Shingles Vaccine Has Successful Trial

Should be made available to seniors now, expert says

WEDNESDAY, June 1, 2005 (HealthDay News) -- A new vaccine against shingles prevents the disease in about 51 percent of those vaccinated and dramatically reduces the severity of the condition in those who develop it, a new study shows.

Shingles, also known as herpes zoster, is a painful nerve and skin infection that is caused by the same virus that causes chickenpox. Those who have had chickenpox or were vaccinated against it are at risk of developing shingles later in life. The virus remains dormant within nerve cells in everyone that had chickenpox as a child, and can become reactivated later in life.

Shingles is so common that half of those who live to age 85 will get it. It is estimated that more than 1 million new cases of shingles occur in the United States each year.

Shingles is characterized by pain in one area of skin on one side of the body or face, and a blistering rash. Shingles also has side effects that range from lingering pain to spinal cord infection to stroke.

The trial was conducted under the auspices of the Veterans Administration Cooperative Studies Program and funded by the VA and Merck & Co., Inc., which supplied the vaccine and placebo. The report appears in the June 2 issue of the New England Journal of Medicine.

In this 10-year trial, the number of shingles cases was dramatically reduced, according to study author Dr. Michael N. Oxman, an infectious disease expert from the Veterans Administration San Diego Healthcare System. "In people 60 and older, it cut the occurrence in half," he said. "It also markedly reduced the severity in those who received vaccine and yet developed shingles."

In the trial, called the Shingles Prevention Study, Oxman's team recruited more than 38,500 men and women, aged 60 or older. Half received the vaccine and half were given a placebo. The vaccine is a higher potency version of the chickenpox vaccine given to children. In fact, it's 14 times more powerful, Oxman noted.

During more than three years of follow-up, there were 642 cases of shingles in the placebo group, compared with 315 in the vaccinated group. In addition, among those who developed shingles, pain and discomfort was reduced by 61 percent in the vaccinated people compared with those who took the placebo.

Furthermore, those who received the vaccine and got shingles were only a third as likely to develop postherpetic neuralgia, a form of chronic nerve pain that is the most common serious complication of shingles, compared with those receiving placebo, Oxman reported.

"If you're looking for good ideas in medicine, you're lucky if half of them pan out," Oxman said. "All of us were very gratified and pleasantly surprised at the result of this trial."

Oxman believes these findings show the safety and efficacy of the vaccine. "I don't see why these results wouldn't be accepted," he said. "I would recommend the vaccine for any of my friends, relatives and patients who are 60 or older."

However, Oxman cautioned that those whose immune systems are compromised and those who have had shingles should probably not get this vaccine. And for adults who have not had chickenpox, Oxman recommends vaccination with the children's chickenpox vaccine.

"This is an impressive result," said Dr. Donald H. Gilden, a neurologist from the University of Colorado Health Sciences Center. "I think that any adult who has a history of chickenpox should be vaccinated."

Gilden, the author of an accompanying journal editorial, doesn't think the U.S. Food and Drug Administration should require another trial before approving the vaccine. "Based on the very impressive findings, they ought to market the vaccine. All adults should be getting the vaccine, but the first 200,000 who get it should be followed very closely."

More information

The American Academy of Family Physicians can tell you more about shingles.

SOURCES: Michael N. Oxman, M.D., Veterans Administration San Diego Healthcare System, San Diego; Donald H. Gilden, M.D., University of Colorado Health Sciences Center, Denver; June 2, 2005, New England Journal of Medicine
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