William Schaffner, MD, is professor of preventive medicine and medicine (infectious diseases) at Vanderbilt University School of Medicine in Nashville, Tenn. Additionally, he serves as a hospital epidemiologist at Vanderbilt University Hospital and is immediate past-president of the National Foundation for Infectious Diseases.

A painful story: Shingles doesn’t have to be like this

Jeffrey I. Cohen, MD, chief of the Laboratory of Infectious Diseases at the National Institute of Health, tells about his father’s bout with shingles and postherpetic neuralgia. For months after the rash resolved, his father was in excruciating, nearly constant pain, unable to sleep and so depressed, he later admitted, that he considered suicide. He saw several physicians, but nothing they prescribed helped. Unable to deal with the pain and continue the active life he had been leading before shingles struck, he retired from a job he loved and never worked again.

This painful story doesn’t need to be repeated. We have a safe, effective zoster vaccine, and it’s recommended for everyone aged 60 and older. Yet, only 10% of the target group has received it, and only 16% even know about it.

That’s another painful story.

The zoster vaccine is a relative newcomer among the adult vaccines; it’s only been available since 2006. Maybe that’s why so few people know about it.

Or is it because physicians aren’t telling their patients because providing the vaccine under Medicare is a hassle and may be expensive? Shame on us! It’s our duty to recommend the best preventive care available and let our patients decide for themselves whether they want to get the vaccine.

The vaccine is not perfect — few things in life are. But, it does cut the rate of shingles by half and the rate of postherpetic neuralgia by two-thirds. Even when the vaccine fails to prevent shingles, it still is helpful, and greatly reduces the duration and severity of the pain.

Who wouldn’t want that?

If you’ve had a family member with shingles, like Dr. Cohen, you know that it takes a toll on the family too. It’s hard to watch a loved one suffer, especially knowing that the debilitating pain could have been prevented.

It’s obvious what we need to do. We need to get the word out to people older than 60, as well as to primary care physicians and geriatric specialists. Yes, we should be aware of cost concerns, but we should let each patient decide if it’s worth it.

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