shingles otherwise known as herpes
zoster is a reactivation of the virus
that causes chickenpox starting in the
1990s most children had been routinely
immunized for chickenpox with a vaccine
prior to this the majority of people
acquire the actual chickenpox virus and
for those that experience chickenpox
there is a risk of the virus coming back
in the form of shingles and that's what
we're talking about today the major
updates and shingles are with regards to
vaccines in 2006 a shingles vaccine
called zoster vaccine goals and it's
complications and is what's known as a
live attenuated vaccine meeting it's not
completely dead and therefore there is a
theoretical risk of getting the
infection from the vaccine itself so
since it's been out since 2006 for the
past 10 years or so there was this
concern for patients who had a rheumatic
disease on high doses of immune
suppressing medications that they could
get the infection however recently at
the 2019 American College of
Rheumatology annual meeting researchers
reported zoster backs is safe for people
who are currently receiving a class of
medications known as tumor necrosis
factor inhibitors or TNF inhibitors and
this study was a big deal these
medications are biologic therapies used
to treat a whole host of different
rheumatic diseases such as rheumatoid
arthritis psoriatic arthritis and many
others there are five different TNF
inhibitors approved by the FDA these are
at a limit mad and flix amad meet enter
Sept go luma mad and Sirte Lizaveta the
name of the study was called the verve
trial and this was a randomized control
trial of more than 600 individuals in
the United States receiving TNF
inhibitor therapies now the goal of the
study was to evaluate how safe and
effective zoster FEX was in these
patients who might have a not normal
immune system due to their TNF inhibitor
treatment the majority of these patients
either had rheumatoid arthritis or in
psoriatic arthritis and what the
researchers did is they gave zoster
vaccine
patience and watch them over a period of
six weeks and at the end of that six
weeks period they said okay well who
developed shingles during that time and
at the end of the day zero patience
developed confirmed shingles
thus this provided evidence that zoster
backs is safe at least in this
particular patient population now that
being said in 2017 a new different
vaccine called Shing ryx was released
that is more than 90% effective in
preventing shingles and his complication
post herpetic neuralgia and at this
point is to prefer vaccine recommended
by the Centers for Disease Control or
CDC adults over the age of 50 are
approved for the vaccine and it is given
in a two shot series administered two to
six months apart now Shane Brooks is
different from zoster vaccine that is a
dead virus and thus there is no risk of
getting the infection from the vaccine
however in order to make the vaccine
effective it contains what is called a
strong adjuvant think of that as a
immune stimulator and the purpose of
this adjuvant is so that your immune
system will better recognize the vaccine
and thus provide long lasting protection
but because of this cynics can produce a
strong response from your immune system
so it may produce short term side
effects that are a little more intense
than you're used to from other vaccines
these side effects can be uncomfortable
but they are expected and typically go
away on their own in about two to three
days of note even if you've had the
original shingles vaccine exhaustive
acts you can still get shingles and if
you had shingles before you should still
get vaccinated
jinguk's is covered by most health care
providers and most healthcare insurers
but you should still call your insurance
company just to make sure you don't have
a lot of out of pocket expense lastly
although approved for those over the age
of 50 there are some individuals that
are younger than 50 who are at high risk
due to their specific disease or the
treatments they receive so they should
speak with their rheumatologist on the
utility of receiving either Zostavax or
Sheng Greeks that's all for now thanks
for watching
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