Shingles affects every third person – when you belong to the risk group

Around one in three gets shingles at least once in their life, an infectious disease that is anything but harmless. Triggers are varicella viruses, which are known to cause chickenpox. After the infection – usually in childhood – some of the pathogens withdraw into nerve nodes and “slumber” there, well guarded by the immune system.

Due to certain factors, such as a weakening of the immune system with advancing age, but also stress and everything that demands the immune system, the viruses can become active again and lead to shingles (herpes zoster).

Shingles can be so dangerous – risk for heart and brain too

Apart from the fact that the skin rash and nerve pain in the acute stage are extremely uncomfortable for some of those affected, risky complications are possible, some of which last:

Up to 20 percent have massive nerve pain months after the illness (post-herpetic neuralgia). The risk of stroke and heart attack is increased by more than half in the first few weeks after shingles. In the case of shingles on the eye (zoster ophthalmicus), a visual impairment can occur. Dizziness and hearing loss can also occur if the ear is affected (zoster oticus).

And not everyone who has ever had shingles is safe from recurrence. Around six percent of those affected fall ill a second time, as a study shows.

Vaccination against shingles approved from the age of 50

It is therefore safest not to get shingles in the first place. This is easy to say, but difficult to implement. After all, more than 90 percent of those over 50 had chickenpox in their childhood and thus carry these “zombie viruses” that can be reactivated at any time. The risk of reactivation can be significantly reduced by vaccination with a so-called adjuvanted subunit inactivated vaccine. In Germany, the vaccination is approved for people over the age of 50.

The serum is a dead substance that contains a specific surface protein of the virus. It stimulates the immune system to develop and maintain special defenses against the virus. This allows the varicella in the nerve nodes to be monitored permanently. The reactivation and thus a herpes zoster infection is prevented in this way in the vast majority of cases.

The vaccine is available as a powder plus solvent, from which the serum is made just before the injection. The inactivated vaccine contains no preservatives such as thiomersal.

This is how effectively the vaccine protects against shingles

Various investigations, which examined the inactivated vaccine for its effects, attest to its high effectiveness:

Zoster was prevented in 92 percent of those aged 50 to 69
90 percent for those over 70

Calculated quite simply for the general population, this means that only three out of 100 adults who have been vaccinated will develop zoster during their lifetime, and 33 without vaccination.

The vaccine is injected twice, at least two to a maximum of six months apart. The full effect is only possible with the second vaccination. Incidentally, patients with immunodeficiency also build up protection against zoster through vaccination.

Zoster vaccination booster – how long the protection lasts

The effect of the vaccination lasts for years. Studies show that the vaccination protection decreases slightly after four years, further investigations are still ongoing. In this context, effects on T cells and antibodies were proven for nine years.

Experts assume that there is immunity for at least this period. Whether a booster vaccination will be necessary later is still the subject of investigations – the inactivated vaccine has only been on the market since 2018.

Vaccination reactions: These side effects are possible

No effect without side effects, this also applies to the zoster vaccine. Because when vaccinated, the reaction shows that our immune system reacts to the serum and thus builds up future protection against infection. The following vaccination reactions occur relatively frequently with the inactivated vaccine:

Local reactions such as pain at the injection site in almost ten percent of those vaccinated; Chickenpox-like, localized rash at the injection site in 0.1 percent. Systemic reactions such as mild fever, fatigue, headache and muscle pain can also occur.

However, these vaccination reactions usually subside within one to three days.

Who should be vaccinated against zoster

The Stiko generally recommends the inactivated vaccine to all people over the age of 60 to protect themselves from herpes zoster, its possible complications and consequences.

Because shingles can be particularly dangerous for people with certain chronic diseases, the recommendations stipulate that this population group should be vaccinated from the age of 50.

The risk group includes patients with

Diabetes mellitus Chronic obstructive pulmonary disease or bronchial asthma Chronic renal failure Rheumatoid arthritis Chronic inflammatory bowel disease Congenital or acquired immunodeficiency or immunosuppression HIV infection Systemic lupus erythematosus

Anyone who has ever had shingles should still be vaccinated. As mentioned, a repeated infection cannot be ruled out. The health insurance companies cover the costs of the vaccination for those over 60 and those chronically ill over the age of 50.