Dr. Crawford led the Shingles Prevention Study at the San Antonio site. It was one of 22 sites that participated in the study.
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Anyone who has ever suffered from chickenpox is at risk for the severely painful nerve and skin infection known as shingles (herpes zoster). But thanks to a recent study of an experimental shingles vaccine that involved more than 38,000 participants at 22 sites nationwide, U.S. adult population may be able to dramatically reduce their risk of suffering from the disease. The findings appear in the June 2 issue of The New England Journal of Medicine.

George E. Crawford, M.D., professor of medicine at the Health Science Center, led the Shingles Prevention Study at the San Antonio site. The 5 ½ - year long study is considered to be one of the largest adult vaccine clinical trials ever.

“The vaccine’s effectiveness, demonstrated in this national study, is great news for all of us,” Dr. Crawford said. “Almost all adults have had chickenpox and are at risk for shingles when the virus reactivates.”

Thirteen hundred men and women age 60 or older participated in the study at Dr. Crawford’s San Antonio site. Half of the study participants received the experimental vaccine, a more potent version of the licensed childhood chickenpox vaccine, while the others received a placebo. During an average of more than three years of follow-up, the vaccine reduced the incidence of shingles by 51 percent, and the total burden of pain and discomfort due to shingles by 61 percent compared with individuals who received the placebo. Moreover, the vaccine reduced the incidence of postherpetic neuralgia (PHN) – the persistent, long-lasting nerve pain after shingles – by two-thirds compared with placebo. PHN is a severe chronic nerve pain that is the most common serious complication of shingles.

“Although shingles is rarely fatal to our elderly population, it is nevertheless a painful and often debilitating illness that can cause serious complications lasting two weeks to several years,” Dr. Crawford said. “It has been shown to reduce quality of life to a degree comparable to congestive heart failure, diabetes, and depression. Treatment is difficult and often offers only partial relief of pain.”

Symptoms of shingles may include:

• pain, itching or tingling in one area of skin
• pain on only on one side of the body
• a blistery rash that takes two to four weeks to heal
• PHN - which can include burning, throbbing, aching, stabbing pains

The national study was led by the Department of Veterans Affairs (VA) and carried out in collaboration with the National Institute of Allergy and Infectious Disease (NIAID) and Merck & Co., Inc. If the zoster vaccine is approved by the Food and Drug Administration, the research team estimates the vaccine could prevent 250,000 cases of shingles that occur in the United States each year and reduce the severity of the disease in another 250,000 cases annually.


Shingles Statistics
A question-and-answer session with Dr. Crawford

What are some complications among the elderly who suffer from shingles?

“The most common serious complication of shingles is Post-herpetic neuralgia – the persistent pain that lasts after the skin lesions heal. It can be severe and last for months or years.

If the zoster virus affects the face, it can affect other cranial nerves, including facial weakness on one side, dizziness, hearing loss and eye inflammation with possible corneal scarring. Rarely, individuals can suffer from strokes.”


What should you do if you suspect you have shingles?

“See your doctor promptly for medications that can speed healing and decrease the risk of PHN. The medications have only been shown to work if taken within the first 72 hours of disease. No topical therapy has been shown to be helpful. I advise keeping clean and covered.”


Is shingles contagious?

“Yes, but it is much less contagious than chickenpox. I usually advise patients to cover the lesions, if feasible, and avoid contact with severely immunosuppressed people (chemotherapy and advanced HIV patients). Immunosuppressed individuals with disseminated zoster are much more contagious.

People who have had chickenpox are immune and are not at risk of getting infected. If a person with shingles infects someone else, that person will get chickenpox, not zoster.”


Is shingles deadly?

“The average person has an extremely low chance of dying of zoster, although suicide is a recognized complication of PHN.

Immunosuppressed individuals can get disseminated disease, which can be fatal.”

To view the NIH press release, visit www.nih.gov.