As a teenager, I would try to do things I wasn’t old enough to do: drive a car, watch R-rated movies, go to bars. As an adult, I tried to get vaccinated against shingles when I was in my early 40s, even though the Centers for Disease Control and Prevention (CDC) recommends it for ages 50 and older.
Shingles is a viral infection caused by the varicella zoster virus, which also causes chickenpox. After getting chickenpox, the virus can remain dormant in the body and reactivate as shingles when the immune system weakens. This often happens with age, but the risk is also high in people whose immunity is compromised by chronic disease or medication, including IBD patients. Recent studies suggest that IBD patients be vaccinated at a younger age.
IBD News Today reported last year on the increased risk of shingles in IBD patients. The article cited a Canadian study’s recommendation that “a more proactive policy of vaccinating persons who may soon start biologicals, perhaps even starting at age 40 years, should be considered.”
In 2017, the Department of Medicine at the University of Wisconsin-Madison received a grant to perform research that could support “universal herpes zoster immunization for all IBD patients above the age of 40.”
Earlier this year at the Crohn’s & Colitis Congress, Dr. Marie L. Borum said, “Increased efforts should be made to administer herpes zoster vaccine in all eligible IBD patients, and there should be additional research focused on determining whether IBD patients under 50 years old, especially those on immunosuppressants or biologic therapy, would benefit from herpes zoster vaccination.” She presented study findings that the average age of IBD patients diagnosed with shingles was 37.
In the United States, people can choose between two vaccines: Zostavax and Shingrix. Zostavax was introduced in 2006 and is given in a single dose. Although the Food and Drug Administration approved the vaccine for people 50 and older, the CDC discourages receiving the vaccine until after age 60. Because Zostavax is a live vaccine containing a small amount of the varicella-zoster virus, people with suppressed immune systems should not receive it.
In 2017, Shingrix was approved and is now preferred over Zostavax for those age 50 and older. It’s administered in two doses with a booster shot given two to six months after the first dose. Because Shingrix is a recombinant vaccine, it’s safe for people with weakened immune systems.
I first asked my doctors about getting vaccinated a few years ago when my father, my future father-in-law, and a colleague all got shingles the same year. With my health issues, I was concerned about exposure to the virus. Although shingles isn’t contagious to people immune to chickenpox — which I had as a child — I still worried about the risks.
My gastroenterologist suggested I get vaccinated. However, when I asked my primary care physician for the vaccine, she said my insurance wouldn’t cover the cost because I was not yet 50. With the cost of the vaccination outweighing my concern about getting shingles, I decided to wait.
After my liver transplant in 2017, my risk for shingles increased. The article “Varicella Zoster Virus in Solid Organ Transplantation” in the American Journal of Transplantation reports that shingles is a frequent complication in 8 percent to 11 percent of organ transplant recipients within the first four years of transplantation. I was able to receive the Shingrix vaccine last year at age 45, and insurance covered the full cost.
I got the first dose in October. Shingrix is injected intramuscularly in the upper arm. When the nurse warned me the muscle soreness would be worse than a flu shot, I didn’t know what to expect. The next day, I could barely lift my arm past chest level. I also experienced other side effects, including extreme tiredness and a low-grade fever. I received the vaccine on a Thursday and slept the entire weekend. The muscle pain didn’t disappear until Monday.
Ironically, when I received my booster shot two months later, I experienced the side effects I didn’t get the first time. My arm didn’t hurt as much, and instead of feeling like I had the flu, I had a pounding headache for two days.
Shingrix is more than 90 percent effective in preventing shingles. Protection against the virus remains at more than 85 percent for four years following vaccination. In four years, I’ll be 50, the age when most people get their first shingles shot and colonoscopy. I’m always trying to stay ahead of the curve.
Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to IBD.
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