People who have had an episode of herpes zoster, also known as shingles , face a relatively low short-term risk of developing shingles,according to a Kaiser Permanente Southern California studypublished online in the Journal of Infectious Diseases . These findings suggest that among people with immune systems thathave not been compromised, the risk of a second shingles episode islow. Researchers reviewed electronic health records and monitoredrecurrence of shingles for more than 6,000 individuals. They foundfewer than 30 cases of recurrent shingles in an average of twoyears of follow-up and little difference in the rate of recurrencebetween the vaccinated and unvaccinated population. |
"This study's findings are important because we found that the riskof having a recurrent shingles episode is not as high as previousresearch indicates," said Hung-Fu Tseng, PhD, MPH, study leadauthor with the Kaiser Permanente Southern California Department ofResearch & Evaluation in Pasadena, Calif. "We now have empiricaldata that show the risk of recurrence is low among an elderlypopulation who did not have compromised immune systems, regardlessof their vaccination status." More than 1 million people develop shingles every year in theUnited States. Shingles is a painful contagious rash caused by thedormant chickenpox virus which can reactivate and replicate, damaging the nervesystem. The elderly are especially vulnerable because immunityagainst the virus that causes shingles declines with age. When the Food and Drug Administration approved the shingles vaccinein 2006, the agency said that having an episode of shingles boostsimmunity and suggested it was unlikely that people would experiencea recurrence.
It further stated that the effectiveness of thevaccine in preventing repeat episodes had not been proven inclinical trials because trials have not been conducted. By contrast, the Centers for Disease Control and Prevention'sAdvisory Committee on Immunization Practices recommended the herpeszoster vaccine for people ages 60 and older, including those whoreported a previous episode. "While this latest study adds to the growing evidence base ofemerging knowledge about the shingles vaccine, more research isneeded. Our findings need to be replicated by studies with largerpopulations.
Kaiser Permanente Southern California researchers willcontinue to follow this population of vaccinated people in order todetermine the long term preventative efficacy," said Dr. Tseng. Researchers studied electronic health records for 1,036 vaccinatedand 5,180 unvaccinated Kaiser Permanente members aged 60 and older.The vaccinated population included members who received vaccinesbetween 2007 and 2010. The zoster vaccine is not recommended forpatients with immune systems that have been compromised as a resultof cancer or other medical conditions, so they were excluded from thisstudy.
Based on the clinically confirmed cases, researchers found the riskof the recurrence of shingles after a recent episode is fairly lowregardless of vaccination status. Each year, on average, 19 personsper 10,000 in the vaccinated cohort experienced a recurrence ofshingles. The rate was only slightly higher for the unvaccinatedpopulation, at approximately 24 persons per 10,000 per year. This is the latest in a series of published Kaiser Permanentestudies conducted to better understand vaccine effectiveness andsafety. Among these studies were: In 2011, Dr.
Tseng was a lead researcher in a Vaccine SafetyDatalink study published in the Journal of Internal Medicine that found the herpes zoster vaccine to be safe. Also last year, Dr. Tseng published a study in the journal Vaccinethat found that administering the pneumococcal and the herpeszoster vaccines at the same time is as beneficial as if they areadministered separately. On top of that study, Dr.
Tseng published a study in 2011 in the Journal of the American Medical Association that found that the shingles vaccine is associated with a 55percent reduced risk of developing the disease. In 2010, another study by Dr. Tseng in JAMA found the pneumococcal pneumonia vaccination is not associated with a reduced risk of heart attacks or strokes in men. Two Kaiser Permanente studies found that the combination vaccinefor measles , mumps, rubella, and chickenpox is associated with double the riskof febrile seizures for 1- to 2-year-old children, compared to same-day administrationof the separate vaccine for MMR (measles, mumps, rubella) and thevaricella vaccine for chickenpox. Other Kaiser Permanente studies found that children of parents whorefuse vaccines are nine times more likely to get chickenpox and 23times more likely to get pertussis (commonly known as whoopingcough), compared to fully immunized children.
Another study found that herpes zoster is very rare among childrenwho have been vaccinated against chickenpox. Additional References Citations.
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