Why some regions of Spain are now starting a vaccination campaign against herpes zoster

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Those of us who belong to the generations prior to the arrival of the chickenpox vaccine have heard many times that “a disease that does not happen twice”. But the virus that causes it can cause problems years after suffering from the disease: herpes zoster or shingles. The good news is that it is a disease that can be prevented through a vaccine, and the first doses are beginning to arrive.

What’s going on? various autonomous communities are launching immunization programs for people vulnerable to this disease. The campaign starts with the vaccination of people aged 65 and 80 this year to cover intermediate ages starting next year. Herpes Zoster is a disease with low mortality, but almost all of its victims, 97.5%, are over 65. This is not the first campaign of its kind.

Why is this action being taken now? Vaccination is now started mainly due to the availability of sufficient doses to start the process. The Public Health Commission approved the strategy in March of last year, anticipating the availability of sufficient vaccines to immunize, at least, the group of those born in 1957.

Keep in mind that vaccines against the virus that causes Herpes Zoster are relatively new, the first appeared in 1995. The immunization strategy, and therefore the formulas used, have focused on the protection of the smallest against chickenpox.

The start of this new campaign happens at the same time as it is published A study that links Covid-19 infections with the risk of developing Herpes Zoster, although the coincidence in time is merely coincidental.

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More exposed than it seems. Shingles is an infection caused by the same virus that causes chickenpox, varicella-zoster virus, VZV, or human herpesvirus type 3 (HHV-3). The first time this virus enters our body, it causes chickenpox, with its characteristic rash, although asymptomatic infections or very mild symptoms can occur.

After overcoming the disease, the virus remains inactive but latent in our body. It does not cause problems until after the years, when the immune system weakens due to age or external causes and Herpes Zoster can appear.

The growing weight of the disease.
The decision to progressively vaccinate the population over 65 years of age against this disease is due, according to the Ministryto health and economic criteria, and is that this disease can cause a significant burden for society, even more so in an increasingly aging population.

It is estimated that 90% of the adult population has been infected at one time or another with chickenpox, which implies that the risk of suffering from Herpes Zoster is 30% (a figure that reaches 50% when you reach 85 years of age.

The agreed protocol.
During this campaign, those born in 1957 will be vaccinated and, depending on the availability of doses, those born in 1942 will be vaccinated. the Ministry of Health, the campaigns of the coming years will cover year by year and from oldest to youngest the people born in the remaining interval.

The recommendation published by the Ministry of Health does not only include the elderly, but also adults with other risk factors such as HIV infection or being a chemotherapy patient. There are two types of vaccine endorsed by the European Medicines Agency: Zostavax and Shingrix. The first is a single dose, while the second requires two punctures to complete the pattern.

Symptoms and possible complications.
Shingles usually makes its presence known with a “one-sided pain, tingling, or burning”, this pain normally appears before the most characteristic symptom of the disease, which would be a rash on the skin of the infected person. This rash causes a series of blisters that break forming small wounds. The rash usually appears on the trunk although it can spread to the face, eyes, mouth and ears.

Possible symptoms include fever and chills, malaise, headache and/or joint pain, and swollen lymph nodes.

It is not, in most cases, a fatal disease, but there are associated complications that can cause serious problems, most notably postherpetic neuralgia (PHN). These complications can lead to loss of capabilities for sick people.

Who is vulnerable to it?
The main risk factor in this disease is age. The probability of suffering from Zoster grows after 50 years. People who are immunocompromised due to AIDS or some other disease and those who take immunosuppressants will also have a greater chance that the latent virus will reactivate.

To suffer from this disease it is necessary to have previously contracted the infection caused by the virus, but it must be taken into account that VZV can cause infections with mild symptoms to the point of being imperceptible. Adults who contract the virus for the first time will get chickenpox, not shingles.

Image: Steven Cornfield

Those of us who belong to the generations prior to the arrival of the chickenpox vaccine have heard many times…

Those of us who belong to the generations prior to the arrival of the chickenpox vaccine have heard many times…

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