Shingles Hard to Bear, Vaccine Hard to Get

Jan. 23, 2011— -- When Kathy Yager awoke with a red bump on her forehead, she wrote it off as a mosquito bite. But later that day she had three painful welts above her right eye. She went to her doctor, who diagnosed her with shingles.

"I always thought it was something that happened to old people," said Yager, who was 55 when she got shingles in May.

Yager, who lives with husband David Boehne in South Lyon, Mich., started antiviral treatment immediately. But the painful red blisters still spread up past her hairline and down to her right eyelid, causing her eyelashes to fall out.

Seeing how miserable his wife was, Boehne asked his doctor for the shingles vaccine -- Zostavax. But the shot is currently only recommended for people older than 60. Boehne, then 52, had to get it "off-label" and foot the $280 bill.

With a million cases every year, about one in three people in the United States will get shingles, according to the Centers for Disease Control and Prevention. And while the majority of cases occur in people older than 60, anyone who has had chickenpox is at risk because the triggering virus, "herpes zoster," is the same.

"The chickenpox virus hibernates in the nerve cells of the spinal cord," said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University Medical Center. "And when it comes out of hibernation, it travels along those nerves to the surface of the body, causing a stripe of blisters that looks like shingles on a roof."

The rash usually forms in a single stripe curling around the left or the right side of the body. But it can occur on the face where, in severe cases, can leave disfiguring scars and even threaten vision.

Underneath the skin, the virus can damage and even destroy the nerve endings, causing postherpetic neuralgia; also known as post-shingles pain.

"Some people have a little, but some people have a lot, so much that it impedes their lives," Schaffner said.

Even the slightest irritation -- like a breeze through a T-shirt -- can trigger pain so severe that some people with post-shingles pain even consider suicide, Schaffner said.

"The pain is very difficult to treat and can last for months and, occasionally, even years," Schaffner said. "So shingles and post-shingles pain are clearly something you want to avoid."