A Shingles Vaccine

By Christine Gorman

If you've ever had shingles--a blistering rash that plagues about 1 million Americans each year, most of them elderly--chances are you know how devastating it can be. And if you've never had shingles--well, just wait. Shingles is caused by the same virus that causes chicken pox--a nasty little bundle of DNA that lies dormant in sensory nerves for decades after the initial infection until, for reasons that are still unclear, it is reawakened. Anyone who has ever had chicken pox is at risk of developing shingles, as well as the nerve damage that often accompanies the rash.

That's why there was so much interest last week in a New England Journal of Medicine report on an experimental vaccine that cuts the risk of shingles--and its painful side effects--by more than half. Like the chicken pox inoculation that is given to children, the new vaccine contains a weakened form of the chicken pox virus. The adult version, though, is 20 times more powerful than the pediatric one because it's working to boost the immune response in bodies where the virus has already taken hold. (Children who are vaccinated against chicken pox still get shingles, but at a lower rate.)

The new vaccine, which was tested in an unusually large study--sponsored by the Department of Veterans Affairs--of 38,500 adults 60 and older, still needs to be approved by the Food and Drug Administration. Even if it is approved, if you've already had shingles, the vaccine probably won't help you.

In the meantime, there are antiviral medicines for treatment of the symptoms, provided the condition is caught early enough. Pain often precedes the rash by a couple of days and can be mistaken for a heart attack or gallstone problem. Unfortunately, nerve pain is difficult to treat and can lead to permanent disability--another reason why a shingles vaccine would be such a blessing.