Friday, March 18, 2011
William Schaffner, MD
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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