people who had chickenpox will eventually get shingles.[3] While factors like weak immune systems, such as those found in cancer and HIV patients, stress and physical trauma are all believed to contribute, being elderly is a well-established risk factor.

Why Vaccines Matter for Shingles Sufferers

There is no cure for herpes zoster. Although pain medicines and antiviral medications can help lessen some of the discomforts of the disease and shorten its duration, they may not always control complications. In one case, a 70-year-old PHN sufferer tried numerous remedies including morphine, codeine, acupuncture, epidural anesthetics, steroids and even electrical nerve stimulation over the course of five years with little beneficial effect.[4]

Widespread Evidence Promotes Vaccine Efficacy

The CDC and other authorities claim that vaccination is the only effective way to reduce herpes zoster risk. This medical opinion seems to be generally accepted in many nations. In September 2013, the U.K. even began providing vaccines for its citizens who were above the age of 70.[5]

Vaccines May Be More Manageable Than Other Treatments

Advocates of such programs also note the fact that in addition to being effective, vaccines can reduce care costs. For elderly patients with limited income or existing fiscal burdens related to healthcare, not having to pay for ongoing shingles treatment may be highly beneficial.

The U.S. Department of Health and Human Services recommends herpes zoster vaccination for anyone above the age of 60.[6] Although the efficacy of this vaccine decreases five years following administration, it’s available as a one-time treatment. Those seeking to minimize the amount of healthcare procedures they have to go through could find it advantageous to get vaccinated before they develop other problems that make their immune systems more vulnerable.

Unlike pain treatment or topical irritation management, shingles vaccines have been shown to be effective in patients who already recovered from a first bout of the disease. In addition, people can derive benefits from vaccination at any age over 60, making it a less-complicated option than many alternatives.
Being Elderly Introduces Extra Factors

Finally, aging populations are at a higher risk for a range of other diseases. True, modern doctors can easily distinguish shingles from ailments with similar symptoms and confirm their diagnoses via testing. Still, catching the disease as early as possible is vital.

For instance, many pain remedies are less effective after an infection has set in. Complications such as PHN may also be more likely under these circumstances. Elderly individuals who already suffer from other painful conditions may be unaware they need to seek additional diagnostic treatment.

As recently as 2013, international scientists said that vaccines were critically underutilized in some elderly populations.[7] People of African descent in the United States and those with lower incomes were noted for receiving vaccines at significantly lower rates than their incidence of shingles would ideally merit. The same held true for other elderly groups, albeit to a lesser extent.

With so much at risk, access to shingles vaccines is a critical factor for elderly individuals. The potential complications, economic burdens and serious discomfort associated with this disease make the takeaways clear. Countries and healthcare providers alike should take action to spread vaccine awareness and improve administration.

Sources:
[1] Vaccines. (n.d.). Retrieved May 27, 2016, from http://www.who.int/topics/vaccines/en/
[2] Clinical Overview. (2014). Retrieved May 27, 2016, from http://www.cdc.gov/shingles/hcp/clinical-overview.html
[3]Skin Conditions: Shingles. (n.d.). Retrieved May 27, 2016, from http://www.webmd.com/skin-problems-and-treatments/shingles/shingles-skin
[4] Schmader, K. (1999). Herpes Zoster in the Elderly: Issues Related to Geriatrics. Clinical Infectious Diseases CLIN INFECT DIS, 28(4), 736-739. doi:10.1086/515205. Retrieved May 26, 2016 from http://cid.oxfordjournals.org/content/28/4/736.long
[5] Roberts, M. (2013, April 30). Shingles vaccine to be routine for people in their 70s. Retrieved May 27, 2016, from http://www.bbc.co.uk/news/health-22335511
[6] Shingles (Herpes Zoster). (n.d.). Retrieved May 27, 2016, from http://www.vaccines.gov/diseases/shingles/index.html
[7] Langan, S. M., Smeeth, L., Margolis, D. J., & Thomas, S. L. (2013). Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study. PLoS Med PLoS Medicine, 10(4). doi:10.1371/journal.pmed.1001420. Retrieved May 27, 2016, from http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001420

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