Patients most in need of the vaccine against shingles don't get it

May 13, 2014, British Medical Journal

People at the highest risk of shingles are those with immunosuppressive conditions (such as HIV) but they are not entitled to vaccination due to safety concerns, suggests a paper published in BMJ today.

Researchers say alternative strategies are needed to reduce the risk of among these .

Shingles is a common disease among older individuals which causes an acute painful rash and can lead to a complication (called postherpetic neuralgia) resulting in pain lasting from months to years that can significantly impair a person's quality of life.

Researchers from the London School of Hygiene & Tropical Medicine used data from over 144,000 UK adults diagnosed with shingles between 2000 and 2011, and compared this with a group of patients without shingles, to explore whether patients with certain may be at increased risk of developing shingles.

The median age at shingles diagnosis was found to be 62 years and around 60% of patients were female.

A number of relatively common conditions were associated with an increased risk of shingles. People with rheumatoid arthritis, chronic obstructive pulmonary disease, or inflammatory bowel disease were 30-50% more likely to have a shingles diagnosis, than individuals without these conditions. Other common medical conditions which were associated with a smaller increase in shingles risk were asthma, chronic kidney disease, type 1 diabetes and depression.

Among those with some of these medical conditions the increased risk of shingles appeared to be greater among younger individuals. But because shingles is less common in younger individuals their absolute risk of developing shingles remains low.

A shingles is currently available and licensed among individuals aged over 50. Further research would be required to establish whether vaccination is warranted in patients with these medical conditions, particularly those in younger age groups not currently targeted to receive the vaccine; these individuals are less likely to develop long-term pain and complications from shingles.

However the emphasise that those at the highest risk of shingles remain patients with conditions causing severe immunosuppression (such as HIV and leukaemia); for example patients with HIV were five times as likely to develop shingles compared to individuals without HIV. Such patients are currently not eligible for vaccination due to safety concerns. The researchers therefore say this study highlights the need to identify strategies to reduce the risk of shingles among patients with severe immunosuppression.

Explore further: Stroke risk higher after shingles, but antiviral drugs may provide protection

More information: Paper: Quantification of risk factors for herpes zoster: population based case-control study, BMJ, 2014.

Related Stories

Stroke risk higher after shingles, but antiviral drugs may provide protection

April 3, 2014
Patients' risk of stroke significantly increased following the first signs of shingles, but antiviral drugs appeared to offer some protection, according to a new study in Clinical Infectious Diseases, now available online. ...

Shingles linked to increased risk of stroke in young adults

January 2, 2014
Having shingles may increase the risk of having a stroke years later, according to research published in the January 2, 2014, online issue of Neurology, the medical journal of the American Academy of Neurology.

Why shingles affects mostly people who are middle age and older

February 28, 2014
Shingles is a painful viral infection that affects almost 1 million people worldwide and 30 percent of Americans every year. Known as herpes zoster, it's caused by the same virus that causes chicken pox, the varicella-zoster ...

Shingles vaccine is associated with reduction in both postherpetic neuralgia and herpes zoster

April 9, 2013
Shingles vaccine is associated with reduction in both postherpetic neuralgia and herpes zoster, but uptake in the US is low.

Children with asthma at higher risk for shingles: study

March 5, 2012
(HealthDay) -- Children with asthma have a higher risk for developing shingles -- a painful skin rash -- following infection with the herpes zoster virus, new research reveals.

Study suggests link between untreated depression and response to shingles vaccine

February 14, 2013
Results from a new study published in Clinical Infectious Diseases suggest a link between untreated depression in older adults and decreased effectiveness of the herpes zoster, or shingles, vaccine. Older adults are known ...

Recommended for you

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

New study validates clotting risk factors in chronic kidney disease

January 17, 2018
In late 2017, researchers from Boston University School of Medicine (BUSM) discovered and published (Science Translational Medicine, (9) 417, Nov 2017) a potential treatment target to prevent chronic kidney disease (CKD) ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

Newly-discovered TB blood signal provides early warning for at-risk patients

January 17, 2018
Tuberculosis can be detected in people with HIV infection via a unique blood signal before symptoms appear, according to a new study by researchers from the Crick, Imperial College London and the University of Cape Town.

New study offers insights on genetic indicators of COPD risk

January 16, 2018
Researchers have discovered that genetic variations in the anatomy of the lungs could serve as indicators to help identify people who have low, but stable, lung function early in life, and those who are particularly at risk ...

Previous influenza virus exposures enhance susceptibility in another influenza pandemic

January 16, 2018
While past exposure to influenza A viruses often builds immunity to similar, and sometimes different, strains of the virus, Canadian researchers are calling for more attention to exceptions to that rule.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.