Why I Got the Shingles Vaccine

Correction: An earlier version of this article incorrectly stated that Shingrix was a live vaccine.

Live or dead vaccines?

People with multiple sclerosis will, at some point, be faced with a Hamlet-like dilemma: To vaccinate or not to vaccinate? But that is not the only question.
Vaccines come in live and dead forms. If you have been getting seasonal flu vaccines then you probably know that most preparations use the dead virus. The consensus among medical professionals is that dead vaccines are safe for everyone, including those with MS, while live ones might be risky depending on your medical profile. But how do you know what vaccines are live and which are dead?

Reputable organizations such as The National Multiple Sclerosis Society publish lists of vaccines that use one or the other and a peer-reviewed annotation of their risks and warnings. Your doctor is another good resource for that kind of information. Your local pharmacist is an excellent resource as well. Pharmacies are often where we’ll get the majority of our vaccinations. A pharmacy is where I got my mine.

Making a decision

My decision to get a shingles vaccine was both spontaneous and well thought out over a long period of time. Years ago, I knew I wanted to avoid getting shingles. There were people all around me that told their horror stories about how it hurt, how long it lasted, and their continuing battle with post-herpetic neuralgia: nerve pain that lingers long after the shingles outbreak has healed. And although it is considered an older person’s medical condition, those I knew who had it were younger people. The age-related piece of it is that the risk increases with age: one in three people age 60 and older will develop shingles. One in three. I didn’t like those odds at all. But when I researched the only shingles vaccine available back then—Zostavax, a live, attenuated virus vaccine—its protective effects seemed less than stellar. It reduced the likelihood of contracting shingles by 51 percent and post-herpetic neuralgia (PHN) by 67 percent in people 60 and older—and it only lasts for five years. In my late fifties at the time, I decided to hold off.

A new option

Shingrix, a new and more effective shingles vaccine, came on the market in late 2017. It requires two shots, the second one to be given two to six months after the first. It is 97% effective in reducing the likelihood of contracting shingles. Unlike Zostavax, this newer vaccine uses a dead virus. Moreover, two shots of Shingrix will provide lifetime protection. I decided that was the one for me. But despite the fact that it uses a dead virus, is it safe?

Is it safe?

The Centers for Disease Control says yes, but with a caveat. Pregnant women should avoid the vaccine, as well as those who have experienced allergic reactions to the ingredients in Shingrix. If your immune system has been weakened by HIV/AIDS then the shingles vaccine would be highly risky. If you are taking an immune therapy that has greatly compromised your immune system, drugs such as steroids, cancer chemo, Cytoxan, Imuran, Rheumatrex, and Novantrone, then you’ll want to consult your medical team before making a decision. In fact, getting your doctors’ opinions about Shingrix is a valuable piece to consider before making the decision to get vaccinated.

Most MS disease-modifying drugs are immunosuppressants, and a number of experts claim they do not weaken our immune systems as to make a live virus a danger. However, it’s best to check with the doctor that is treating your MS first. Back when I thought any shingles vaccine would be a live virus, I did not ask my doctors for the go-ahead first, deciding that the risk was worth taking. When I got the vaccine in August, I’d recently had blood work done and all my numbers are in the normal range.

I called my primary care doc to give me the shot, but the office staffer told me they aren’t allowed to stock Shingrix and I should go to a pharmacy for the vaccine. I had to call four pharmacies before I found one that had the vaccine in stock, two cities away. My peace of mind was worth the drive.

Side effects from the vaccine

Since Shingrix is administered via intramuscular injection, I experienced muscle soreness at the injection site the next day along with all-over weakness and fatigue. Today is the day after that and my sore arm feels much better; the weakness and fatigue have resolved. Other possible minor side effects include a rash at the injection site and itching. A two-shot procedure, my second injection will be two months down the road commencing on September 30, 2018. Those two doses of the vaccine will protect me from shingles for the rest of my life.

Be assertive!

If you are considering getting the shingles vaccine, it is possible that you will be challenged like I was to actually find one. Demand has exceeded supply ever since it was approved in October, 2017, so suppliers send small amounts to pharmacies and doctors only sporadically. Be prepared to make a few phone calls and do some sleuthing. If the pharmacies you call seem to blow you off and don’t recommend where else to call, I suggest being assertive and asking them for ideas. They’re busy and generally apathetic and distracted.

The shingles vaccine might not be a priority for you, nor a concern. But as you near the age of 60, I urge you to give it more thought with feedback from your medical team and local pharmacists.

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