The Case for Shingles Vaccination at 70
The varicella-zoster virus, which causes chickenpox, remains dormant in the body after the initial infection. As people age, their immune system weakens, allowing the virus to reactivate and cause shingles. For a 70-year-old, the risk of developing shingles and experiencing severe, long-term complications is particularly high. Vaccination is the most effective way to prevent this painful disease.
High Efficacy of the Shingrix Vaccine
The recombinant zoster vaccine, known as Shingrix, is the only shingles vaccine currently available in the United States. It is a non-live vaccine given in two doses, two to six months apart. For healthy adults aged 70 and older, two doses of Shingrix are 91% effective at preventing shingles. This high level of protection is crucial for older adults, whose immune systems may be less robust. The previous live-virus vaccine, Zostavax, which is no longer used in the U.S. since 2020, had significantly lower efficacy in this age group and its protection waned over time.
Preventing Postherpetic Neuralgia and Other Complications
One of the most compelling reasons for a 70-year-old to get vaccinated is to prevent postherpetic neuralgia (PHN), the most common complication of shingles. PHN is a long-lasting and often debilitating nerve pain that can persist for months or even years after the rash has cleared. The risk for PHN increases with age. For adults aged 70 and older, Shingrix is 89% effective at preventing PHN.
A shingles infection in seniors can also lead to more serious health issues such as pneumonia, brain inflammation, blindness, or hearing problems. By preventing shingles, the vaccine also prevents these potential complications.
Other Health Benefits
Recent studies have suggested a potential link between the shingles vaccine and a reduced risk of developing dementia and heart health problems. While more research is needed, these findings further highlight the potential benefits of vaccination for older adults.
Potential Risks and Considerations
The benefits of getting the shingles vaccine far outweigh the minimal risks. Common side effects are generally mild to moderate and temporary.
Common side effects include:
- Pain, redness, and swelling at the injection site.
- Tiredness, headache, and muscle pain.
- Fever and shivering.
- Stomach pain or nausea.
These typically resolve within two to three days and indicate the vaccine is building an immune response. Rare but possible serious side effects include severe allergic reactions and Guillain-Barré syndrome. These are closely monitored, but the risk of serious complications from a shingles infection is much higher for older adults.
Shingrix vs. Zostavax (Discontinued)
A table comparing Shingrix and Zostavax regarding availability, age recommendation, doses required, effectiveness, protection from PHN, vaccine type, and prior vaccination can be found on {Link: NCOA website https://www.ncoa.org/article/how-long-does-the-shingles-vaccine-last/} and {Link: UCHealth News https://www.uchealth.org/today/shingles-vaccines-prevent-painful-infections-and-cut-the-risk-of-dementia/}. Key differences include Shingrix being currently available as a two-dose, non-live vaccine recommended for adults 50 and older, offering high efficacy against shingles and PHN, even if Zostavax (a discontinued one-dose, live-virus vaccine with lower efficacy) was previously received.
Special Considerations for a 70-Year-Old
Specific considerations for a 70-year-old include recommendations for vaccination even with a prior shingles infection (after the rash clears) or previous Zostavax vaccination (no waiting period required for Shingrix). Medicare Part D covers the Shingrix vaccine at no cost as of 2023. Immunocompromised individuals aged 19 and older are also recommended to get Shingrix, possibly with a shorter dose interval. Vaccination should be postponed if moderately or severely ill, but not for a minor illness.
Conclusion
The answer to "should a 70 year old get the shingles vaccine?" is a definitive yes. The risk of shingles and severe complications like PHN increases with age. Shingrix offers over 90% protection for this age group. The temporary side effects are minimal compared to the potential pain and debilitation from shingles. The vaccine is accessible with Medicare Part D coverage. Consulting a healthcare provider is recommended to discuss individual health, but for most 70-year-olds, vaccination is a crucial step for health and quality of life UCHealth News offers further information on the broader health benefits of the shingles vaccine.
