17 Oct 2016

Aim to make shingles vaccine free for over-65s

7:32 am on 17 October 2016

The drug-buying agency Pharmac is aiming to make the costly shingles vaccine free to everyone over 65 within two years.

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The shingles vaccine currently costs about $200, and is available from a GP. Photo: 123rf.com

About 13,000 New Zealanders contract the debilitating illness each year, several hundred are hospitalised with complications, and some suffer lasting pain.

Shingles, or herpes zoster, is a reactivation of the chicken pox virus and commonly strikes people after age 50, with a sharp rise in cases in people over 60.

The first vaccine against shingles was developed two years ago, and is available from GPs for about $200.

Immunisation Advisory Centre director Nikki Turner said there was growing interest in the vaccine despite the cost.

Dr Turner said it was effective, especially in reducing post-shingles pain.

"More and more GP colleagues are becoming aware of it and offering it, " she said.

"Our organisation has a list of what we see as useful private-market vaccines, and the shingles vaccine is on it. Our national phone line is taking more and more calls about it."

Unfortunately, a lot of those calls were from people who had had shingles wanting to know if they can ward off a second attack, she said.

She says if you've recently had shingles, there's little point in being vaccinated in the next year or so because the illness itself will have heightened your immunity.

Pharmac has put it on its funding list with a medium priority and the vaccine should become free for over-65s by 2018.

And the chicken pox vaccine which is also relatively new, will be free for children from July next year.

'The pain was agonising' - shingles sufferer Brenda Saunders

Brenda Saunders said she had been gardening and I thought she had overdone it and pulled a muscle.

"But the pain just kept getting worse. And in the end it was the physio who said, 'What are these spots on your back? And I thought 'What spots on my back?' And it was he who said, 'You know what, I think you might have shingles. "

Ms Saunders shingles was diagnosed too late for anti-viral medication to be of any use. Ideally they should be started within 48 hours of the beginning of an attack.

The communications manager was off work for six weeks in agony, on the ultra-strong painkiller Tramadol - one step down from morphine.

"The ordinary painkillers just didn't touch it, " she said.

"I'd be just lying in bed and couldn't move. The pain was agonising: on a scale of one to ten it would be up there about 8 or 9, I'd say. "

The attack receded, but in its wake came post-herpetic neuralgia - ongoing pain, exhaustion and depression.

Brenda Saunders, who was about 50 when the illness struck, said it took about two years till she felt like her old self again.

Older people more susceptible

And that's not uncommon, according to specialist Dr Mark Thomas.

Dr Thomas, who is an associate professor of infectious diseases at Auckland University, said shingles was considered a moderate illness.

"Shingles is the virus that causes chicken-pox, reactivating, decades after your childhood illness," he said.

"It travels down the nerves from your spinal cord where it's lived ever since, to an area of skin where it causes a red, then a blistering rash. On the way, it can damage the nerves and make them more sensitive for weeks or sometimes months.

Dr Thomas said about 10 percent of patients go on to suffer persistent, stabbing, burning pain in the shingles area.

And the tiredness and depression reported by Ms Saunders and other sufferers were not uncommon, he said.

Older people are more vulnerable to shingles because their immune systems weaken with age.

And factors like stress, illness and some drugs such as steroids, can weaken them further, Dr Thomas said.

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