The Marion County Health Department is now offering the vaccination for shingles.
Zostavax, a single dose vaccination, is recommended to those who are 60 years of
age and above.

Zostavax works by helping your immune system protect you from getting shingles
and the associated pain and other serious complications.  If you do get shingles
even though you have been vaccinated,
Zostavax may help prevent the nerve pain
that can follow shingles in some people.

Zostavax cannot be used to treat shingles once you have it. If you have an outbreak
of shingles, see your health care provider within the first few days of getting the

Due to the cost of this vaccine, those wanting this vaccination are asked to pre-pay a
non-refundable $200.
After the health department receives the vaccine, the clients
will then be contacted to schedule an appointment.

For more information call Shelley Yoder, Director of Nursing, at 548-3878.

What is shingles (herpes zoster)?
Shingles, also called herpes zoster or zoster, is a painful skin rash caused by the varicella zoster virus
(VZV). VZV is the same virus that causes chickenpox. After a person recovers from chickenpox, the
virus stays in the body. Usually the virus does not cause any problems; however, the virus can reappear
years later, causing shingles. Herpes zoster is not caused by the same virus that causes genital herpes, a
sexually transmitted disease.

What does shingles look like?
Shingles usually starts as a rash on one side of the face or body. The rash starts as blisters that scab
after 3 to 5 days. The rash usually clears within 2 to 4 weeks.

Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop.
Other symptoms of shingles can include fever, headache, chills, and upset stomach.

Are there any long-term effects from shingles?
Very rarely, shingles can lead to pneumonia, hearing problems, blindness, brain inflammation
(encephalitis) or death. For about 1 person in 5, severe pain can continue even after the rash clears up.
This pain is called post-herpetic neuralgia. As people get older, they are more likely to develop
post-herpetic neuralgia, and it is more likely to be severe.

How common is shingles in the United States?
In the United States, there are an estimated 1 million cases of shingles each year.

Who gets shingles?
Anyone who has recovered from chickenpox may develop shingles, including children. However,
shingles most commonly occurs in people 50 years old and older. The risk of getting shingles increases
as a person gets older. People who have medical conditions that keep the immune system from working
properly, like cancer, leukemia, lymphoma, and human immunodeficiency virus (HIV), or people who
receive immunosuppressive drugs, such as steroids and drugs given after organ transplantation are also
at greater risk to get shingles.

How often can a person get shingles?
Most commonly, a person has only one episode of shingles in his/her lifetime. Although rare, a second or
even third case of shingles can occur.

Can shingles be spread to others?
Shingles cannot be passed from one person to another. However, the virus that causes shingles, VZV,
can be spread from a person with active shingles to a person who has never had chickenpox through
direct contact with the rash. The person exposed would develop chickenpox, not shingles. The virus is
not spread through sneezing, coughing or casual contact. A person with shingles can spread the disease
when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer
contagious. A person is not infectious before blisters appear or with post-herpetic neuralgia (pain after
the rash is gone).

What can be done to prevent the spread of shingles?
The risk of spreading shingles is low if the rash is covered. People with shingles should keep the rash
covered, not touch or scratch the rash, and wash their hands often to prevent the spread of VZV. Once
the rash has developed crusts, the person is no longer contagious.

Is there a treatment for shingles?
Several medicines, acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir), are available to
treat shingles. These medications should be started as soon as possible after the rash appears and will
help shorten how long the illness lasts and how severe the illness is. Pain medicine may also help with
pain caused by shingles. Call your doctor as soon as possible to discuss treatment options.

Is there a vaccine to prevent shingles?
Yes. Zostavax, made by Merck, was licensed May 25, 2006 by the Food and Drug Administration (FDA)
for use in people 60 years old and older to prevent shingles. Zostavax does not treat shingles or
post-herpetic neuralgia (pain after the rash is gone) once it develops.

How are vaccine recommendations made?
Once a vaccine is licensed by the FDA, the federal Advisory Committee on Immunization Practices
(ACIP) votes on whether to recommend this vaccine, and if so, who should get it and at what ages.
Neither the ACIP nor the federal government makes mandates or laws requiring immunization for adults.
Recommendations made by the ACIP will be reviewed by the Director of CDC and the Department of
Health and Human Services (HHS). Recommendations become official when published in CDC's
Morbidity and Mortality Weekly Report (MMWR).

When will the ACIP provide recommendations
on the FDA-approved vaccine?
The ACIP is meeting on October 25, 2006 to consider recommendations for use of the FDA-approved
vaccine. For more information on the upcoming ACIP meeting, visit

Is the FDA-approved vaccine safe?
The FDA has licensed the vaccine as safe. The vaccine has been tested in about 20,000 people aged 60
years old and older. The most common side effects in people who got the vaccine were redness,
soreness, swelling or itching at the shot site, and headache. CDC, working with the FDA, will continue
to monitor the safety of the vaccine after it is in general use.

How effective is the FDA-approved vaccine?
In a clinical trial involving thousands of adults 60 years old or older, Zostavax prevented shingles in about
half (51%) of the people and post-herpetic neuralgia in 67% of the study participants. While the vaccine
was most effective in people 60-69 years old it also provided some protection for older groups.

Will zoster vaccine be covered by Medicare for Medicare beneficiaries?
While details are evolving, it is anticipated that zoster vaccine will not be covered under Medicare part B
(which covers influenza and pneumococcal polysaccharide vaccine as well as hepatitis B for moderate
and high risk persons). The vaccine will instead be reimbursed through the Medicare Part D program.  
Beneficiaries should contact their Part D plan for more information.  
Shingles Vaccination
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