It’s that time of year again. With all the fall back-to-school preparations comes the medical check-up, including those routine immunizations –  making sure all those “shots” are up to date. 

Kids aren’t the only ones who need to keep up with routine immunizations.  We do too. Although there was a lull period after childhood and during young adulthood during which we didn’t really need any immunizations – other than perhaps tetanus shots – now that we’re in midlife and older, there are again many shots recommended to keep us healthy. 

One of the most effective and safest immunizations recommended for those of us 60 years old and beyond is the herpes zoster vaccine that protects against shingles, a disease associated with pain and disability that can last long after the acute stage is over.  In addition to those complications of the infection, having shingles may lead to a later stroke according to two studies.

One study* found an increased risk of stroke after an episode of shingles that occurred anywhere on the body. A more recent study** showed – in the one year follow up period after the episode of shingles – an even greater risk of stroke when the shingles occurred in one of the nerve roots supplying the eye, a disease known as Herpes Zoster Ophthalmicus (HZO). Furthermore, the risk of stroke remained the same whether or not the disease was treated with antiviral medication.

Bottom line: it is much better to avoid getting shingles than to get it and treat it.

The vaccine (Zostavax) lowers the chances of getting shingles by 50%, has been proven to be safe, well-tolerated, and is covered by Medicare.  But most of us are not getting it; one estimation states that only 7% of those eligible for the vaccine are actually getting it. Why is this?

One major reason is that we (your physicians) are not recommending it strongly enough, if at all. A recent survey*** of 598 family doctors and general internists in the U.S.,  showed that while 91% recommended influenza and pneumococcal vaccinations, only 41% strongly recommended vaccination against shingles. In addition, the perceived difficulty of reimbursement for the vaccine (from either Medicare or private insurance) was cited by over 30% of the physicians as a major barrier for recommending the vaccine.

If you’ve read our book, you know that we strongly advocate that we each take responsibility for our own health. This means educating ourselves about preventable diseases commonly associated with aging, and then advocating for ourselves.

Because this vaccine is officially recommended by the CDC, is safe and can prevent a painful and disabling disease in at least half of those receiving it, this is another of those instances where YOU need to ask your physician about it. I can tell you from my patients’ and from personal experience with the disease that this particular vaccine is every bit as important as the influenza vaccine or any of the others recommended.

Shingles is a disease that you’d rather not get if you have the choice. And in this case, you do.

* Stroke 2009; 40:3443

**Lin H-C et al. Herpes zoster ophthalmicus and the risk of stroke: A population-based follow-up study. Neurology 2010 Mar 9; 74:792.

*** Hurley LP et al. Barriers to the use of herpes zoster vaccine. Ann Intern Med 2010 May 4; 152:555