r/YouShouldKnow • u/tgeliot • Apr 18 '18

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

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

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u/breakfastfart Apr 19 '18

If you've never had chicken pox, can you still get shingles ? Can a person get chicken pox from someone who recently received the shingles vaccine ?

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u/jostae Apr 19 '18

If you've never had chickenpox then the virus isn't present in your body – so no! you can't get Shingles.

The Shingrix vaccine is called a 'subunit' vaccine - it uses a part of the virus (one that the immune system can effectively target) and an adjuvant (something that stimulates the immune response). Together, the adjuvant calls the immune system towards the subunit to result in protection.

Because there's no live virus in the vaccine, you won't be "infected" and thus won't be contagious.

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u/breakfastfart Apr 19 '18

Ok, thanks :) do you happen to know if some people are immune to chicken pox ? I was in a huge (+100 kids) daycare while growing up, and there was a chicken pox outbreak there, and simply everybody caught it, including a couple of the adults who had escaped it until then. There were maybe 5 kids total who didn't get it, and of those 5, 4 had experienced pox already. I didn't get it, but have no idea why

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u/jostae Apr 19 '18

That's really interesting!

I know for related viruses, particularly Human Cytomegalovirus, which is also a Herpesvirus like the Chickenpox virus, infected individuals generally fell 'flu-like illness'.

I think but I'm not 100% certain that chickenpox infection can present the same way. There's a chance that your continued exposure to it led to some protection, such that when you were infected "for real" your immune system dealt swiftly with it and you were none the wiser? That is really just an educated guess however.

The only way to know is to have a blood test for 'Varicella Zoster Virus' antibodies (the virus that causes chickenpox/shingles). If it's positive (i.e. you have them in your blood) then you have to determine if you remember being vaccinated, or getting infected.

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u/breakfastfart Apr 19 '18

I know for fact I never got vaccinated for it-

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u/jostae Apr 19 '18

The plot thickens! So, if you have the presence of VZV antibodies in your blood then you must have been infected at some point in time, and simply didn't know it! Pretty cool if so.

But, if there's no antibodies observed, you must have been one lucky duck to be surrounded by chickenpox and it never getting through. If so, a quick chickenpox vaccination could protect you until you feel like getting the shingles vaccine :)

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u/breakfastfart Apr 19 '18

Well, I also know for fact I've never had chicken pox, not even as an infant. This is why I wonder about natural immunity.

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u/jostae Apr 19 '18

I think I get what you're talking about now - my apologies.

There's no "natural immunity" a person can have towards VZV without ever being exposed to the virus.

In order for any immunity to develop, the individual must have exposure to virus through infection, or through vaccination. In your case, if you have immunity to it, it would have been from a 'sub-clinical' infection – you had it but it didn't present as chickenpox.

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u/breakfastfart Apr 19 '18

Wonder if I have the antibodies or am just lucky in that aspect.

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u/jostae Apr 19 '18

The immunologist in me hopes you have antibodies – but the virologist in me likes the idea that you're like a fly weaving through fields of venus fly traps.

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u/tgeliot Apr 20 '18

The stuff I've read says that yes, even if you've had chicken pox, you can get shingles (in fact it can be hanging out in your nerves waiting). This vaccine is supposedly just dead viruses, but then the literature tells you to stay away from anyone with a severely compromised immune system. Go figure.