Stansberry Research

Special Q&A Edition: Answering Your Shingles Questions

Dr. David EifrigHealth and Wealth Bulletin

It's one of the worst pains any of us could ever experience... And a third of us are at risk.

So we're not surprised so many of you have been sending us questions about this debilitating illness... shingles.

Last month, we shared some of the basics you need to know about shingles, including how to determine your risk, the dangers the virus poses to your heart, and why it's important for older folks to get the vaccine.

Since then, there's been big news... If you have Medicare Part D, your shingles vaccine is free. (Prior to this, the cost of the shot was more than $200.)

So today, we're sending you this special Q&A about both shingles and its vaccine...

Q: Isn't getting the shingles vaccine more dangerous than having shingles? – R.N.

A: The Shingrix vaccine, approved by the U.S. Food and Drug Administration in 2017, contains an inactivated form of the virus. It's essentially a "dead" virus. Your body reacts to the dead virus, mounts a less-severe reaction, and creates antibodies. In rare cases, folks can have a more serious reaction, like developing blisters (something another reader shared with us some time ago).

In a five-and-a-half-year study of more than 38,500 adults across 22 sites in the U.S. Department of Veterans Affairs system, most folks reported only mild side effects: redness, swelling, pain, and irritation at the site of injection. Otherwise, this vaccine appears to be quite safe, and it reduces the pain and occurrence of the disease by at least 50%.

And while a few participants also developed pneumonia and atrial fibrillation after taking the shingles vaccine, around the same number of folks experienced these conditions after taking a placebo.

On the other hand, as we mentioned last month, a full-blown shingles infection can lead to severe cardiac responses, including heart attack. According to a study from Brigham and Women's Hospital, there's a 38% greater risk of having a stroke for the first time among folks who had shingles compared with those who never had shingles. And the risk of coronary heart disease was 25% greater. Even after 12 years, there was still a significant risk of a cardiovascular event.

If you're worried about potential side effects and your individual risk, or if you already have heart issues, talk to your doctor before you decide to get the vaccine.

Q: Do I need the shingles vaccine if I haven't had chickenpox? – S.V.

A: Lots of people think that if they haven't had chickenpox, they're safe from shingles. That's because shingles is derived from the chickenpox virus, which stays dormant inside folks who've had chickenpox or been vaccinated against it.

However, if you come in contact with someone with active shingles, you could contract chickenpox. Adult chickenpox is much worse than getting the virus as a child, and it's potentially fatal.

Generally speaking, although it's most important for folks who've had chickenpox, everyone over the age of 50 should get the shingles vaccine. The vaccine clearly cuts down on both the pain and the actual occurrence of the disease.

Q: Hey Doc... I don't remember if I had chickenpox as a kid (that was a long time ago!). Is there a way to find out? – A.B.

A: Your doctor can recommend a viral test to see if you have antibodies to the chickenpox virus. If you had chickenpox, or received the vaccine, your body will have these chickenpox-specific antibodies. If you were never exposed, you won't have any antibodies. If you don't have these antibodies, be very careful around children with chickenpox and around open blisters on shingles patients – you can contract chickenpox through both of these forms.

And as we said before... getting chickenpox as an adult is much worse than getting it as a child. Side effects like pneumonia complicate the disease in adults, and recovery isn't as fast. In fact, adults are 25 times more likely to die from chickenpox than children. The good news is that about 90% of adults today have had chickenpox, even if they don't remember it. If you want to be sure, ask for a viral test.

Q: I've already had shingles. Can I get it again? – M.F.

A: Unfortunately, shingles can strike twice. The chance of recurrence is about 4.5% in patients younger than 50. But the risk increases to nearly 6% for folks 50 and older. And if you have a weak immune system, or you experience a stressful event, your risk of another case of shingles rises even more.

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team

January 19, 2023