#67475- Chicken pox vaccine

[Fredjikrang]

So, at first I was a little bit confused about the answers to this question, since I read an information sheet at my parents house that said that since the chicken pox vaccine is a live vaccine, it does not prevent future outbreaks of shingles, but I can't find any information like that on the internet. In fact, the CDC informational sheet seems to imply the contrary. Have any of you seen something like this?

[Eirene]

It is a live vaccine, although I'm not sure why that would make anyone think it wouldn't protect against shingles. Live vaccines tend to produce a much more vigorous immune response, which is good in this case. Do you remember what the source of that information sheet was?

Varivax, which is one of the main vaccines given for chicken pox, isn't specifically approved for preventing shingles (the vaccine just hasn't been around for long enough to get that data), but pretty much everyone thinks it will decrease incidence of shingles. There is actually another vaccine (Zostavax), which is just a higher dose of Varivax, and that one can be given to older adults after they're had chicken pox to prevent shingles. Interestingly, Zostavax isn't approved to prevent primary chicken pox, but again, people are pretty sure that it would work fine.

[Fredjikrang]

I think the reasoning is that, if it is a live vaccine then it can still "insert" itself. Or, as Wikipedia says much more concisely,

After primary infection, VZV is hypothesized to spread from mucosal and epidermal lesions to local sensory nerves. VZV then remains latent in the dorsal ganglion cells of the sensory nerves. Reactivation of VZV results in the clinically distinct syndrome of herpes zoster (i.e., shingles)

I've asked my mom if she still has the sheet, but I kind of doubt it. It was several months ago. But it was a sheet that they got from insurance or a doctor, which is why I thought it might have been the CDC sheet, but it seems like it wasn't.

[Fredjikrang]

Wow, my mom is quick!

Anyway, turns out that it was the shingles vaccine sheet. I'm not sure that it was the CDC one exactly, since the language seems slightly different, but it does mention the possibility, while also mentioning that it is very rare.

http://www.cdc.gov/vaccines/pubs/vis/do ... ingles.pdf

[NerdGirl]

Ok, this is my understanding of how it works. I'm not an immunologist, but I am a medical student. You can't get shingles unless you have first had chickenpox. The chickenpox vaccine should stop you from ever getting chickenpox (it won't work 100% of the time, but it will stop the vast majority of people who get it from getting chickenpox, and reduce the incidence in general which should also reduce the incidence in un-vaccinated people, etc etc). So if you get the chickenpox vaccine and it works, you can't get shingles. If you get the chickenpox vaccine and don't develop immunity from it for whatever reason, and then you get chickenpox, then you can get shingles later. The vaccine is a "live" virus, but it's not live in the same sense that the wild form of the virus is. It's been altered (attenuated) so that it can't infect you, but your immune system still recognizes it as a foreign invader and produces antibodies to it so that if it ever does encounter the actual chickenpox virus, it will kill it before you become infected with it. But the virus in the vaccine can't get down and hide in your sensory nerves like the wild virus can (ok, I realize here that there are people out there who don't believe that, but I'm hoping to not get into a vaccine debate here). Like Eirene said, it hasn't been around for very long so there isn't actual epidemiological data saying that it prevents shingles yet, but by preventing people from becoming infected with chickenpox, which is an absolute necessity for ever developing shingles, so the logical thing is that it will be shown to prevent shingles as well. And I'm not actually seeing anywhere in the CDC fact sheet where it seems to say otherwise. Could you point out the exact statement you're talking about, since I'm obviously missing it?

Also, I feel a little ripped off about the fact that I actually had chickenpox only three years before the vaccine came into being, because I really don't want to ever get shingles!!

[Fredjikrang]

Only someone who has had chickenpox – or, rarely, has gotten chickenpox vaccine – can get shingles.

First page, left side, next to last paragraph. This would seem to imply that even though they never had chicken pox, but had the vaccine, they could get shingles, but it is a rare occurrence.

My guess is that "rarely" would put it at about the same percentage as those who actually get sick from the vaccine. But that is a completely unfounded guess.