Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother "

Case study ( 3245 views as of October 16, 2018 )

Monica is 51-years-old and recently became a new grandmother. She received a call from her son telling her that her new and only granddaughter, Jane, had developed red spots and has been diagnosed with chicken pox at 12 months old. Jane did not receive the chicken pox vaccine, and after contracting chicken pox will no longer need the vaccine. Monica is excited to visit with her granddaughter and wants to spend time with her and her family and has been planning for this trip for months. Monica does recall having the chicken pox when she was a young girl and remembers it was an awful experience. This situation has raised a number of questions for Monica about the chicken pox, shingles and the shingles vaccine.

Monica can have a consultation with her pharmacist who can help answer some of her concerning questions. For example, should Monica visit her new granddaughter and what are the risks and concerns? Monica wants to understand what causes shingles, and how the chicken pox and shingles are connected. Would visiting Jane cause shingles? Should Monica receive the shingles vaccine?

Along with answering questions, pharmacists in several provinces in Canada are authorized to give the shingles vaccine and can administer the chicken pox vaccine to children aged 5 and older (check with your local pharmacist in your own province for specific criteria and requirements). The assessment and administration in pharmacies has been more convenient for many people compared to seeing their family doctor.

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Conversation based on: Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother "

Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother "

  • About 90% of people born before 1995 have had chicken pox, and about one-third of these people develop shingles when they are older, generally at ages over 50. Although there has been a shingles vaccine available for many years, the uptake of the vaccine has been low in those who need it, around 30% received the vaccine (depending on what area is being measured). A new vaccine was introduced earlier this year which showed a very high effectiveness rate in clinical trials. The new vaccine, called Shingrix, in a study evaluating over 15,000 subjects who were aged 50 and up, found the vaccine reduced the number of people developing shingles from about 91 people per 10,000 to 6 people per 10,000 which is over a 90% reduction in the incidence of shingles. Those over 50 may want to speak with their healthcare professional about being vaccinated against shingles and discuss the benefits and risks of the new vaccine. Your pharmacist, in most jurisdictions, can provide not only information, but also the injection without the need for a prescription from your physician. If you have health insurance benefits which may cover the vaccine, you may require a prescription.
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  • In fact 95% of the Canadian population. The reason why it's important to speak to your physician is that as we age the risk for shingles increases as well as a painful condition related to that called post herpetic neuralgia.
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  • As Chantal has mentioned, provincial plans do not cover the cost of the shingles vaccine currently.. However, if the person receiving the vaccine is part of a private health insurance plan, it is likely that it may be one of the covered treatments. Some private plans have retirees on the plan and they could benefit from the coverage for the shingles vaccine. As more data showing the benefits of the vaccine become available, the public plans may change the coverage. Health care payers must regularly evaluate a large number of new and existing drugs against comparators, looking at its efficacy, safety, effectiveness, cost, convenience and practicality in treatment. Because of the reality of a limited healthcare budget, not all treatments can be covered. Since coverage for medications and treatments is constantly changing, you should check with your pharmacist in your area who will be better informed of the coverage in your specific province. If you belong to a private plan, you may have to check with your plan provider to find out your particular coverage situation related to the vaccine.
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    • It's good to know that the shingles vaccine isn't currently covered by provincial medical care
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  • One of the commentators mentioned taking vitamins to help improve your immune system. If stress can be a contributing factor in contracting shingles, or the severity of your shingles, are their vitamins that can help your body handle stress ?
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    • Stress as been associated with the development of shingles, although the strength of the association is not strong, it could be just coincidental. Reducing stress is always a good thing and there are many approaches. There was a comment about wanting to know if there were vitamins which could help with reducing stress on the body, however, there are no reliable studies clearly demonstrating a direct benefit of vitamins and supplements to the body by reducing stress or making your body more "stress-proof". However, this assumes that your body has adequate levels of all the necessary nutrients and vitamins you require to maintain a normal homeostasis. One of the vitamins which have often been detected in the blood as being low is Vitamin D. This is sometimes called the "sunshine vitamin" because it is produced in the skin when exposed to sunlight. In certain parts of the world during winter months, there is insufficient exposure of the skin to sunlight by some people, especially those who are bedridden or in nursing homes, so that they may have low levels of Vitamin D. For those who are 50 years old and older can usually benefit from a Vitamin D supplement at a dose of 800 IU to 2000IU per day. Some experts recommend even higher dosages. Not that Vitamin D has been demonstrated to reduce the impact of stress on the body, but like any nutrient or vitamin, when there is a deficiency, the body is less able to cope with stress and illness. Maintaining a balanced diet and exercise program individualized to you is best, and sometimes requires the help of experts to help identify your individualized needs to ensure you maintain your health and productivity. If you do not have a balanced diet and your diet is deficient in certain vitamins, nutrients or minerals, then a supplementation of those may be necessary. Another example is if you do not normally consume 3 servings of dairy or more daily, you likely are not receiving your recommended intake of calcium and could benefit from a calcium supplement to maintain your bone strength and bone density to help prevent fractures and osteoporosis.
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    • @K.Michael, I know there are many lifestyle measures that can be practiced to help manage and reduce stress. Things like regular physical activity, and a healthy sleep routine are a few things that can reduce stress. I would be interested as well to hear of vitamins or supplements that can be helpful in this regard.
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  • It is my understanding that the re-activation of the chicken pox virus resulting in shingles occurs more readily in individuals with a compromised immune system. In addition to the vaccine, it might be worthwhile for Monica to see a dietitian to assess her dietary intake. Many micronutrients (Vitamin D, A, E, folate, zinc to name only a few) promote good immune system functioning through antibody production and supporting mucosal barriers. Assuring that her diet is providing enough immune support may also be a good consideration.
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    • I know that stress can affect your immune system, so I would imagine that this could play a role in your susceptibility to contracting shingles.
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    • Would stress also be a factor in increasing the risk of contracting shingles ?
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  • Do provincial health plans cover the cost of the shingles vaccine?
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    • @Chantal - do you know if the BC Medical Plan exclusively refuses coverage of the shingles vaccine, or if it is only reserved for those patients considered high risk and therefore vaccination would be covered?
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    • The BC Provincial medical plan does not cover patients for a Shingles vaccination unfortunately. This would have to be done privately through your pharmacy. Your doctor would need to give you a prescription for this. Keep in mind that this vaccine needs to be kept very cold so when you pick it up you might want to consider having the pharmacist inject you right there, which you typically have to pay a fee for as well. Otherwise, you either need to see your physician right away or find out from your pharmacist how to properly store the vaccine at home until you can see your physician.
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    • @Healthymama I could be wrong but I thought I saw the Shingles vaccine on the list of vaccinations public health offers.
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    • K Michael are you sure about that? I didn't think the shingles vaccine was covered by OHIP? How long has that been the case?
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    • I know that in Ontario the Shingles vaccine is offered by public health so yes, it is covered by the provincial health plan
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  • Is the chicken pox vaccine a required vaccination or an optional ?
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    • Chicken pox is going to become one of the "required" vaccines this year I believe but yes you can opt out of vaccines with special reasons.
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    • All are optional, technically. To attend school, I don't think public health flags children with or without the chicken pox vaccine.
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  • My father in law had shingles a couple years back and it was a very painful experience. He had a hard time dealing with the pain during the outbreak and did not feel himself for a few months. Is he at risk for having shingles again or is it something that only occurs once in a lifetime ?
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    • Shingles can definitely reoccur.
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    • Hopefully the vaccine works and prevents your father in law from getting Shingles again
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    • He spoke to the family doctor and was told he can get them again. He has now considering the vaccination.
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    • I think that you can get it again. It would be a good idea to speak to his family doctor about getting the shingles vaccine
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  • Having chicken pox as a child means that you have been exposed to the chicken pox virus and it is in your body, this virus is called the varicella zoster virus and sometimes also called the herpes zoster virus. This is the virus that causes chicken pox. You will build immunity against this if you have a normal immune system and you will not likely get the chicken pox again, rarely some people do even if they have built immunity and were exposed as a child. Shingles is the reactivation of the varicella zoster virus in adulthood, usually occurring after age 50. When the chicken pox virus (its proper name is the varicella zoster virus) reactivates in adulthood for an unknown reason and the reactivation is called shingles and has a different set of symptoms than chicken pox. It is very painful and some people have post-herpetic neuralgia which lasts for a very long time (months to years). See the video at http://www.healthchoicesfirst.com/health-talks/chicken-pox-and-it-s-link-to-shingles#slide-0 As mentioned in a previous post by K. Michael, many people do not realize the risk of getting shingles, the risks associated with developing shingles and the availability of a vaccine to prevent shingles that is available in the pharmacy (and can be administered by the pharmacist often without the need for an appointment in many jurisdictions)
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    • Does the chicken pox vaccine come with the same future risk of developing shingles?
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    • What are the risk factors for developing shingles, other than having had chicken pox as a child?
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    • Would it be safe to say that if Monica has had chicken pox and has an otherwise safe immune system her risk of developing Shingles from visiting her granddaughter is slim ?
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  • Does having chicken pox provide you with an immunity to Shingles ?
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    • No, I think it makes it more likely that you will get shingles actually.
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  • A friend of mine developed Shingles last year. It was incredibly painful and took almost 6 months to fully recover. I don't think that most people realize that they can get the vaccine at their local pharmacist or what to look out for
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    • Is there a group of higher-risk people that are able to get the shingles vaccine free of charge? I'm thinking seniors, immunocompromised people, etc...
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    • The shingles vaccine is an optional vaccine that is often not covered by the public health system. In many provinces in Canada, but not all, the pharmacist is authorized to inject the vaccine. Speak with your local pharamcist about the availability and coverage of the vaccine. In addition, there were questions about the effectiveness of the vaccine is the person has already developed shingles. In these cases, there is no data to show that the shingles vaccine will have any impact on the current shingles situation and the vaccine should not be used within a year of the shingles. It may have benefit for someone after the shingles resolves to prevent a subsequent reactivation.
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    • Can you get the shingles vaccine once you already have symptoms? Or is it too late?
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