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» LymeNet Flash » Questions and Discussion » Medical Questions » New vaccine- shingles- you figure it out- ha!

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Author Topic: New vaccine- shingles- you figure it out- ha!
Tincup
Honored Contributor (10K+ posts)
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It appears there is about a 50/50 chance you won't get shingles it if you have their new vaccine.

I can hardly wait for my 60th birthday to arrive!

[Big Grin]

`````````````````````````````````````````````

"Spurred by the results of the Shingles Prevention Study, the ACIP recommended that all adults aged 60 years or older receive the zoster vaccine, regardless of a prior history of shingles."


THE EFFICACY OF A VACCINE AGAINST HERPES ZOSTER AND POST-HERPETIC NEURALGIA


Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005; 352:2271-2284.

(For non-journal subscribers, an additional fee may apply for full text articles.)

View journal abstract View full article


In June 2005, the results of one of the largest vaccine efficacy trials, the Shingles Prevention Study, were reported. In a randomized, double-blind, placebo-controlled trial of adults age 60 or older, the use of a vaccine against zoster (containing 14 times the minimum estimated potency found with its pediatric counterpart) was studied. Subjects with a history of varicella (chicken pox) or residence of at least 30 years in the continental United States were eligible for enrollment.

Immunocompromised persons, those with chronic pain syndromes, and persons with a prior history of herpes zoster (shingles) were excluded. Randomized by study site and age group (age 60-69 years, and ≥70 years), subjects received either zoster vaccine or placebo.

Subjects were educated regarding the signs and symptoms of herpes zoster, and were followed via monthly automated phone calls to assess for the presence of the disease.

Suspected zoster rashes were evaluated using polymerase chain reaction (PCR) and culture testing of a swab from a characteristic lesion.

The final determination of a case of herpes zoster was made by a physician committee blinded to the subject's treatment assignment.

The primary end point for the study was the burden of illness due to herpes zoster (a measurement of pain and discomfort associated with the disease), while other end points included the incidence of post-herpetic neuralgia and the incidence of herpes zoster.

A remarkable 38,546 adult subjects enrolled in the trial, with 95.3% completing the study for a mean duration of herpes zoster surveillance of 3.13 years (no difference between study arms).

Vaccination with the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (95% confidence intervals [CI], 51.1-69.1%), the incidence of post-herpetic neuralgia by 66.5% (95% CI, 51.1-69.1%), and the incidence of herpes zoster by 51.3% (95% CI, 44.2-57.6%).

The zoster vaccine led to a significantly higher rate of injection site complaints, but these were generally mild.

Spurred by the results of the Shingles Prevention Study, the ACIP recommended that all adults aged 60 years or older receive the zoster vaccine, regardless of a prior history of shingles.1

Issues such as the cost-effectiveness of vaccination, reimbursement for the vaccine by third-party payors, and the timing of vaccination in persons with a recent history of shingles still must be ascertained and further defined.


References

1. Centers for Disease control and Prevention's Advisory Committee on Immunization Practices. ACIP Provisional Recommendations for the Use of Zoster Vaccine. Accessed on November 15, 2007.

[ 29. December 2007, 11:48 AM: Message edited by: Tincup ]

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map1131
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Thanks I'll take my chances. 50/50 not the best of odds. Can't they do better than that? Thank goodness I still have 9 yrs before someone tells me I need it. I'd hate to kick someone in the shins.

Pam

--------------------
"Never, never, never, never, never give up" Winston Churchill

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duramater
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Not that I'm pro this vaccine and not that scientists are very welcome on this board in recent months, but I felt the need to clarify what this study is saying.

It IS NOT saying there is a 50/50 chance you will get shingles with the vaccine. Rather there is a 50% REDUCTION in the incidence of getting shingles. So, if there is a likelihood of 30% of getting shingles from 60 onward, then you reduce that likelihood by 50% making it 15% chance of getting it.

Now, back to your regularly scheduled program.

Posts: 689 | From western MA (we say buttER and pizzA) | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
Tincup
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Yo dura...

It matters.

[Big Grin]

Ok.. it says...

"Vaccination with the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (95% confidence intervals [CI], 51.1-69.1%), the incidence of post-herpetic neuralgia by 66.5% (95% CI, 51.1-69.1%), and the incidence of herpes zoster by 51.3% (95% CI, 44.2-57.6%). "

I see the reduction of illness as you said... in the 61.1percent figure (?) but still see the 50/50 deal where it mentions actually 51.3 percent.

?? So I'm lost now.

You also said.. "It IS NOT saying there is a 50/50 chance you will get shingles with the vaccine."

I don't think I said it did? I am really confusing myself here. I THINK I said .. flip as I was.. that with the vaccine you had about a 50 percent chance of not getting it... and 50 percent chance of getting it.

Can you explain more how it works for this un-scientist? It would really help if I could grasp it as I need to read this stuff day in and out and it might be nice if I understood what I was reading. Ya think? HA!

THANKS!

[Big Grin]

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duramater
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quote:
"Vaccination with the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (95% confidence intervals [CI], 51.1-69.1%), the incidence of post-herpetic neuralgia by 66.5% (95% CI, 51.1-69.1%), and the incidence of herpes zoster by 51.3% (95% CI, 44.2-57.6%). "

I see the reduction of illness as you said... in the 61.1percent figure (?) but still see the 50/50 deal where it mentions actually 51.3 percent.

?? So I'm lost now.

You also said.. "It IS NOT saying there is a 50/50 chance you will get shingles with the vaccine."

I don't think I said it did? I am really confusing myself here. I THINK I said .. flip as I was.. that with the vaccine you had about a 50 percent chance of not getting it... and 50 percent chance of getting it.

Can you explain more how it works for this un-scientist? It would really help if I could grasp it as I need to read this stuff day in and out and it might be nice if I understood what I was reading. Ya think? HA!

THANKS!

Two things as a pre-quel, 1. people should not try to understand studies based only on abstracts -- that is not the purpose for which the abstracts are written, 2. scientific papers (and their abstracts that are particularly obtuse because of strict word limits) take time and education to learn -- what you've accomplished on your own is superb.

That said, your headline screams 50/50 chance of not getting shingles in the face of the new vaccine which is patently false. Why? Because you don't even have a 50/50 chance of getting shingles in the absence of the vaccine.

If you parse the stats reported in the abstract, it states that the vaccine reduces the INCIDENCE of illness from shingles by 60%, it reduces the INCIDENCE of neuralgia from shingles by 66%, and the INCIDENCE of shingles by 51%. However, the abstract DOES NOT state the rate of incidence. Whatever the incidence rate prior to the vaccine(not reported in abstract), then you multiple the rate of incidence by the rate of reduction (which is reported) to get the new rate of incidence (not reported in abstract).

Thus, if there is a 30% baseline rate of shingles (say over the age of 60, which I believe is a fairly reasonable estimate), then of those obtaining the vaccine, the rate of shingles was 15% on average (a 50% reduction in the incidence of shingles).

No 50-50 about it.

Anyway, that's my best explanation given utter fatigue, a long day, and only a short paragraph to explain complex concepts to a non-scientist. Hope this sheds even a photon of light (heh - another geeky science joke... not as great as Dura -- Matters!).

Posts: 689 | From western MA (we say buttER and pizzA) | Registered: Nov 2004  |  IP: Logged | Report this post to a Moderator
lymie tony z
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Hey thanks for the news folks,

Pardon my not reading any of it....not out of disrespect but just the fact that I have already

experienced zoster herpes and shingles at one time or another before, durring, after any one of my monthly herxes.

I would be almost deathly afraid to get a vaccine for this particular virus.


The itchies and rashes, that go with these viral episodes of eruption,not to mention the deep nerve pain, called by some ducks,

I presented these rashes to,as being caused by,
"cellulitis" and or "contact dermatitis" or

psoryasis or a form of arthritis that errupts thru the derma, before or after the arrival of

arthritis, just beneath the dermal psoratic erruption. Sometimes referred to as 'psoratic arthritis'.

Given the fact that TBD's seem to have the ability to seemingly "call up to the forefront"

past viral entities we've experienced in our lifetimes.

I doubt any lymie would be able to avoid experiencing one form of the "herpes" virus,

some time durring their battle with TBD's, vaccine or no vaccine.

Add to this fact, that I, personally, have ALWAYS had some form or other of bad reactions

to past vaccines, (and anti-biotics) since at least my childhood, (possible in utero lyme

infection, that went dormant for awhile). I would have to hazzard a guess at my having a better

than, 50/50 chance, I would have an unfortunate reaction, should I choose to have this innoculation.

This, in the face of, whether that 50/50 percent chance, means 15% of the previously

mentioned corrected variables by Dura, do, matter.

Based soley, on my previously mentioned experiences of susceptability and actual events

of erruption, do to some unproven antagonist,(but an antagonist I suspect is TBD related),

which obviously enough for me, caused me to experience past,


viral activation, now that my body has an, active infection of TBD's. I suspect my chances

would be 100%, that I, would have some kind of reaction(a bout of parentheral shingles not being ruled out).

I certainly hope I did'nt get too unscientific for those that are'nt and not scientific enough for those who are!?

Final deduction................They ain't stickin that in me buddy!....LOL!

You would agree Dura, if you were'nt such a lit., hard mother.(slight anatomical joke)!

zman

[ 29. December 2007, 11:07 AM: Message edited by: lymie tony z ]

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I am not a doctor...opinions expressed are from personal experiences only and should never be viewed as coming from a healthcare provider. zman

Posts: 2527 | From safety harbor florida(origin Cleve., Ohio | Registered: Jan 2004  |  IP: Logged | Report this post to a Moderator
h8lyme
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I just wanted to say that it was recommended to my mother that she take this vaccine, and guess what within a month of taking it she developed SHINGLES. I'm not saying the vaccine caused the shingles, maybe she was going to get them anyway, but she never had a bout of shingles prior to getting the vaccine. I talked to the doctor and asked if there was a possible connection, he told me that the vaccine was relatively new and he was not sure.

Great, my mother was an experiment for these clowns. Hope you guys don't get the same reaction. Shingles is not fun, hope most of you can avoid them.

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Tincup
Honored Contributor (10K+ posts)
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Good morning Dura...

Bless your heart for the explanation. I understood some of it.. but like you.. I'm working on exhaustion levels and just woke up. Soooooooooo..

I will re-visit this tonight when my early birds who got the worms are sleeping and I can think.

THANK YOU for the explanation! I really want to get the concept... and try to relate it to other studies I care about.

I laugh. One thing scientists don't calculate or consider when reading my posts is my scarcasm when posting stuff.. especially on topics such as vaccines.

So many people were burned by the Lyme vaccine (waited for a miracle that was promised for years while more were getting sicker and sicker, and when it arrived many were hurt and those begging for help with the epidemic, like myself, were very disappointed).

And so many involved in the research and making of it got away with bad things in the process.. that my faith in most vaccines is so low I am not respectful at all.

I have a study.. the one about the ability of Lyme blood tests to detect it. It is from the Hopkins/IDSA out-to-lunch-bunch.

It is written so poorly that even scientists and doctors are saying what the hay... and I doubt the ones writing it have any clue what they are saying. Typical IDSA style; like their latest guidelines.. but 100 times worse.

If you are at all interested in deciphering it.. any part of it at any time.. please advise.

I KNOW there is important info in there.. but can only pull out facts here and there to use.

Again, thanks for the explanation.

[Big Grin]

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www.TreatTheBite.com
www.DrJonesKids.org
www.MarylandLyme.org
www.LymeDoc.org

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