Viral infection in children with chickenpox can reappear after dormancy for years or even decades

A new, effective vaccine is available from the four health funds to the elderly and immunocompromised against shingles.

A rash from herpes zoster [Illustrative]. (photo credit: Wikimedia Commons)
A rash from herpes zoster [Illustrative].
(photo credit: Wikimedia Commons)

People over 65 and those of any age who have a weak immune system will be eligible for two doses of a new vaccine against shingles called Shingrix. The vaccine, which was added to the latest basket of health services, protects people from the varicella-zoster virus that also causes chickenpox. The disease has been known since ancient times.

In the case of chickenpox, the initial infection with the virus typically occurs during childhood or adolescence, but once the chickenpox has resolved, the virus can remain dormant in human nerve cells for years or even decades. 

What are Shingles?

Shingles, also known as herpes zoster, usually passes within a month, but in some cases, it can also cause symptoms involving fatigue, debilitating pain, insomnia, and problems in the eyes like conjunctivitis, keratitis, uveitis, and optic nerve palsies and even vision loss. The shingles rash can also become infected with bacteria. If the virus spreads to the facial nerve, it can also cause hearing loss and vertigo (rotational dizziness). Very rarely, shingles can also develop into an infection of the lungs (pneumonia).

Maccabi Healthcare Services, the second-largest public health fund, has already started giving eligible members the first shot; it is the first to do so. The vaccine is given in two doses with an interval of two to six months between them. Studies have shown that the new vaccine can prevent over 90% of shingles cases. It is estimated that about a third of people develop shingles at some point in their lives, and while it is more common among older people, children may also contract the disease. 

The immunocompromised category includes all who have received stem-cell or organ transplants; HIV carriers; oncology patients with an active solid malignancy before and after chemotherapy; and patients with active hematological malignancy.

 View of a Maccabi Health Center in Modi'in, on January 26, 2021.  (credit: YOSSI ALONI/FLASH90)
View of a Maccabi Health Center in Modi'in, on January 26, 2021. (credit: YOSSI ALONI/FLASH90)

Maccabi also allows members aged 50 to 64 who are not eligible according to the basket, to receive the vaccine at a significant discount through their supplementary insurance from the health fund. Health fund members must schedule an appointment at the nurses’ clinic through their call centers, websites, and apps. 

Dr. Shirley Shapira Ben-David, who heads the infectious diseases department at Maccabi, said that “the new vaccine has been in use abroad for several years, and now it has arrived in Israel.” She added that Shingrix is more effective against the disease and preventing its complications than the Vostavax vaccine that was given until now to people aged 60 and over but offered only about 70% protection. 

Since Shingrix is a killed vaccine, it can also be given to immunosuppressed people who are part of the risk populations. “I recommend that all patients in the target population get vaccinated, whether they have been vaccinated for it in the past or not. With a prescription from your personal doctor, you can go to the nearest Maccabi clinic and thus prevent shingles and its complications,” Shapira Ben-David added. 

Shingles is a painful and usually itchy rash that develops on one side of the face or body. The rash consists of blisters that typically scab over in seven to 10 days and clears up completely within a month. The rash develops on one side of the face or body and consists of blisters that typically scab over in seven to 10 days. 

People can have pain, itching, or tingling in the area where the rash will develop. This can happen several days before the rash appears. People can also have a fever before the rash appears.

People with a shingles infection should rest to allow the rash to heal and the immune system to get the viral condition under control. They should also avoid wearing tight clothes, eating unhealthful foods or scratching the rash. One should try to stay at home until the rash scabs over so as not to infect someone else. 

Hot water increases blood flow, which can worsen shingles, so a hot shower should be avoided, as should physical activity that irritates the rash or results in a lot of sweating. Swimming, contact sports and group exercise situations that could spread the virus should also be put on hold until after the rash heals. Towels should be washed immediately to avoid spreading the virus.