Recently we’ve received many questions about whether to get the shingles (herpes zoster) vaccine. As always, the issue is not as black and white as some would have us believe, so here we discuss what you may not read in the mainstream about the shingles vaccine.
The US Centers for Disease Control and Prevention (CDC) recommends that anyone over the age of 60 receive the shingles vaccine manufactured by vaccine giant Merck. CDC also says that the shingles vaccine is only 51% effective in all those over 60 years of age but this effectiveness, or efficacy, falls to 38% in those over 70.1
So what are the facts around the shingles vaccine?
1) The shingles vaccine is essentially a souped up chicken pox vaccine. The shingles vaccine is made using the same strain of weakened chicken pox used in the pediatric chicken pox vaccine but the shingles vaccine contains at least 14 times as much chicken pox antigen.2
2) Shingles is a live virus vaccine and transmission of shingles from vaccine recipients to susceptible individuals has been documented.3
3) Shingles vaccine contains: aborted fetal tissue, pig gelatin, MSG, bovine calf serum, antibiotics, and more.4
4) Adverse reactions to shingles vaccine include: headache, anaphylaxis, pain in the extremities, pain, erythema (redness of the skin), pruritus (itching), swelling, and chicken pox-like rash at injection site5. In one studied mentioned on the package insert, these reactions were not infrequent with 53.9% of the vaccine group reporting pain, 48.1% reporting erythema, and 40% reporting swelling.6
5) Any immunity induced by the vaccine is not permanent. According to CDC research shows the vaccine lasts 6 years.7
6) Merck and CDC both claim that the vaccine is 51% effective, i.e. that the vaccine reduces an individual’s risk of contracting shingles by 50%. While that 50% reduction sounds impressive, how do they arrive at that figure? The study looked at 19, 254 patients and found that 642 (3.3%)of the placebo or control group developed shingles whereas only 315 (1.6%) of the vaccinated group developed shingles. So while it is true that 1.6% is indeed half or 51% less than 3.3% a more telling way to interpret the numbers would be according to absolute risk. If you aren’t vaccinated for shingles your risk of contracting shingles in the study was 3.3% and the risk of developing shingles in the vaccinated groups was 1.6%. The improvement in risk of developing shingles from being vaccinated is therefore only 1.7% (3.3%-1.6%)!8 Not quite so impressive as the 50% reduction claimed!
7) The biggest concern with shingles is the post-herpetic neuralgia (PHN) or nerve pain that can persist after one has developed shingles. This can be very painful and very debilitating so it is understandable that folks would want to protect against PNH but what do the data say on this front? Merck claims that the vaccine reduces one’s risk of developing PNH by 35%. That said, in the data reported on the package insert, Merck reports that 80 of the control group developed PNH whereas 27 of the vaccinated group developed PNH out of a total of 19,254 patients. So .415% of the control group developed PNH compared to .14% of the vaccinated group and yes .14% is 34% less than .415% but the absolute chances of developing PNH are improved only .275% by being vaccinated. That doesn’t seem very effective to me. Can you imagine being charged for a car repair that only improved your chances of getting back on the road by .275%? I don’t think that car mechanic would be in business for very long!
As always, vaccine choices are personal choices so we aim to provide you with all the information you need to make an informed choice for yourself. You can read more about this and other issues in our Catalogue of Science.
If you hear that the vaccine is 51% effective that sounds kind of good, especially if you believe that it’s safe so you think, “Hey, might as well get it!”
But if you think about it in these terms it doesn’t sound as good:
Without the vaccine 96.7% of people won’t get shingles.
With the vaccine 98.4% of people won’t get shingles.
Without the vaccine 99.6% of people won’t get PHN.
With the vaccine 99.9% of people won’t get PHN.
That doesn’t seem as impressive. And a little skepticism about the tracking/reporting/understanding of adverse reactions to vaccines tips the risk/benefit balance a little further towards questioning this vaccine’s usefulness.
Although as the chicken pox vax continues to reduce our natural exposures the shingles rate may continue to increase.
Not only will the shingles rate continue to increase, a development predicted by several researchers Brisson et al, but it is more dangerous and results in more deaths than chicken pox did. So we have exchanged a pretty benign childhood disease for a much more problematic one in old age. But at the same time vaccine maker Merck makes off twice with a vaccine for children and then a vaccine for adults that was never needed before.
I was thinking that actually those 96% to 99% numbers are for the percentage of people who did not come down with shingles during the study period – not over the course of years. So the rate might be lower over the course of a few years.
If you catch shingles early isn’t there a medication that speeds recovery?
The shingles vaccine gave me shingles:
I had the singles vaccine (shot) at my doctors office on Tuesday morning Dec. 24, 2013. During the night of Dec. 29 ( 5 days later) I woke with itching on my torso and then went back to sleep. The next morning Dec. 30 I noticed a large area of blotchy raised red rash across my right front torso and across my right back almost to the spine. I called my doctor and was given an appointment that afternoon. The Doctor was shocked. He said I had shingles. He prescribed 7 days 3x daily of Valacyclovir 1GM tablets. He thinks since we got on top of it so early that it should last only about 2weeks. – Dec. 31 effected area has increases and much of area is now blistered – Jan 1, 2014 now I have a low grade fever and have been keeping calamine lotion on the rash & blisters. I have also been having a ear ache in my right ear ( I hope this is not related to the shingles).
I had been thinking about getting the vaccine for many years, and now that I did – the vaccine gave me singles!!!! I’m praying this isn’t the start of bigger problems singles can cause. I’m worried and concerned, but hoping for the best. (I am 65 yr. old female who is good health and take no prescription medicine).