In April 2018, Ma Sichun suffered from shingles and posted that "the scalp is painful, the face is itchy, and the lymph is swollen." Although her tone was relaxed, everyone who had been through knew that the nerve pain from the shingles attack was really terrible, and the pain was worse than childbirth! And serious ones can cause blindness. In fact, vaccination against shingles can effectively avoid the occurrence of the disease.
Ma Sichun suffers from shingles (Source: Sina Weibo)
In 2006, the FDA approved Zostavax, the first herpes zoster vaccine in the United States. The landmark study, published in the New England Journal of Medicine in 2005, involved 38,000 people aged 60 and older (Note: the study only included people aged 60 and over, so it was only approved for this group), and found that the vaccine reduced the incidence of shingles by 51%! In addition, herpes zoster vaccine is a live attenuated virus, while live attenuated vaccine refers to pathogens that mutate after various treatments, their toxicity is weakened, but they still retain their immunogenicity. Inoculation into the body does not cause disease, but pathogens can grow and multiply in the body, triggering the body's immune response and playing a role in obtaining long-term or lifelong protection. Thus live attenuated vaccines are contraindicated in most immunocompromised individuals. In 2011, the FDA expanded the vaccination to people 50 years of age and older.
About shingles
1
What is shingles?
- Herpes zoster, commonly known as "lumpanosaurus", is caused by the chickenpox virus, which can be latent in the human body all the time, and the reappearance of chickenpox causes shingles.
-Shingles is a painful blistering skin lesion that lasts for several weeks. It has complications that cause sequelae neuralgia after herpetic herpes. For postherpetic neuralgia, the pain continues after the episode of shingles subsides. This pain can last for many years.
-97% of adults carry the herpes zoster virus in their bodies.
-1 in 3 adults is at risk of developing shingles.
- The incidence and severity of shingles increases with age.
2
Typical manifestations of shingles
- Pain caused by postherpetic neuralgia is often described as burning or tingling.
-There are many treatments that can reduce pain, but it is often difficult to fully control.
- Shingles may increase the risk of stroke within six months of the onset.
3
Severe condition: Ocular shingles
- Ocular shingles is a condition in which shingles involves glasses, and its incidence reaches more than 25% of shingles cases. Ocular shingles is very severe, leaving scars on the face and putting the risk of blindness.
-The virus invades the eye branch of the trigeminal nerve, more common in the elderly, with severe pain and can involve the formation of ulcerative keratitis of the cornea. The virus invades the eye branch of the trigeminal nerve, is more common in the elderly, and the pain is severe, and can involve the formation of ulcerative keratitis of the cornea.
Ocular shingles (Source: Victoria Point Surgery website)
The vaccine has reduced the incidence of shingles by 51%, although the prevention rate has not reached 100%, but it is well known that shingles is extremely harmful to the eyes, and the effect that the vaccine can achieve has been a milestone breakthrough, so it is still necessary to encourage middle-aged and elderly people over 50 years old to get the shingles vaccine.
In 2017, the FDA approved a recombinant subunit shingles vaccine (Shingrix). The clinical trial involved more than 15,000 participants aged 50 and older, and the vaccine was more than 96 percent effective across all age groups. Obviously, the prevention rate of 96% is a ceiling-level breakthrough compared to 51%, and the sheningrix vaccine is not a live attenuated virus, so it can be used in people with weakened immune systems.
The results of clinical trials are not always repeated in the real world, and these trials generally target shingles rather than ocular shingles. So, can this new shingles vaccine prevent ocular shingles?
Effectiveness of recombinant herpes zoster vaccine on ocular shingles (Source: 2021 American Academy of Ophthalmology)
The study's database involved 4.8 million people in the two years from 2018 to 2019, and the researchers found that the recombinant shingles vaccine was 89% effective against ocular shingles, which is really good news for the real-life ocular shingles disease, avoiding many vision problems and even saving blindness! However, the researchers also found that only 3.7 percent of patients received two doses of the vaccine in an effective dose (2 doses in total for the recombinant herpes zoster vaccine). This is also to be expected. The researchers note that nearly a decade after the FDA approved the shingles vaccine, only 31 percent of older adults over the age of 60 were vaccinated against the original shingles vaccine.
Maybe there are people who don't know how terrible the eye shingles is. Dr. Elisabeth Cohen, a partner at Wells Eye Hospital, has publicly stated that one of the reasons she had to stop clinical practice was because she had herpes zoster in her eyes, which led to a sharp decline in vision! Dr. Elisabeth Cohen is now conducting a large multicenter trial at New York University: the efficacy of inhibitory antiviral therapy on ocular shingles.
It is revealed that many provinces in China have opened up vaccination of recombinant herpes zoster vaccine, a total of 2 injections are required, and the interval between the two needs to be 2-6 months. A number of professional experts appealed: it is recommended that all middle-aged and elderly people aged 50 or above go to get the shingles vaccine, hoping that everyone will enhance their immunity and stay away from shingles.
Source: Victoria Point Surgery website, for academic communication purposes only
Written by | Qiao Weijun
Typography | Qiao Weijun
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