One out of three adults aged 50 years or older is at risk of contracting shingles (herpes zoster). After an individual recovers from chickenpox (which they usually caught as a child), the varicella-zoster virus which causes chickenpox continues to live in some of their nerve cells. People get shingles when the varicella-zoster virus reactivates in their bodies after they have already had chickenpox.
Shingles usually develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline. Common symptoms include fluid-filled blisters; burning, shooting pain; tingling, itching, or numbness of the skin; and chills, fever, headache, or upset stomach.
For some people, the symptoms of shingles are mild, such as itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze.
If you notice blisters on your face, see your doctor right away because this is an urgent problem, warns the US National Institute on Aging (NIA). Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain (encephalitis) can also occur.
Most cases of shingles can be diagnosed by a doctor from a visual examination. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain.
Most cases of shingles last three to five weeks. After the shingles rash goes away, some people may be left with ongoing pain called postherpetic neuralgia (PHN). The pain is felt in the area where the rash occurred. The older a person is when they get shingles, the greater their chances of developing PHN.
The PHN pain can cause depression, anxiety, sleeplessness, and weight loss. Some people with PHN find it hard to go about their daily activities, such as dressing, cooking, and eating. Consult your doctor if you are experiencing PHN or have any of these symptoms. Usually, PHN will lessen over time.
Shingles vaccination is the only way to protect yourself against this painful disease, according to the US Centers for Disease Control and Prevention (CDC). Vaccination is over 90% effective at preventing shingles and PHN in adults 50 years and older with healthy immune systems.
The CDC recommends two doses of recombinant zoster vaccine to prevent shingles and related complications in adults 50 years and older. The CDC also recommends the recombinant zoster vaccine for adults 19 years and older who have weakened immune systems because of disease or therapy.
Doctors from various specialties across the country, particularly geriatricians and dermatologists, see many cases of shingles with PHN as the most common complication, revealed a paper by Panaligan et al.
The paper was published in the August 2023 issue of the international monthly peer-reviewed medical journal Human Vaccines & Immunotherapeutics. It presented the insights and recommendations of two multispecialty advisory boards participated in by specialists in adult infectious diseases, dermatology, geriatrics, obstetrics-gynecology, pulmonology, endocrinology, neurology, hematology, medical oncology, rheumatology, transplant surgery, and nephrology.
The specialists noted that shingles imposes a heavy socioeconomic burden on patients in terms of the high cost of antiviral treatment and distress due to pain. Moreover, antiviral medicines do not prevent shingles complications such as PHN. Shingles may also complicate the treatment of ongoing conditions, they added.
The specialists agreed that the introduction of the recombinant zoster vaccine, which has received regulatory approval from the Philippine Food and Drug Administration, could help in the prevention of shingles.
To address low disease awareness, the specialists recommended stepping up education on the burden of shingles and benefits of vaccination through patient advocacy groups, social media, and the dissemination of infographics. They underscored the importance of educating local healthcare professionals (HCPs) on shingles vaccination guidelines, efficacy, and vaccinology principles to improve confidence in making strong recommendations for shingles vaccination.
Capacity building and increased support for shingles immunization infrastructure is also crucial for enabling HCPs to start vaccination in their practice. With an improved infrastructure, shingles vaccination could be offered at primary care facilities and dermatology centers.
Among others, the specialists suggested forming a collaborative, multispecialty special interest group to address barriers to shingles vaccination in the country.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
