The short answer: Do people over 80 get shingles?
Yes, people over 80 are at the highest risk for developing shingles. This is because the immune system weakens with age, a process called immune senescence. The varicella-zoster virus (VZV), which causes chickenpox, remains dormant in the body after recovery. As the immune system declines, it's less able to keep VZV in check, allowing it to reactivate and cause shingles. Older adults often experience more severe symptoms and a greater risk of serious, long-term complications.
What makes the risk so high for people over 80?
Several factors contribute to the significantly higher incidence and severity of shingles in the elderly.
The reactivation of a dormant virus
Shingles is caused by VZV, the same virus as chickenpox. After chickenpox, VZV stays in the body but is inactive in nerve tissue. Later in life, the virus can reactivate, most often due to advanced age.
The role of a weakening immune system
The age-related decline in immune function, or immune senescence, is the primary reason the dormant VZV can reactivate in older adults.
Other factors that increase risk in seniors
Other factors can further suppress the immune system and increase shingles risk in older adults. These include chronic health conditions like cancer or diabetes, immunosuppressant medications such as chemotherapy or corticosteroids, and physical or emotional stress. For more details, see {Link: UCHELATH https://www.uchealth.org/today/shingles-vaccines-prevent-painful-infections-and-cut-the-risk-of-dementia/}.
Symptoms of shingles in older adults
The symptoms of shingles can be more intense and persistent for older adults. Early recognition is vital for effective treatment.
Distinctive rash characteristics
The initial sign is often pain, itching, or tingling on one side of the body. A red rash with fluid-filled blisters then appears, typically in a band on one side of the torso or face. The blisters eventually crust over and heal over several weeks.
Beyond the rash
Older adults may also experience other symptoms such as fever and chills, fatigue, headaches, or upset stomach.
Complications of shingles are more serious in the elderly
The risk of serious complications from shingles is significantly higher for those over 80.
Postherpetic neuralgia (PHN)
PHN is the most common complication, causing persistent nerve pain after the rash heals. This pain can last for months or years and is much more likely and severe in older individuals, impacting their daily life.
Other severe complications
Other potential severe complications include Ophthalmic Herpes Zoster, neurological issues, an increased risk of stroke, and bacterial skin infections. For further information on complications, see {Link: UCHELATH https://www.uchealth.org/today/shingles-vaccines-prevent-painful-infections-and-cut-the-risk-of-dementia/}.
Prevention is key: Vaccination for seniors
Vaccination is a highly effective way to prevent shingles and its complications, especially for people over 80. The CDC recommends the Shingrix vaccine for all healthy adults aged 50 and older.
Shingrix vaccine effectiveness
Shingrix is highly effective, with clinical trials showing it to be 91% effective in preventing shingles in people aged 70 and older. It also provides long-lasting protection and is highly effective against PHN.
Who should get the vaccine?
Vaccination is recommended for all adults 50+ and immunocompromised adults aged 19 and older.
Do you still need it if you've already had shingles?
Yes, vaccination is recommended even if you've had shingles to prevent future outbreaks. While there's no set waiting period, healthcare providers usually suggest waiting until the rash is gone before vaccination. More information can be found on the CDC website.
How vaccination protects people over 80 compared to other age groups
| Feature | People 50-69 with healthy immune systems | People 70+ with healthy immune systems | Immunocompromised Individuals | Notes |
|---|---|---|---|---|
| Shingles Prevention Efficacy | 97% | 91% | 68%-91% (depending on condition) | Efficacy remains high for years after vaccination. |
| PHN Prevention Efficacy | 91% | 89% | Not specified, but protection is high | The vaccine protects against the most common complication. |
| Severity of Side Effects | Often mild-moderate (injection site pain, fatigue) | Often mild-moderate (injection site pain, fatigue) | Mild-moderate, depending on immune status | Side effects generally resolve within a few days. |
| Overall Risk | Increased risk compared to younger adults | Highest risk group for shingles and complications | High risk due to underlying condition | Vaccination is critically important for these groups. |
What to do if you suspect shingles in someone over 80
Immediate medical attention is crucial for a suspected case of shingles in an older person. Antiviral medication is most effective when started within 72 hours of the rash appearing.
Prompt antiviral treatment
Antiviral drugs like valacyclovir can reduce the duration and severity of shingles and lower the risk of long-term nerve pain. This is especially important for older patients due to their increased risk of complications.
Managing symptoms
Alongside antiviral medication, symptom management can include over-the-counter pain relievers, cool compresses on the rash, soothing baths or calamine lotion, and keeping the rash clean and covered.
Conclusion
People over 80 face the highest risk for developing shingles and its potentially severe complications due to age-related immune system decline. The Shingrix vaccine offers highly effective prevention for this vulnerable population. Prompt medical care for suspected shingles in an older adult is essential for early antiviral treatment and effective symptom management.
