Those of us who belong to the generations before the chickenpox vaccine came into existence have heard the phrase “a disease that doesn’t come twice” many times. But the virus that causes it can cause problems years after you suffer from the disease: herpes zoster or shingles. The good news is that it’s a vaccine-preventable disease, and the first doses are starting to arrive.

What’s going on? Various autonomous communities are launching immunization programs for people who are vulnerable to this disease. The campaign begins this year by vaccinating people aged 65 and 80 to cover middle-aged people starting next year. Herpes Zoster is a disease with a low mortality rate, but almost all of its victims, 97.5%, are over the age of 65. This is not the first campaign of its kind.

Why is this action being taken now? Vaccination was initiated mainly due to the availability of sufficient doses to initiate the process. The Public Health Commission approved the strategy in March last year and estimated that enough vaccines would be available to at least immunize the group of those born in 1957.

It should be noted that vaccines against the virus that causes Herpes Zoster are relatively new, first appearing in 1995. The immunization strategy, and hence the formulas used, focused on protecting the youngest against chickenpox.

The start of this new campaign coincides with the publication of a study linking Covid-19 infections with an increased risk of developing Herpes Zoster, although the coincidence over time is mere coincidence.

It’s more exposed than meets the eye. Shingles is an infection caused by the same virus that causes chickenpox, the varicella-zoster virus, VZV, or human herpes virus type 3 (HHV-3). When this virus first enters our body, it causes chickenpox with its characteristic rash, although asymptomatic infections or very mild symptoms may occur.

After defeating the disease, the virus remains dormant but remains hidden in our body. It does not cause problems until years later, when the immune system weakens due to age or external factors and Herpes Zoster can occur.

Increasing severity of the disease.
The decision to gradually vaccinate the population over 65 years of age against this disease depends on health and economic criteria, according to the Ministry itself, and this disease can cause a significant burden for society, and moreover, it is getting older.

It is estimated that 90% of the adult population is infected with chickenpox at one time or another, meaning that the risk of suffering from Herpes Zoster is 30% (a figure that reaches 50% by reaching the age of 85).

Agreed protocol.
During this campaign, those born in 1957 will be vaccinated, and those born in 1942 will be vaccinated depending on the availability of doses. people born in the remaining December.

The recommendation published by the Ministry of Health includes not only the elderly, but also adults with other risk factors such as HIV infection or being a chemotherapy patient. There are two types of vaccines approved by the European Medicines Agency: Zostavax and Shingrix. The first is a single dose, while the second requires two holes to complete the mold.

Symptoms and possible complications.
Herpes Zoster usually presents with “pain, tingling or burning on one side”, this pain often precedes the most characteristic symptom of the disease, which is a rash on the infected person’s skin. This rash causes a series of blisters that form small sores. The rash usually appears on the trunk, but may spread to the face, eyes, mouth, and ears.

Possible symptoms include fever and chills, malaise, headache and/or joint pain, and swollen lymph nodes.

It is not a fatal disease in most cases, but there are associated complications that can cause serious problems, particularly postherpetic neuralgia (PHN). These complications can lead to loss of ability for sick people.

Who is vulnerable to this?
The main risk factor for this disease is age. After the age of 50, the likelihood of suffering from Zoster increases. People who are immunocompromised due to AIDS or another illness and people who take immunosuppressive drugs will also have a greater chance of reactivating the latent virus.

In order to suffer from this disease, it is necessary to have been infected by the virus before, but it should be taken into account that VZV can cause infections with symptoms that are too mild to be detected. Adults who contract the virus for the first time get chickenpox, not shingles.

Image: Steven Cornfield