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For healthy older adults, new shingles vaccine is worth the wait

A pharmacist prepares a dose of the shingles vaccine to be administered at Blanchfield Army Community Hospital's Town Center Pharmacy, Fort Campbell, Kentucky. (U.S. Army photo by Maria Yager) A pharmacist prepares a dose of the shingles vaccine to be administered at Blanchfield Army Community Hospital's Town Center Pharmacy, Fort Campbell, Kentucky. (U.S. Army photo by Maria Yager)

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Availability of the new shingles vaccine is improving across the Military Health System, according to Defense Health Agency Immunization Healthcare. The vaccine, Shingrix, is recommended for healthy adults 50 and older to prevent the painful skin rash that can have debilitating long-term effects for older people.

Shingrix was licensed in late 2017. "Supplies are still limited nationwide because of the overwhelming demand," said Army Lt. Col. Christopher Ellison, deputy director of operations for the DHA's Immunization Healthcare Division.

"But availability to the Department of Defense has improved from a year ago and continues to get better," he said, adding that beneficiaries should contact their local MTF to confirm supplies. "Now is the time to get your shingles immunization."

Who’s at risk for getting shingles? "Anyone who’s had the chickenpox,” said retired Air Force Col. David Hrncir, an allergist-immunologist at Lackland Air Force Base in San Antonio.

A virus called varicella zoster causes shingles. It’s the same virus that causes chickenpox. After chickenpox clears, the virus stays dormant in the body. The virus may reactivate many years later as shingles. It's not clear what causes this eruption, said Hrncir, who's also medical director of Central Region Vaccine Safety Hub, Immunization Healthcare Division.

According to medical literature, Hrncir said, “Anywhere from 90 to 99 percent of people now over the age of 40 had chickenpox, before there was a chickenpox vaccine. About one-third will get shingles at some point in their lives, if they’re not protected.”

Some people under age 50 get shingles, Hrncir said. But the risk of contracting the illness increases continually after age 50. Immunization before age 50 results in decreased protection during ages when the risk of contracting shingles is the highest, he said. That's why early immunization generally is not recommended.

An earlier shingles vaccine was introduced in 2006. That vaccine was for people 60 and older when it first came out. Further, it was only about 70 percent effective in offering full protection against the virus, he said.

The Centers for Disease Control and Prevention offers recommendations about people who should not get the new vaccine.

“Those who had the old vaccine will benefit from getting the new one,” Hrncir said. “Also, shingles can recur. So even if you’ve already had shingles, get the new vaccine.”

Retired Air Force Col. Scott Coale said he plans on getting the Shingrix vaccine. He came down with shingles in the fall of 2015, when he was in his mid-50s. His lower back started hurting before any rash appeared. Very quickly, he said, it became "the most excruciating pain I had ever experienced."

Shingles usually develops as a stripe across one side of the body or face, according to the CDC. People may feel pain, itching, or tingling in the area where the rash occurs a few days before it actually appears, the CDC said. Other symptoms may include fever, headaches, and chills.

A few days after the rash appears, it turns into fluid-filled blisters. They usually scab over after a week or 10 days, and then the scabs clear up a couple of weeks after that, Hrncir said.

Coale said his symptoms lasted for a few weeks but luckily, he's had no lingering issues. For some shingles patients, however, the pain may persist even after the rash clears.

“The older you are when you get shingles, the more likely it is you’ll develop post-herpetic neuralgia, or PHN, and have longer-lasting and severe pain,” Hrncir said. “The pain is not easily treated. So you’re left with constant pain that can significantly affect quality of life.”

The new vaccine is a two-dose series, with the second dose administered anywhere from two to six months after the first. A majority of patients have reported side effects for two or three days after vaccination, Hrncir said. They include headaches, fatigue, and nausea. The CDC recommends patients talk with their providers about possible side effects.

Learn more about TRICARE coverage of the shingles vaccine.

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DHA IPM 19-006: 2019–2020 Seasonal Influenza Vaccination Program (IVP)

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This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (o), implementing instructions, assigns responsibilities, and prescribes procedures for the seasonal influenza vaccination program. • This DHA-IPM cancels and reissues DHA-IPM 18-005. • This DHA-IPM is effective immediately and will expire 12 months from the date of issue.

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Staff Sgt. Shaun Martin, a combat medic assigned to Blanchfield Army Community Hospital's LaPointe Army Medical Home on Fort Campbell, drinks from a 16-ounce bottle of water to maintain his hydration for optimal performance. On average, the Army recommends men should consume about 100 ounces of fluid (3 liters) each day, and women should aim for about 70 ounces (2 liters) for baseline hydration. In hot and humid environments and during physical activity, more is needed to maintain hydration — about one ounce per pound of body weight. To reach your goal, drink regularly and frequently, even if you are not thirsty to avoid dehydration. Water is usually the best choice over coffee, soda, energy drinks and alcohol because those beverages can pull water from the body and promote dehydration. (U.S. Army photo by Maria Yager)

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