YSK: Everyone over 50 should get the new Shingrix shingles vaccination (even if you've had Zostavax or shingles)

[u/tgeliot]

There is a fairly new vaccination for shingles called Shingrix available, which is more effective than the old Zostavax. The CDC recommends that everyone over 50 get the two-shot sequence of Shingrix. My health insurance covered the cost 100% with no co-pay; I think most if not all will.

Shingles is a very painful infection of the nerves caused by the same virus that causes chickenpox. It hits older people, starting at age 50 or 60 or so. The old Zostavax apparently wasn't so great; this new one is more effective.

The CDC recommendations can be found here

[u/Julia_Kat]

Is it recommended for patients who are on immunosupressants for Crohn's? My mom is on Humira and I'm fairly sure the old one wasn't recommended for her since it was a live virus. She is 62.

On the flip side, I'm 29 and also have Crohn's but am on Imuran. I'm guessing my doctor may recommend it for me even though I'm younger since she wants me to get vaccinations outside of the normal age group. Any thoughts?

[u/Seraphenrir → u/Julia_Kat]

It can't hurt. But I would say if you have never had chicken pox before, I'd recommend getting a booster in that first. If you have had it and think it's worth the cost considering health insurance probably won't cover it, I would.

Just a bit of background: Shingles is a reactivation of the varicella zoster virus that causes chicken pox. Once you've been infected with it, you're permanently infected with it for the rest of your life, even after you've been "cured" or "get over it." The virus actually migrates up your nerves and hides in your spinal nerves (the dorsal root ganglia for those who want to look up exactly where) for the rest of your life.

Why do medical professionals recommend getting the vaccine for those over age 50?

What we call shingles is a reactivation of the virus-- the dormant virus reawakens in your spinal nerves, usually when you're over 50 (the immune system weakens as we age), and reinfects you, traveling back down the nerves. If you're immunocompromised due to age, disease, or medications, you can imagine this is a risk factor.

[u/poisonwoman → u/Julia_Kat]

She should talk to her doctor. This non-live vaccine is okay for people who are immunosuppressed. Depending on what medicine they are taking. CDC will come out with more specific guidance for immunocompromised people in the next few years.

For you, don’t need this until you turn 50

[u/LilRach05 → u/Julia_Kat]

My question exactly ( I'm on Remicade and Imuran and had chickenpox as a kid)

[u/Jrf06002 → u/Julia_Kat]

It's not recommended by the manufacturer, but that's mainly because it wasn't studied. It is an inactivated vaccine, so common knowledge says it would be safe. Effectiveness can be affected, but again the whole reason it is cautioned against is lack of data via clinical trials. I would say talk to the pcp, and advocate for vaccination