Anyone get Shingles even though you had the Shingles vaccine? (ears, break)
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a) While each pt experiences & tolerates the pain of shingles to a different degree, 10% of the afflicted will develop continuing pain (post herpetic neuralgia) and 5% will develop the potentially serious ocular involvement...So, given 10 groups of your 6 people (ie- 60 people) 54 of them are at no particular risk, and another 3 won't be helped anyway. Is it worth vaccinating 60 people so 3 won't get a complicated case?
b) Advertizing claims 1 in 3 people will get shingles in their lifetime-- I definitely don't believe that and found no studies claiming it. I don't even believe the study I quote above claiming a 20% incidence rate. In my 40 yrs of practice the incidence rate was more like 1 in 100.
Low efficacy rate of the vax and relatively low rate of serious morbidity (virtually no mortality) from the disease...It's just not scientifically clear that the vax SHOULD be taken.
As you noted, the 1 in 3 is the cumulative lifetime risk. Your anecdotal experience would not cover the entire lifetime of every patient in your practice. I find it credible based on the number of DH's family members who have had it.
"In adults 50 to 69 years old with healthy immune systems, Shingrix was 97% effective in preventing shingles; in adults 70 years and older, Shingrix was 91% effective.
In adults 50 years and older, Shingrix was 91% effective in preventing PHN; in adults 70 years and older, Shingrix was 89% effective.
In adults with weakened immune systems, Shingrix was between 68% and 91% effective in preventing shingles, depending on their underlying immunocompromising condition."
You can get shingles after the vaccine, but it probably helps.
I’ve had shingles about 3-4 times, but always caught it really early. The first time I got it, the vaccine was new, and my doctor didn’t believe in treating his patients like guinea pigs. I’m not sure why I didn’t eventually get it, or if I had, would I have never gotten shingles again.
I guess at some point I got too old for the vaccination, because I’ve had a different doctor for 12 years now, and she has never suggested that I get it either.
You can still take the vaccine. You do not age out of eligibility.
As you noted, the 1 in 3 is the cumulative lifetime risk. Your anecdotal experience would not cover the entire lifetime of every patient in your practice. I find it credible based on the number of DH's family members who have had it.
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Good point, Suzy-- but over the course of a 40 yr career, with an active pt population of ~300 at a time (dynamic-- 1 in, 1 out) I still only treated about 10 cases. Double the career to make it 80 yrs (a lifetime)- that would be only 20 out of 300...more like a 5-10% lifetime risk.
As far as your DH's family-- clustering &/or genetic predispositon and you have nothing more than an anecdote...
...and that 97% risk reduction quoted for the newer vax is Relative RR. ARR remains low enough to cast doubt on the need.
It seems to me that it's the Baby Boomer genration that has a higher rate f shingles than the older or younger generation...? change in viral antigenicity?...and what about those vaccinated for chicken pox starting in '95 ( now aged ~40 or younger)? What's their risk of shingles going to be? will the shingles vax make any sense?
Good point, Suzy-- but over the course of a 40 yr career, with an active pt population of ~300 at a time (dynamic-- 1 in, 1 out) I still only treated about 10 cases. Double the career to make it 80 yrs (a lifetime)- that would be only 20 out of 300...more like a 5-10% lifetime risk.
As far as your DH's family-- clustering &/or genetic predispositon and you have nothing more than an anecdote...
...and that 97% risk reduction quoted for the newer vax is Relative RR. ARR remains low enough to cast doubt on the need.
It seems to me that it's the Baby Boomer genration that has a higher rate f shingles than the older or younger generation...? change in viral antigenicity?...and what about those vaccinated for chicken pox starting in '95 ( now aged ~40 or younger)? What's their risk of shingles going to be? will the shingles vax make any sense?
I was just pointing out that my anecdotal experience is different from yours. The one in three figure is based on large populations.
The impetus behind developing the vaccine was the desire to reduce the risk of PHN, which is a horrible condition, and Shingrix reduces that risk. PHN is the leading cause of pain related suicide in elderly folks.
The incidence of shingles rises with age, likely due to decline in immune function. By age 85 the risk of having had it is about 50%.
I was just pointing out that my anecdotal experience is different from yours. The one in three figure is based on large populations.
The impetus behind developing the vaccine was the desire to reduce the risk of PHN, which is a horrible condition, and Shingrix reduces that risk. PHN is the leading cause of pain related suicide in elderly folks.
The incidence of shingles rises with age, likely due to decline in immune function. By age 85 the risk of having had it is about 50%.
Not sure how anyone can say that yet. The people who got the vaccine are generally too young to get shingles. My children didn't get that vaccine and the youngest is 33. They all had chicken pox before the vaccine was available.
Not sure how anyone can say that yet. The people who got the vaccine are generally too young to get shingles. My children didn't get that vaccine and the youngest is 33. They all had chicken pox before the vaccine was available.
Children do get shingles, though less commonly than older age groups.
"Approximately 38 per 100,000 children vaccinated against chickenpox developed shingles per year, compared with 170 per 100,000 unvaccinated children, researchers found. Furthermore, shingles infection rates were lower in children who received both recommended doses of the chickenpox vaccine compared with those who only got the first dose."
Suzy-- we're not saying shingles vax doesn't have an effect. I'm just pointing out that the effect isn't all that great considering how many vaxes have to be given to "save" one adverse event...
Questionable public policy.
Do you need fire insurance?...Only if your house burns down, and the risk of that is really pretty low, but the cost/benefit ratio is awfully good.
Suzy-- we're not saying shingles vax doesn't have an effect. I'm just pointing out that the effect isn't all that great considering how many vaxes have to be given to "save" one adverse event...
Questionable public policy.
Do you need fire insurance?...Only if your house burns down, and the risk of that is really pretty low, but the cost/benefit ratio is awfully good.
That was my reasoning with not getting the vaccine to begin with, then of course I got shingles at 51 lol
I don't understand how they can even predict how many people that had the shingles vaccine would have gotten shingles when they can't possibly know unless they're doing some sort of genetic testing to see if we have the gene that makes us susceptible to it.
Just like with every vaccine, they want to make money off of selling it. That is their ultimate goal.
I did get one shot of two, am allergic to it, hopefully having shingles plus one shot will stop me from getting it a second time. It was almost in my eye or I would have taken my chances with not getting it. I knew I'd be allergic to it.
There are logistical problems to doing medical reaearch that involves long time spans-- Research funding is usually only shelled out for a year or two at a time, and a researcher's career probably only spans a couple decades....
To compensate, they use statistical tricks to evaluate the short term data...They try to evaluate
"patient-years."...It shoud be obvious that following 100 pts for 10 yrs (1000 pt-yrs) is not going to be quite the same as following 10 pts for 100 yrs or 20 pts for 50 yrs, or 500 pts for 2 yrs etc-- all "1000 pt -yrs."
Yes, got the regular shingles shot years ago but was told to get the Shingrex shot. We are in our 70's and our doctor recommended it. I had more of a reaction than any other vaccine but it was still better than dealing with shingles. My mother and sister in law both had shingles and were sick a long time.
Yes, got the regular shingles shot years ago but was told to get the Shingrex shot. We are in our 70's and our doctor recommended it. I had more of a reaction than any other vaccine but it was still better than dealing with shingles. My mother and sister in law both had shingles and were sick a long time.
That first shingles vaccine did not have good odds of stopping someone from getting shingles from what I remember reading. I tried to get it at age 50, my insurance refused. In hindsight I'm glad they refused, 2nd vaccine is supposedly better. I'd read some early articles about the 2nd vaccine, the odds on that one weren't that great either and was why I almost opted out of getting it. It took me a few years before I did break down and got it.
Quote:
Originally Posted by guidoLaMoto
There are logistical problems to doing medical reaearch that involves long time spans-- Research funding is usually only shelled out for a year or two at a time, and a researcher's career probably only spans a couple decades....
To compensate, they use statistical tricks to evaluate the short term data...They try to evaluate
"patient-years."...It shoud be obvious that following 100 pts for 10 yrs (1000 pt-yrs) is not going to be quite the same as following 10 pts for 100 yrs or 20 pts for 50 yrs, or 500 pts for 2 yrs etc-- all "1000 pt -yrs."
Sounds like it's all just a guess which is all they really can do unless they test for specific genes.
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