This vaccine can help your heart
Health experts have long suspected that shingles can lead to an increased risk of heart disease and stroke. And a new study, done by researchers at Brigham and Women’s Hospital in Boston and published in the Journal of the American Heart Association, has found the association between shingles and stroke and coronary heart disease is more significant, and lasts longer than previously thought.
The study involved more than 200,000 adults with no previous history of stroke or heart disease. It found that shingles was associated with up to 38 percent increased risk of stroke and 25 percent increased risk of heart disease. The risk lasted up to 12 years with a peak between five and 12 years.
Researchers believe the risk is due to changes in the blood vessels that occur with shingles, including arterial wall damage and endothelial disfunction that disrupts plaque and changes how blood clots.
Primary care physician Zachary Zanfes, DO, at Fontaine Primary Care said that he was aware of the association and the reasons behind the risk makes sense to him.
“The study’s description of the mechanism of injury, disruption of the endothelial lining of the blood vessels and plaque rupture, makes complete sense,” he said. “When plaque can rupture and clot somewhere else, whether it be in the brain, a coronary artery, or smaller vessel in the heart, that can precipitate a stroke or heart attack.”
The study points to the importance of getting vaccinated against shingles, but Dr. Zanfes said aside from the new risks there is another good reason to get vaccinated, and it’s something he knows from personal experience. He had a bad case of shingles on the back of his head when he was 15 years old.
“Unfortunately, I suffered post-herpetic neuralgia, which can develop after the shingles rash dissipates,” he said. “I had severe pain for months before it slowly went away. In my opinion, the rash and burning sensation that you can get for a week or two is terrible but the post-herpetic neuralgia, the potential long-term nerve pain that you can have for months, was the most debilitating to me — and the vaccine can prevent that.”
Over 90 Percent Effective
Unlike the old vaccine, which was only 50 to 60 percent effective, the new Shingrix vaccine is over 90 percent effective against both shingles and post-herpetic neuralgia, Dr. Zanfes said. Anyone who had chicken pox as a child is at risk to develop shingles. Since the chicken pox vaccine wasn’t available in the United States until 1995, most people over the age of 28 have had chicken pox.
Anyone 50 years or older is eligible for the Shingrix vaccine. It is a two-shot series given two to six months apart. Some patients don’t know or remember if they had the chicken pox as a child. “For patients 50 years and older who do not report a prior episode of chickenpox, there is no need to conduct laboratory testing for serologic evidence of prior chickenpox, before giving the shingles vaccine.”
Shingles is a rash of small blisters that itch and burn and follow a dermatomal pattern along nerve paths. The involvement of nerves is why it is such a painful condition. It’s important to recognize shingles early in the disease progression and seek immediate medical attention. For people who do get shingles, there is an antiviral medication called Valtrex or Valacyclovir.
“The earlier you catch it, the more effective the treatment is,” Dr. Zanfes said. “That’s the most important thing – to recognize a potential issue and to seek treatment as soon as possible.”
The other thing Dr. Zanfes wants patients to know is that if they already got the old shingles vaccine, they can still get the Shingrix vaccine.
“It is recommended that you receive the Shingrix vaccine even if you have previously received the Zostavax vaccine,” he said.
