Prevention of Herpes Zoster

At present there is more than one method of prevention of herpes zoster or shingles, which include vaccination, administration of VZIG (varicella-zoster immune globulin) and use of antiviral drugs. Vaccination is one of the most commonly used and popular method of prevention of herpes zoster. At present there are two types of vaccines available for prevention of shingles, namely chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine.

Chickenpox vaccine (Varivax):

In many countries chickenpox vaccine (a live attenuated vaccine) is administered routinely in children (1 year to 12 years of age) for prevention of chickenpox. For children single dose is sufficient and for adults two doses of chickenpox vaccine is required. This vaccine can reduce chickenpox (the vaccine is very efficacious, but does not guarantee that you will not get chickenpox) as well as reduce the frequency of shingles, severity and complications of herpes zoster, such as post-herpetic neuralgia.

Varicella-zoster vaccine (Zostavax):

This vaccine is generally administered to individuals aged over 60 years and who have had chickenpox in early life. This vaccine can reduce the duration and severity of the disease and reduce your risk of complications. The vaccine can be administered to anybody over 60 years of age irrespective of previous incidence of chickenpox or herpes zoster.

Varicella zoster vaccine should not be given to:

  • People with impaired immunity, such as HIV/AIDS patients or organ transplant patients.
  • If allergic to gelatin, neomycin or any other component of the shingles vaccine.
  • If patient is receiving steroids, radiation and chemotherapy.

Varicella-zoster immune globulin (VZIG):

Administration of varicella-zoster immune globulin is another approach for prevention of herpes zoster (as well as chickenpox). It should be administered within 96 hours (ideally within 72 hours) after exposure, especially to individuals who are susceptible to the disease and have high risk of developing complications of herpes zoster. But the availability of varicella-zoster immune globulin is very limited even in developed countries.

Antiviral therapy for prevention of shingles:

Antiviral drugs can be administered for prevention of herpes zoster to individuals who are not eligible for vaccination of those beyond the 96-hours window after direct contact. Antiviral therapy should be started 7 days (when the host is midway into the incubation period) after exposure, which can reduce severity of disease, although can not prevent it. The antiviral drugs used are acyclovir, valacyclovir or famciclovir.


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