Immunization Experts Recommend 'Shingles' Vaccination

The ACIP to the Centers for Disease Control and Prevention (CDC) voted Wednesday, October 25, 2006, to recommend a newly licensed zoster vaccine, Zostavax manufactured by Merck, to protect against shingles be given to all people age 60 and older, including those who have had a previous episode of shingles.

"Vaccines aren't just for kids anymore -- and this vaccine represents an important medical breakthrough aimed at improving health in older people," said Dr. Anne Schuchat, Assistant Surgeon General and director of CDC's National Center for Immunizations and Respiratory Diseases. "These vaccine recommendations address a health problem for people age 60 and older. It has been tested and has been found to be safe and effective in providing protection against shingles and associated chronic pain."

Zostavax, the only zoster vaccine on the market, was studied in approximately 38,000 individuals throughout the United States who were age 60 years and older. Half received the vaccine and half received a placebo. Study participants were followed for an average of three years to see if they developed shingles and, if they did, how long the pain lasted. Zostavax reduced the occurrence of shingles by about 50 percent and post herpetic neuralgia (pain persisting after an episode of shingles) by 67 percent.

While the ability for the vaccine to prevent shingles declined with age, the risk of chronic pain among those older vaccinated persons who still developed shingles was lowered. The most common reported side effects in vaccine recipients were mild, such as reactions at the injection site and headache.

Varicella zoster virus (VZV) causes varicella, or chickenpox and becomes dormant within the nerves following exposure or a case of chickenpox. It can reactivate later in life to cause shingles. About 25% of people develop zoster during their lifetime, and there are about one million cases of shingles per year. The risk is highest in the elderly, and it increases with age starting at around 50 years. Shingles often causes chronic pain, and the risk of suffering chronic pain increases with age, starting at 60 years. Shingles is much less contagious than chickenpox.

The ACIP, consisting of 15 members appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP become CDC policy when they are accepted by the director of CDC and are published in CDC's Morbidity and Mortality Weekly Report (MMWR).