2023-10-06 09:08:20
IT·Science
Entered 2023.10.06 18:08 Modified 2023.10.06 18:37 Ground A20
Reporter Ji-Hyeon Lee’s live health
Everything regarding shingles64% of shingles patients are over 50 years old
High risk of recurrence, need to get vaccinated
607,354 people. This is the number of people who received the shingles vaccine in Korea as of July this year. The number of people vaccinated annually (535,720) last year has already been exceeded. Although the vaccination is a non-coverage item that requires the patient to pay the entire cost, many people visit hospitals every year and voluntarily receive the shingles vaccine to lower the risk of developing shingles.
There are three types of shingles vaccines distributed in Korea. Depending on the type of vaccine, the targets that can be vaccinated and the price vary. Adverse reactions following vaccination may also appear slightly differently. We learned regarding shingles, which increases in the number of patients during the change of seasons, and the vaccine to prevent it.
○ Shingles may occur in the eyes or bladder.
Shingles is usually caused by reactivation of the chickenpox-zoster virus that entered the body during childhood. This is why many people think that people who have had chickenpox as a child develop shingles. The domestic chickenpox-zoster virus infection rate reaches 98% for people over 20 years of age. The infection rate among 1-4 year olds is 67.3%, and the infection rate among 10-14 year olds is also relatively high at 94.2%. This means that any adult can develop shingles.
When you get shingles, rashes and blisters spread laterally along the ganglion. There are many patients who complain of extreme pain. Many people think of lesions occurring on the torso, such as the back or lower back, but shingles lesions can also occur on the eyes, tongue, and ears. Shingles can cause paralysis on one side of the face and loss of hearing. Complications such as bladder problems may occur, causing symptoms such as inability to urinate. In the elderly or patients taking immunosuppressants, shingles may develop all over the body or lead to complications of encephalitis. Many elderly patients suffer from postherpetic neuralgia for a long time. If shingles occurs, it is important to treat it early.
Kwon Soon-hyo, a professor of dermatology at Kangdong Kyung Hee University Hospital, said, “If you administer antiviral drugs quickly, you can suppress the proliferation of the virus.” He added, “You should initially receive treatment using antiviral injections or oral medications for regarding a week.”
○Vaccination is recommended for adults over 50 years of age
Antiviral treatment prevents significant nerve damage caused by the virus. This will help prevent neuralgia later on. If treatment is received late, the risk of postherpetic neuralgia lasting for several years increases. The incidence of shingles increases with age. This is because the immune cell function to suppress virus reactivation is reduced due to aging or disease. Even people who have had shingles once can get it once more. Recently, research results showed that middle-aged people over 50 years of age have an increased risk of developing shingles if they contract COVID-19. When adults over 50 years of age in the United States were divided into two groups according to their history of COVID-19 infection, the risk of developing shingles increased by 15% for those who had been infected compared to those who had not been infected. People who had been hospitalized with COVID-19 had a 21% higher risk of developing shingles.
64% of domestic shingles patients are in their 50s or older. For these reasons, the Korean Society of Infectious Diseases recommends that adults over 50 years of age receive the shingles vaccine.
○With the launch of the killed vaccine, the prevention rate increased to 97%.
There are three shingles vaccines distributed domestically. These are SK Bioscience’s Sky Zoster, Merck (MSD)’s Zostavax, and GlaxoSmithKline (GSK)’s Shingrix. Skyzoster and Zostavax are both live vaccines administered by weakening the toxicity of the varicella-zoster virus. In Korea, Zostavax vaccination began in 2012. Sky Zoster was released in 2018. Shingrix, which was launched in Korea in December last year, is a killed vaccine using recombinant protein. Shingrix quickly became the number one shingles vaccine overseas, reporting a high prevention rate. Zostavax’s shingles prevention rate in people over 50 years of age is 51%, and Sky Zoster’s prevention rate, which has proven non-inferiority to Zostavax, is at a similar level. Typically, these live vaccines lose their protective effect as people age. The live vaccine prevention rate for people over 80 years of age is reported to be around 18%.
Shingrix recorded a prevention rate of 97% in people over 50 years of age. Even among those over 80, it is 91%. Unlike live vaccines, whose effectiveness almost disappears regarding 8 years following vaccination, Shingrix maintained its prevention rate even following 10 years. Considering this preventive effect, the Korean Society of Infectious Diseases recommends that people who have previously received a live vaccine can also receive the killed vaccine.
Because live vaccines use live viruses, there are restrictions on who can be vaccinated. People with severe immunocompromises cannot receive the vaccine because the vaccine can cause shingles. Park Jeong-ha, a professor of family medicine at Kyung Hee University Hospital, said, “If you get a live vaccine when your immunity is low, you may actually develop shingles. If you have shingles, you should get the vaccine 6 months to 1 year following the acute symptoms of shingles have passed.” . The disadvantages of Shingrix are the number of doses administered and the high price. Zostavax and Skyzoster require only one injection, but Shingrix requires two injections, spaced 2 to 6 months apart. It is known that because it is an intramuscular injection and because it contains immune-boosting ingredients, the pain is somewhat significant.
According to the Health Insurance Review and Assessment Service, the average prices of Zostavax and Sky Zoster at local clinics in Seoul are 170,000 won and 150,000 won, respectively. Shingrix requires two injections, costing regarding 250,000 won each time.
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