Shingles is a painful condition suffered by approximately 5 out of every 1000 patient over the age of 50 years old.^1,2  It is caused by the same virus that causes chicken pox. Typically, after once experiences chicken pox, the virus lies dormant in the body. Sometimes, it reoccurs later in life as the condition known as shingles.

Shingles is caused when this virus infects the central nervous system. This condition is characterized by painful, bumpy, fluid-filled bumps on the body.  This condition usually affects people over 50 years old.  For those patients who are prone to shingles outbreaks, a new vaccine is available. The vaccine is called Zostavax® and it is covered by many Medicare Part D programs.  The vaccine was approved by the FDA in October 2006. Although not finalized, the Centers for Disease Control (CDC) is expected to recommend that all people over the age of 60 years old receive the vaccine, including those that have a history of prior outbreaks.

What about people younger than 60 who have a history of outbreaks? Outbreaks in this population are generally less severe, but still contribute to lost production at work. Despite this evidence, the drug is not currently indicated for patients younger than 60 years of age³ This may change in the future, but for now, may affect reimbursement for the vaccine by insurance companies for individuals less than 60. 

Author: Christi Larson, Pharm. D.

REFERENCES:

1. Gilden DH. Herpes xoster with postherpetic neuralgia—persisting pain and frustration. N Engl J Med. 1994;330:932-934.

    

2. mamdani FS. Pharmacologic management of herpes zoster and postherpetic neuralgia. Can Fam Physician. Q1994;40:321-326, 329-332.

    

3. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices. June 29-30, 2006 . Record of the proceedings. http://www.cdc.gov/nip/ACIP/minutes/acip-min-jun06.pdf. (Accessed December 20, 2006).