Costly shingles vaccine may be worth it to older adults

Price might range from about $200 to $300

Retired restauranteur Benno Steinborn, of Royal Oak, Mich., went through seven years of unrelenting pain in his arm and shoulder after a shingles infection. A morphine patch has helped him after many other methods failed.

The discomfort from chickenpox has probably long faded from the minds of adults who had what's generally considered a childhood disease.

But those memories might come back to anyone who learns that the virus can lay dormant in the body and years later cause a painful case of the shingles. Recalling how miserable they were might prompt some people to get the shingles vaccine, which is a good idea, according to health officials.

The cost of the vaccine can range from about $200 to $300, which is undoubtedly prohibitive for some people, said Dr. David Grossman, health commissioner for the Toledo-Lucas County Health Department. But he said that amount could be little compared to the pain that some shingles patients experience even after the rash has dried up.

"The treatment of that pain is very difficult and it could be expensive itself and it's not always guaranteed," Dr. Grossman said. "When [the rash] is gone, you are left sometimes with the possibility of severe and long-term pain because the disease affects the nerve root."

Adults who remember how miserable they were as children with chickenpox might want to do all they can to avoid getting shingles as adults.

"Sometimes people don't want a T-shirt on because the rash is very painful," said Dr. Janice Bright, an emergency room doctor at Flower and Toledo hospitals. Her group of doctors, Emergency Physicians of Northwest Ohio, also travel to Fostoria and Lima. "You can continue to have pain after the rash and all the symptoms are gone; that's called post herpetic neuralgia. So people can get severe pain in that same area for years after."

Like chickenpox, shingles is caused by the Varicella virus, which also is called Herpes Zoster, or simply Zoster, according to the Centers for Disease Control and Prevention.

While CDC information about shingles states that one person cannot get shingles from another, it issues this warning: "However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles. This is not very common."

And while the CDC acknowledges that shingles is common in people age 50 and older, it recommends that anyone age 60 and older be immunized. That seems confusing, which is why the age for immunization could be lowered, Dr. Grossman said.

"Though it's not a reportable disease, it's not an infrequent occurrence. You see shingles a fair amount. It's not a rare disease. It's more prevalent as you get older," he said. And 60 is the recommended age for the shingles vaccination because it occurs more frequently in that age group.

Though health officials don't know exactly what causes the virus to become active, a weakened immune system could be one suspect.

The CDC says that annually at least 1 million people are diagnosed with shingles. Dr. Bright said patients should ask their doctors about the vaccine. She explained that symptoms can occur in multiple stages.

"People may feel like they have the flu, a headache, itching, or tingling or pain in a certain area and a rash will occur a few days after the first symptoms," she said. "The rash is only ever on one half of the body. It will never cross the midline of the body. It doesn't cross because it only attacks one single nerve area and it only wraps around half of the body and it would be a separate nerve that wraps around the other half of the body."

The rash looks like a cluster of red, painful blisters that can last from two to four weeks. That time can be shorter in some and longer in others.

Upon noticing a suspicious rash, promptly seek medical attention. Antiviral medication is prescribed, and besides pain medication and keeping the rash area clean to reduce chances of an infection, there apparently is no cream or other treatment for it.

Dr. Bright said many unfortunately don't get the vaccine.

"Sometimes people are scared because they fear it will make the disease happen or they will have bad side effects," she said. Or, they may "not be aware that it's out there and that they need it."

There can be risks from the vaccine just as there can be from any medical procedure, she said. Some patients experience a mild headache afterward or such side effects as redness, swelling, and pain at the injection site.

Though the CDC says serious problems have not been associated with the vaccine, Dr. Bright adds that "anybody can get an allergic reaction, but it's worth getting the vaccine."

Contact Rose Russell at: rrussell@theblade.com or 419-724-6178.