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Herpes zoster: what the shingles vaccination brings
About every fifth person suffers from shingles (medical term: herpes zoster) in his life, particularly often it affects older people. Health experts advise that the disease be treated as quickly as possible. Prevention is even better. A vaccination is available for this. Experts explain what this brings.
Every fifth person falls ill
Shingles (herpes zoster) is a disease caused by the virus that also causes chickenpox: varicella zoster can be dormant in the nervous system for decades. Age, stress and diseases can reactivate the pathogen and trigger shingles, visible on the rash. About one in five will develop this infectious disease in their lives, which occurs primarily in the elderly or in patients with a weakened immune system. Stress or serious illnesses also favor younger people. In the meantime, two vaccines against shingles have been approved in Germany. The Stiftung Warentest explains on “test.de” how vaccination experts rate them.
Shingles usually heals within a few weeks
A sudden burning pain - usually between the waist and chest, sometimes also on the face, ear or eye: This is how shingles usually announces itself. A few days later, a mostly band-shaped rash covers the increasingly violent pain in the body.
Usually shingles heals in four to six weeks. But every tenth person suffers from chronic nerve pain afterwards.
Doctors speak of post-herpetic neuralgia. The pain can be painful for months, years or a lifetime.
How dangerous is the disease?
Shingles is usually not contagious. The disease breaks out when the individual's immune system weakens.
Those affected have long been carrying the pathogen in their bodies. The chickenpox virus, varicella zoster, is responsible and, after surviving the disease, settles in the nerves of the spinal cord and brain.
There it often slumbers decades in duplicate. If the defense weakens, it can become active again. Then it shows up in its second appearance - as a shingles.
Herpes zoster is only contagious for those who have not had chickenpox: around five percent of Germans.
These people can become infected with the secretion that releases the blisters of shingles - but only if they come into direct contact. The infection then does not lead to herpes zoster, but to chickenpox.
Anyone who has had childhood sickness need not be afraid of chickenpox patients. On the contrary: According to Stiftung Warentest, studies show that contacts with them can train the immune system and protect against shingles.
Antidepressants can help
If you suspect shingles, affected people should see a doctor immediately. This may prescribe antiviral drugs.
Powder and creams are used to treat the rash.
In addition, the pain must be alleviated so that it does not become chronic.
“Not only common painkillers are used, but also anti-depressants. However, they are dosed lower than for depressive disorders, ”writes the professional association of German internists (BDI) on its website“ Internists on the Net ”.
Special plasters and epilepsy are also available for treatment.
Vaccines against herpes zoster
There are currently two shingles vaccines available on the market in Germany: Zostavax and Shingrix. The latter has only been approved since 2018 and is one of the so-called dead vaccines. It contains certain proteins from the varicella zoster virus that are no longer active.
Although the Stiftung Warentest has not yet evaluated the new vaccine, it has been assessed by the Standing Vaccination Commission (STIKO). She recommends that everyone over the age of 60 be vaccinated with the newer preparation.
The Federal Center for Health Education (BZgA) explains on the “impfen-info.de” portal that vaccination is also recommended for anyone over 50 years of age whose immune system is weakened by illness or treatment.
The same applies to everyone aged 50 and over with underlying diseases such as diabetes, rheumatoid arthritis, inflammatory bowel diseases, COPD (chronic obstructive pulmonary disease or smoking lung) and asthma.
Recommendation for one vaccine only
In the December 2018 Epidemiological Bulletin, STIKO only recommends Shingrix - however depending on age and previous illnesses.
The experts attest that this vaccine is generally effective. It is 92 percent for protection against shingles in people aged 50 and over and 82 percent for protection against chronic nerve pain.
Protection decreases slightly with age. STIKO still rates it at around 90 percent for those over 70 years old.
In the September 2017 Epidemiological Bulletin, STIKO does not recommend the older Zostavax vaccine as a standard vaccine - due to "limited effectiveness" and "limited duration of action".
The drug experts at Stiftung Warentest are also not convinced by Zostavax.
Although they found that Zostavax could prevent a good two-thirds of shingles in 50 to 59 year olds and also reduce the risk of severe courses, it was worse for older people.
This is sobering because shingles occurs more often and with complications in old age.
Serious side effects possible
Side effects are less common and less serious after vaccination with Shingrix than after vaccination with Zostavax. STIKO states that the approval studies for Shingrix did not reveal any serious side effects.
Minor side effects are possible, which could last for about a day or two: Accordingly, about every tenth patient may experience redness, pain or swelling at the injection site, or fever, fatigue, muscle and headache.
On the other hand, after a vaccination with Zostavax, these slight side effects occur in about every second person and in ten to 100 out of 1,000 people vaccinated, there are also mild allergic reactions.
In isolated cases severe allergic reactions with rapid heartbeat, shortness of breath and dizziness have been observed.
According to the Stiftung Warentest, everything looks like statutory health insurance companies will pay for shingles vaccination in the near future - but only with the Shingrix vaccine.
Some health insurance companies already cover these costs. (ad)