Shingles (Herpes Zoster)
What is Shingles?
Shingles is the name commonly used for herpes zoster (HZ). HZ is a painful skin infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. Shingles appear as a rash with blisters, usually on one side of the body (left or right), often in a strip. The rash consists of groups of small, fluid-filled blisters that dry, scab over, and heal (like chickenpox) in a few weeks. Healing is usually complete, but some people may be left with scars.
After a person recovers from chickenpox, the virus (VZV) remains dormant in the body. You can get Shingles when that virus gets reactivated, often many years after having had chickenpox. VZV tends to reactivate when your immune system is weakened due to aging, stress, or other health problems.
What are the risk factors for Shingles?
Almost one third of Canadians will develop shingles in their lifetime. The occurrence and severity of shingles and its complications increase with age. Shingles occur most frequently in older adults and in those with a weakened immune system. The incidence and severity of both herpes zoster (HZ) and Postherpetic neuralgia (persistent nerve pain) (PHN) increases significantly after age 50. Some people experience pain around the rash site for a month or more–pain that is severe enough to interfere with daily activities. Scratching the rash can also cause a secondary infection if harmful bacteria get into the sores. Shingles on the face can involve the eyes, which is serious because it can cause scarring and blindness. The occurrence and severity of shingles and its complications increase with age. It occurs most frequently among older adults and immunocompromised persons.
How does Shingles affect asthma?
Chronic respiratory diseases, including asthma, can increase the risk of developing shingles and its complications. Individuals with asthma may have a higher likelihood of experiencing shingles, especially if they are using inhaled corticosteroids, which can weaken the immune system. As we age, our immune system also naturally weakens. As a result, the shingles virus may reactivate and increase the risk of getting shingles.
Shingles can lead to serious complications, including postherpetic neuralgia (PHN), which is a type of nerve pain that persists after the rash has healed. For people living with asthma, managing both conditions effectively is essential to minimize complications.
Vaccination against shingles is particularly important for individuals with asthma, as it helps protect against both the infection and its potential complications.
Why get vaccinated for Shingles?
The best protection from shingles is vaccination. People can still get shingles after receiving the varicella (chickenpox) vaccine but they are 4 to 12 times less likely to do so than if they haven’t been vaccinated. The vaccine is recommended for most people aged 50 and older.
How does Shingles vaccine work?
The Shingrix vaccine helps prevent reactivation of the virus that causes shingles. It contains glycoprotein E (gE), a protein found on the surface of the varicella zoster virus (VZV). When your immune system is exposed to gE at vaccination, it creates antibodies that will fight against it.
Type of Shingles vaccine available in Canada?
The recommended vaccine for use in Canada to protect against shingles is the Shingrix vaccine (Recombinant Zoster Vaccine, RZV). RZV is injected into a muscle (usually in the upper arm) in two doses. The second dose is given two to six months after the first dose. It is safe and highly effective in reducing the incidence of shingles and persistent nerve pain (postherpetic neuralgia, PHN). Treatment options for shingles (HZ) and persistent nerve pain (PHN) have limited effectiveness.
Recommendations for Vaccination:
- Recommended for individuals 50 years and older without contraindications.
- Individuals ≥50 years of age without contraindications who have received LZV, or who have had a previous episode of shingles, should be vaccinated with RZV after at least one year.
- RZV may be considered for immunocompromised adults ≥50 years of age based on a case-by-case basis.
Some individuals should not receive the vaccine; for example, those with certain allergies or who are taking certain medications.
Useful Resources:
Asthma and Vaccines
People with asthma face a higher risk of serious illness from preventable diseases, making vaccination extremely important.
Lung Vaccination Working Group
Within Canada, vaccine uptake continues to be a significant area of concern.
Controlling Asthma
When asthma is unmanaged, it can put a pause on your life. Learn how to break breathlessness and press play on life.
Asthma Canada's FREE Asthma & Allergy HelpLine
If you have questions on managing your asthma and vaccines, please contact our free HelpLine at 1-866-787-4050 or info@asthma.ca. Our team of asthma and allergy experts will happily assist you with your asthma control and help put your mind at ease.
Jaqueline Murdoch: Asthma and Vaccine Champion
Jaqueline Murdoch, 75, a retired IT manager and personal trainer, is a passionate advocate for vaccination, shaped by a lifetime of health challenges and early experiences with preventable diseases. Diagnosed with asthma in 2012, she manages her condition with a rigorous health routine and proactive vaccination. Jaqueline received all available COVID-19 doses, annual flu shots, and vaccines for shingles and pneumonia, seeing immunization as essential to reducing severe illness. Having witnessed the impact of diseases like polio and shingles, she urges others to “look at the science” and stay informed, firmly believing that vaccines are key to a long, healthy life.