Herpes zoster is commonly known in Taiwan as “live snake,” “snake skin” or “flying snake.” The cause of shingles is that the varicella virus lurks in the dorsal root ganglion after the patient was cured of chickenpox as a child or after being vaccinated against chickenpox. As the immune system and resistance decline with age, the virus is reactivated. The reactivated virus will spread to the skin surface along the nerve innervated by the nerve ganglia, causing skin rash and blisters, combined with the inflammation of the nerve ganglia, thus resulting in severe herpes zoster skin lesions and neuralgia.

Herpes zoster vaccine

The herpes zoster vaccine is a live attenuated strain vaccine. Its concentration is 14 times that of the varicella vaccine. It can enhance cellular immunity and reduce the risk of disease. Although the effect of prevention decreases with age, it can effectively reduce the risk of chronic neuralgia.

Vaccination suggestions

The government suggests that the vaccination target adults over 50 years old who are healthy or chronic patients but have no immunodeficiency or contraindications, including those who have ever suffered from varicella or herpes zoster, whether or not they have a history of varicella or herpes zoster. We suggest that one dose of live attenuated herpes zoster vaccine be given.

Vaccine contraindications

Those with primary or acquired immunodeficiency, immunosuppressive therapy (including high doses of corticosteroids), untreated active tuberculosis, pregnancy, and allergic reactions to any component of the vaccine (including gelatin).

Possible side effects and vaccine response after injection

• After vaccination, please take a rest under observation for 30 minutes. If there is no discomfort, you can leave hospital.
• The most common side effects include erythema, pain, swelling, itching, haematoma, warmth and induration at the site of the injection. Headache and limb pain may also occur.
• Less common side effects include allergic reactions, varicella, fever, and temporary lymphadenopathy at the injection site. If symptoms persist or are more serious, seek medical attention immediately.

Unknown history of varicella

• More than 90% of adults over 50 have been infected with varicella-zoster virus. Therefore, regardless of the patient's self-narrated history or memory, most adults over 50 years of age have been infected with varicella-zoster virus. Before vaccination, there is no need to test individual immunity, nor to ask recipients whether they have ever been vaccinated with the varicella vaccine before giving the herpes zoster vaccine.

Reminders

• The herpes zoster vaccine (ZOSTAVAX) can be administered simultaneously with the influenza vaccine. If you have other vaccination problems, consult your family doctor.