Shingles and Chickenpox (Varicella-Zoster Virus) - Diagnosis

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Children most at risk for having chickenpox after having been vaccinated only one time are ages 8 - 12 years and have generally been vaccinated at least 5 years before their current chickenpox infection.

Recommendations for the Chickenpox Vaccine in Adults

The U.S. Centers for Disease Control and Prevention (CDC) recommends that every healthy adult without a known history of chickenpox be vaccinated. Adults should receive 2 doses of the vaccine, 4 - 8 weeks apart. Adults in the following groups should especially consider vaccination:

• Those with high risk of exposure or transmission (hospital or day care workers, parents of young children)
• People who may come in contact with those who have compromised immune systems
• Nonpregnant women of childbearing age
• International travelers

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As with other live-virus vaccines, the chickenpox vaccine is not recommended for:

• Women who are pregnant or who may become pregnant within 30 days of vaccination. (Women who are pregnant and not immunized should receive the first dose of the vaccine upon completion of their pregnancy.)
• People whose immune systems are compromised by disease or drugs (such as after organ transplantation).

Patients who cannot be vaccinated but who are exposed to chickenpox receive immune globulin antibodies against varicella virus. This helps prevent complications of the disease if they become infected.

Side Effects. Most side effects are mild and include pain at the injection site and low-grade fever. In rare cases, the vaccine may produce a mild rash within about a month of the vaccination, which can transmit chickenpox to others. Individuals who have recently been vaccinated should avoid close contact with anyone who might be susceptible to severe complications from chickenpox until the risk for a rash passes.

Shingles Vaccine

The herpes zoster (shingles) vaccine (Zostavax) is a stronger version of the chickenpox vaccine. It was originally approved in 2006 for adults age 60 years and older. In March 2011, the FDA lowered the recommended age for Zostavax to 50. Because the vaccine contains live virus, it cannot be administered to people with weakened immune systems.

A single shot of the vaccine can reduce the risk of developing shingles by 55 - 70 percent and may also help prevent postherpetic neuralgia and ophthalmic herpes. However, although the shingles vaccine is strongly recommended for older adults with healthy immune systems, many patients are not receiving it. Barriers to vaccination may include limited insurance coverage and the sometimes limited availability of the vaccine product.