What to Know About Measles and Shingles Vaccines
Depending on your medical history, you might need one or both
You probably know there’s a measles outbreak. And you may have heard that there’s a shortage of the most effective vaccine to prevent shingles, a cousin of the childhood disease chickenpox.
Did you know that both viruses are especially bad news for older Americans?
"We think back to childhood and most kids did fine. But above age 50, people start having complications."
“What’s true for both diseases is that they are more severe the older you get,” says Dr. Gregory Poland, director of the Mayo Clinic Vaccine Research Group in Rochester, Minn.
“We think back to childhood and most kids did fine. But above age 50, people start having complications. We have no treatment. The only recourse is prevention,” Poland says.
Measles Cases Increasing
As of May 13, the number of measles cases totaled 839 in 23 states, reported the Centers for Disease Control and Prevention (CDC). That’s the most cases the United States has seen since 1994.
Measles is an infectious viral disease usually associated with fever and a red rash. But it can be much worse. Some people suffer severe complications, such as pneumonia or encephalitis (swelling of the brain).
Complications From Shingles
Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the varicella-zoster virus, which causes chickenpox.
The most common complication from shingles, according to the CDC, is postherpetic neuralgia (PHN), severe pain in the areas where the shingles rash originally occurred.
About 10% to 13% of people who get shingles will experience PHN; older adults are more likely to have PHN and to have longer lasting and more severe pain.
Shingles also may lead to serious complications involving vision loss. New research conducted by the University of Michigan’s Kellogg Eye Center found that, among a group of 21 million adults, occurrences of herpes zoster ophthalmicus, when shingles gets in the eyes, tripled over a 12-year period.
“You can go blind from it,” says Dr. Thomas Steinemann, an ophthalmologist in Cleveland and clinical spokesman for the American Academy of Ophthalmology. “Most cases are not blinding, thankfully. But it can kill nerve endings and cause ulcers on the eye and intensive inflammation on the inside of the eye. It can cause glaucoma and can damage the back of your eye — the retina and optic nerve.”
If you feel tingling, pain, burning and develop a rash on your scalp, forehead, eyelids or tip of your nose, it’s a warning sign, Steinemann says. “There’s a strong possibility that you will get it in your eye. The nerve endings there are the nerves that connect to the eye. It tracks like a roadmap.”
If you have the warning signs, you should see a physician right away and have the rash assessed to determine whether it is shingles. If it is, you should start an antiviral medicine right away, Steinemann says.
Rarely, shingles can lead to pneumonia, hearing problems, encephalitis or death.
The National Foundation for Infectious Diseases (NFID) recommends that “adults born in 1957 or later who do not have a medical contraindication should receive at least one dose of the MMR (measles-mumps-rubella) vaccine, unless they have documentation of vaccination with at least one dose of measles-containing vaccine or other acceptable evidence of immunity to the disease.”
College students, health care personnel and international travelers are at increased risk for measles and should receive two doses of the MMR vaccine to ensure adequate protection, according to the NFID.
“If you don’t know you’re immune, you can have your antibodies levels checked. If you’re not immune, you might need a booster,” says Dr. Christopher Labos, an associate with the McGill Office for Science and Society in Montreal.
Or, if you’re not sure, you could just get vaccinated again, Labos and Poland say.
All health insurance plans offered through the federal Health Insurance Marketplace, as well as most other private insurance plans are required to cover measles vaccines, according to the CDC. Medicare Part D plans cover measles vaccinations.
If you’ve had chickenpox, you are at risk for shingles. The CDC’s Advisory Committee on Immunization Practices recommends that adults 50 and older who have had chickenpox get two doses of the shingles vaccine Shingrix (recombinant zoster vaccine), separated by two to six months. GlaxoSmithKline (GSK), the manufacturer of Shingrix, first made it available in November 2017.
But getting the new vaccine can be tricky. The CDC’s website says that due to high demand for Shingrix, GSK is limiting orders and health care providers have experienced shipping delays. This is expected to continue throughout this year.
There’s also Zostavax, a less effective vaccine introduced in 2006. But the CDC recommends that anyone who has had Zostavax also receive Shingrix and says that Zostavax cannot be used as a substitute for a second dose of Shingrix.
GSK now is distributing twice-monthly shipments of Shingrix in large volumes into the marketplace throughout the year, according to Sean Clements, U.S. head of vaccines communications for the company.
Clements notes that the company just invested $100 million in its Hamilton, Mont., manufacturing site to expand the production capacity of key components of Shingrix. An existing facility in France was approved by the Food and Drug Administration in January to produce Shingrix. GSK also has created a vaccine locator.
Shingrix is covered for more than 95% of U.S. commercial medical benefit enrollees and 100% of Medicare Part D enrollees, according to GSK.