Benefit of the Shingles Vaccine After an Outbreak

Summary: If you’ve had shingles once already your chances of getting another outbreak go down because you have some natural immunity and antibodies.  However, many doctors will recommend you get the shingles vaccine anyways.  Here are some other points to consider and discuss with your doctor if you’ve already had shingles and are considering the vaccine.

Dear Curtis: My mom had a shingles outbreak recently.  It wasn’t as bad as her first one, but it was still bad enough.  Can she get the shingles vaccine and, more importantly, should she get it?  Would it be of benefit to her?

I’m actually surprised that your mom had two outbreaks of shingles.  That’s pretty rare.  Of course, the trouble is in predicting whether she’s at risk for getting another outbreak.  I really don’t know.  Also, I don’t have your mom’s age which confounds the matter even more.

First and foremost, she needs to consult with her doctor.  Different doctors will take different approaches with the shingles vaccine.  But, we give the shingles vaccine to give people immunity and help them build antibodies against shingles.  Because your mom has already had shingles, twice, she definitely has antibodies to it.  Which probably explains why her second outbreak wasn’t nearly as bad as the first.

In that vein, I don’t know how much value the shingles vaccine would be to her as she has already developed naturally immunity.  However, I don’t know whether or not the vaccine wouldn’t actually help her here too.  And frankly, I don’t think you’re going to get a cut and dried answer here.

But, I can give you and your mom some points to consider that she can bring to her doctor and discuss.

  • Does she have prescription insurance that will cover the Zostavax vaccine?  Too many patients automatically assume that Medicare D plans will cover the whole cost – they don’t.  I’ve seen a lot of copays come in high.  The cash cost of a vaccine right now in my area is just a bit under $200.  That gives your mom a number to go off of as far as risk vs. reward.
  • How old is your mom?  In studies, the older the patients the less effective the vaccine became.  That’s one of the reasons why they suggest getting the vaccine as soon as you hit the 60 year old mark.  It’s much more effective.  Effectiveness drops off substantially in the eighties and beyond.
  • Opinions vary: some doctors will recommend it no matter if she’s had outbreaks in the past or not.  And, there’s nothing saying this is wrong.  In fact, the official recommendations are that even if a patient has had a shingles outbreak before they should still get the vaccine.  But, here’s something to consider, the patient should wait two years before getting the vaccine from their last shingles outbreak.  From the sound of your question it seems that the last shingles outbreak for you mom was fairly recently so you’re going to be waiting irregardless.

As always, this is something your mom needs to discuss with her doctor.  From all the post-marketing data I’ve seen the shingles vaccine has been well tolerated.  So, if you’re mom is outside of the two year window from her last shingles outbreak her doctor may opt to go for it and it might be advantageous to her.

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