By Anthony L. Komaroff, M.D.

DEAR DOCTOR K:

I'm a healthy, 65-year-old woman. I recently read that I should get the shingles vaccine. What is shingles? And should I get the vaccine?

DEAR READER:

Shingles is caused by the same virus that causes chickenpox. After a case of chickenpox, the virus can lie dormant inside your nerves. Some people get infected with the virus without knowing it -- that is, without getting chickenpox. It gets into their body, infects some nerves and remains inactive. People catch the virus from other people, usually during childhood.

Shingles occurs when the virus become reactivated. The infected nerves, and the skin the nerves go to, get inflamed. More serious damage to the nerves leads to long-lasting pain known as postherpetic neuralgia.

The two symptoms of shingles are a very unpleasant pain and a rash where the pain is.

The pain often comes before the rash. Most of my patients describe the pain as "burning" or "stabbing." The pain often gets worse when the skin touches something, even something as light as a shirtsleeve. The rash usually lasts a week to 10 days. If postherpetic neuralgia develops, the pain can be severe. It can last for months or sometimes years.

Most often, the painful rash of shingles occurs on the chest or abdomen, front or back. But it can also occur on the arms, legs and face.

The Centers for Disease Control and Prevention (CDC) recommends that all Americans ages 60 or older should get the shingles vaccine, even if they've already had shingles. The vaccine consists of a single shot in the upper arm.

Getting the vaccine does not guarantee that you won't get shingles. But it does reduce your chances by 50 percent or more. And it does an even better job of reducing your risk of postherpetic neuralgia.

I've had patients worry that the vaccine itself could give them shingles. That's because the shingles vaccine is made with a weakened -- not dead -- form of the virus. And a tiny percentage of people do get either a shingles or chickenpox-like rash within a month or so of getting the vaccine.

Not all health insurance policies cover the cost of the shingles vaccine. You may want to look into this in making the decision to get the vaccine.

You may wonder if the risks associated with the shingles vaccine, though minimal, outweigh its benefits. And if we were only talking about shingles, you might be right. It's not pleasant, but most people get through shingles just fine.

Postherpetic neuralgia is another story. It can last for months, even years, and be quite debilitating. The shingles vaccine can cut the risk of that happening by two-thirds. And I'd say that tips the balance in favor of getting the vaccine. I've voted with my feet. I got the vaccine, because I've seen too many of my patients suffer from postherpetic neuralgia. Chronic pain can disrupt a person's life. If there's a simple way to reduce your risk, why not do it?

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Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.

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