DEAR DR. DONOHUE: You recommend that everyone 60 and over get the shingles vaccine. The cost is outrageous. My total out-of-pocket expenses were $395. – A.P.
DEAR DR. DONOHUE: My doctor doesn’t agree with you about the shingles vaccine. He says I could pass the virus on to my grandchildren. – R.C.
DEAR DR. DONOHUE: My doctor says the shingles vaccine is only 60 percent effective and that you have that much protection if you have had shingles once. – B.S.
ANSWER: Shingles is a result of a reawakened chickenpox virus that lives in the body’s nerve cells until the person dies. Later in life, the virus might waken, travel down the nerve to the skin and show itself as a shingles rash.
The estimate is that 99.6 percent of the population older than 40 harbor the chickenpox/shingles virus in their bodies. Upward of 600,000 new cases of shingles happen each year in the United States.
Most of those cases occur in people over 60. An outbreak of shingles is bad, but what’s worse is pain that can linger long after the shingles rash has gone. That’s called postherpetic neuralgia, and it makes life miserable.
The shingles vaccine Zostavax reduces the chances of coming down with shingles by 61 percent and reduces the chances of postherpetic neuralgia even more. That’s decent protection.
The shingles vaccine is a one-shot affair. The cost is between $150 and $190. Health organizations, pharmacists and physicians are free to charge what they want. The charge to A.P. was outrageous. He belongs to a health care system. Price should be discussed prior to getting the shot, and insurance companies should be questioned about coverage.
After having had shingles, a person’s chance for recurrence is less than 5 percent – not a big threat. The Advisory Committee on Immunization Practices says that everyone over 60, even if they have had shingles, should be immunized. People who have had shingles can agree or disagree with that policy, keeping in mind that the chance of recurrence is slim.
The shingles vaccine contains live but very weakened virus. A person might pass the virus on to others who had not previously been infected if the vaccinated person breaks out in a rash. That seldom happens.
DEAR DR. DONOHUE: My son is 6 months old. He is missing one testicle. The doctor says it’s still in his abdomen. He thinks the boy should be operated on to place the testicle where it should be. Isn’t this too young for such an operation? What if we don’t have it done? – J.B.
ANSWER: Your son has an undescended testicle, something that happens to 2 percent to 5 percent of baby boys. During fetal life, the testicles are in the abdominal region. They should migrate downward to their final destination in the scrotum before birth.
If a testicle doesn’t attain its position in the scrotum by 6 months to 12 months, it’s unlikely ever to do so. An undescended testicle carries a greater risk of becoming cancerous later on than does a testicle in its normal position. That’s why surgery is advocated. Your son isn’t too young for such an operation. It’s not a procedure that requires a long convalescence.
DEAR DR. DONOHUE: On my notice for the flu vaccine it says: “1 flu vaccine, 3 yrs.” Am I interpreting this correctly to mean that the injection is good for three years? – F.H.
ANSWER: I don’t understand the meaning of the “3 yrs” notation either.
I do know that a flu shot is good for only one season. Every year the flu virus makes a few changes in its appearance. Those changes are enough for it to elude the previous season’s vaccine.
A new vaccine has to be devised every year. Scientists get together to predict what the changes might be so that the new vaccine can be prepared in time for the next season. Usually, they are correct in their predictions.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com
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