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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Shingles Despite Taking Shingles Shot?

I am 79 years of age and have the Shingles on the front left side of my body. I had the shingle shot several years ago? Is it unusual after having the shot to have shingles and since it appears on my left front side that I would have tingling pains in my left are? What is the recovery period?
Fri, 5 Aug 2016
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General & Family Physician 's  Response
Shingles is characterized by a painful skin rash with blisters involving a localized area. It is caused by varicella zoster virus. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. Shingles occurs when viral antibody titer and cellular immunity decline to levels that allow viral reactivation. Predisposing factors are old age, immune-compromised patients such as HIV infection, patients on chronic steroid and chemotherapy. Shingles resolves within 3–5 weeks, but secondary bacterial infection and chronic pain due to post – herpetic neuralgia may occur. High potency live attenuated VZV vaccine (Zostavax) is available and it reduce the risk of getting shingles in individuals 50 years of age and older. Vaccination reduces the frequency of post – herpetic neuralgia. Duration of recovery from post – herpetic neuralgia is uncertain and variable.
Advice
1.     You can take Zostavax vaccine as your age is 79 years under medical supervision
2.     For fresh attack, you can take valaciclovir 500 mg three times daily per oral if blisters are covering large area. No need of oral valaciclovir if blisters are localized to smaller area
3.     You can also apply locally aciclovir 3% ointment five time daily for all types of shingles
4.     For post – herpetic neuralgia, you can take gabapentin 100 mg three times daily
5.     Do not take mental stress as it aggravates shingles
Thanks
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What Causes Shingles Despite Taking Shingles Shot?

Shingles is characterized by a painful skin rash with blisters involving a localized area. It is caused by varicella zoster virus. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. Shingles occurs when viral antibody titer and cellular immunity decline to levels that allow viral reactivation. Predisposing factors are old age, immune-compromised patients such as HIV infection, patients on chronic steroid and chemotherapy. Shingles resolves within 3–5 weeks, but secondary bacterial infection and chronic pain due to post – herpetic neuralgia may occur. High potency live attenuated VZV vaccine (Zostavax) is available and it reduce the risk of getting shingles in individuals 50 years of age and older. Vaccination reduces the frequency of post – herpetic neuralgia. Duration of recovery from post – herpetic neuralgia is uncertain and variable. Advice 1. You can take Zostavax vaccine as your age is 79 years under medical supervision 2. For fresh attack, you can take valaciclovir 500 mg three times daily per oral if blisters are covering large area. No need of oral valaciclovir if blisters are localized to smaller area 3. You can also apply locally aciclovir 3% ointment five time daily for all types of shingles 4. For post – herpetic neuralgia, you can take gabapentin 100 mg three times daily 5. Do not take mental stress as it aggravates shingles Thanks