ASK THE DOCTOR - Shingles Vaccination

Question: “Two doctors have told me not to have the new shingles vaccination because I have already had shingles (about 4 years ago).  I've looked it up on the internet and this is never addressed.  Dr. Donohue (whose column is in the Riverside Press Enterprise) did say anyone over the age of 60 should have it, but didn't mention if people had already had shingles whether they should.”

Answer: The shingles is caused by the varicella-zoster virus, which is the same virus that causes the chickenpox. Once you have been infected with this virus, it can lie dormant in your body along the nerves for decades. During times of stress or weakness in the immune system, the virus can re-activate. When this happens, a series of small blisters develop along the path of the affected nerve. The blisters then eventually crust over, similar to the chickenpox, and ultimately the rash resolves.

Some people develop a severe burning pain with the shingles known as post herpetic neuralgia which may persist for months or years. Because 90% of adults have had the chickenpox, they are at risk of developing the shingles. The risk increases with age and one of every two people who reach the age of 85 will develop the shingles. Although there are treatments if the rash is caught early, they may fail to prevent the development of post herpetic neuralgia.

The Centers for Disease Control came out with a recommendation in May of this year that all adults over the age of 60, including those who have already had the shingles, should receive the vaccine. The ZOSTAVAX vaccine is not 100% effective at preventing the shingles but has been shown to reduce the risk of the shingles by over 50% and can also reduce the risk of post herpetic neuralgia by over 65%. ZOSTAVAX should not be withheld just because you have had the shingles; but individuals who are allergic to gelatin or neomycin should not receive this vaccine. It is also not recommended for patients with certain cancers or those taking chemotherapy.

ZOSTAVAX costs around $150 per dose; but may be covered in part by some insurance plans. Please check with your doctor for more information.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

A Holiday Message

The theme for this year’s Hemet Hospice Volunteers, Inc. Annual “Light up a Life” was Peace. Peace is defined as 1) A state of tranquility, quiet, and harmony; 2) Harmony in personal relations; and 3) A state free of oppressive and unpleasant thoughts and emotions: “That will give me some peace of mind.”

Throughout history, many have spoken of peace. Helen Keller said “I do not want the peace which passeth understanding. I want the understanding which bringeth peace.” Lyndon B Johnson, our 36th President said, “Peace is a journey of a thousand miles and it must be taken one step at a time." Harry Truman, the 33rd President of the United States said, “Our goal must not be peace in our time but peace for all time.” And finally, John Lennon, wrote of peace in his song “Imagine” saying, "Imagine all the people living life in peace. You may say I'm a dreamer, but I'm not the only one. I hope someday you'll join us, and the world will be as one."

During the holiday season, we often hear the phrase “Peace on Earth, Goodwill towards men”. The song “Let there be Peace on Earth” which is commonly sung during church services and played on the radio during the Christmas season, includes the phrase “let there be peace on earth, and let it begin with me”, a simple reminder that this is a special time of year which should include loving and giving.

One of my favorite childhood holiday programs, “The Charlie Brown Christmas”, includes a passage about peace. Viewing that program was the absolute signal to me as a child that Christmas was just around the corner. Today the signal begins somewhere around Labor Day, when Costco, WalMart and other department stores begin hanging the Christmas decorations.

In “The Charlie Brown Christmas”, on Lucy’s advice, Charlie Brown gets involved in directing a school play about The Nativity. Charlie arrives at the rehearsals, but try as he might, he cannot seem to get control of the uncooperative kids, even his own dog Snoopy, who all seem more interested in modernizing the play with dancing and lively music than of sharing the Christmas story. Charlie Brown, on the other hand, is determined not to let the play become commercial by directing the traditional side of the story.

Second guessing himself, Charlie Brown begins to wonder if he really knows what Christmas is about, becoming more and more concerned about the commerciality of the holidays and the obvious lack of spirituality from his classmates. The most memorable part of the program involves a very moving speech given by Linus, who quietly tells Charlie Brown the he can tell Charlie Brown what Christmas is all about.

Linus walks to center stage to make his point. Under a spotlight, Linus quotes Scripture, particularly the second chapter of the Gospel of Luke, verses 8 through 14:

“And there were in the same country shepherds abiding in the field, keeping watch over their flock by night. And, lo, the angel of the Lord came upon them, and the glory of the Lord shone round about them: and they were sore afraid. And the angel said unto them, Fear not: for, behold, I bring you good tidings of great joy, which shall be to all people. For unto you is born this day in the city of David a Saviour, which is Christ the Lord. And this shall be a sign unto you; Ye shall find the babe wrapped in swaddling clothes, lying in a manger. And suddenly there was with the angel a multitude of the heavenly host praising God, and saying, Glory to God in the highest, and on earth, peace, good will toward men.”

As we enter this holiday season let us remember the important message, so eloquently quoted by Linus. Let us pray for peace in the world, in the nation, and in our community. Let us remember those who are alone, who are troubled, who are ill or afraid. Let us utilize our gifts and our talents so that others less fortunate than ourselves can experience peace and tranquility. May God’s grace and Peace be with you all during this holiday season and in the coming year.