From: "BECKY.Garbarino**At_Symbol_Here**usda.gov"Date: May 21, 2008 10:15:52 AM EDT (CA) Subject: RE: [DCHAS-L] Shingles Vaccine As with every personal medical decision, the shingles vaccine issue is just that: a PERSONAL issue and decision. The best approach is to gather as much (valid) data as possible and discuss the options with your personal health care provider. As for me, I'll probably get the vaccine. == From: ahalltoxic**At_Symbol_Here**msn.com Subject: RE: [DCHAS-L] Shingles Vaccine Date: May 21, 2008 11:08:10 AM EDT (CA) To the DCHAS group: As one of the few (if not the only) physicians as a member of DCHAS: What happens is that the virus that causes chickenpox lies dormant in the spinal cord nerve roots/ganglia and can emerge years and years after the original (usually childhood) infection and presents as a quite painful vesicular rash along 1 or more dermatomes (the anatomical areas of the skin that are innervated by nerves from the nerve roots and extra-spinal cord ganglia). The disease, as some members have noted, can range from mild to severe. Prehaps the worst case in when the eye is involved (specifically the cornea) (innervated, if I recall correctly from medical school, by the 2nd branch of the Vth cranial nerve). Shingles tends to occur unilaterally (on one side of the body). It does tend to be a disease of the somewhat elderly (I'm pushing 60 myself), but also occurs when the immune system is not in full working order (which usually keeps the dormant virus in check). Such occurences as a need for immunsuppressant medication (for organ/tissue transplantation), any immunodepressed condition, corticosteroid medications (for anything from COPD to severe asthma to a bad case of urticaria [hives], etc.) to even severe stress of any kind can trigger the onset. Treatment is available, but the disease can be quite severe and quite long-lasting. I'm in Europe for a scientific meeting at present and haven't been able to fully research the disease, what's changed about it or knowledge of it since I began devoting my time to Medical Toxicology many years ago, nor the literature available on the new vaccine. Once I return to the US in a week or so, I'll take some time and research the issue and post the results on this website. In the meantime, I'd recommend that you use your own judgement, discuss it with your personal physican, and make up your own mind about whether or not this is for you (I haven't yet been able to look at the downside: what adverse/side effects may occur with the vaccine). Without having looked at it today, I'd suggest those who are contemplating having the vaccination Google the topic and also perhaps see what's available on e-medicine.com (best to Google "Shingles" and look for an emedicine.com hit or hits -- generally fairly thorough reviews from a person or persons knowledgeable in the field). Another place is to look is in the National Library of Medicine's "MedlinePlus" database which is written for non-medical folks (http://www.nlm.nih.gov and then select Medline Plus; you can also check the medical literature by choosing PubMed from the main menu). Mind, I'm not recommending that anyone choose to have or not have the vaccination based on this email. I'm not your personal physician. I've provided this for information purposes only and will provide more information when I have time to research it. The choice is between you and your physician, based on your patient-doctor/doctor-patient relationship. However, I have always believed that informed and educated patients are in a better position to make their own choices regarding their healthcare. More later when I'm not in France. And to Susan Hadden: Nurses are worth far more than their weight in gold or any other precious metal or highly compressed and arrayed carbon you care to name (hint: Superman used to squeeze lumps of coal and what did he produce?). We need many more of them. Alan H. Hall, M.D. Medical Toxicologist ahalltoxic**At_Symbol_Here**msn.com == From: ACTSNYC**At_Symbol_Here**cs.com Subject: Re: [DCHAS-L] Shingles Vaccine Date: May 21, 2008 8:47:26 AM EDT (CA) Good thinking. Add to that the very small possibility of serious complications and it makes the rationale complete for getting the vaccine. A family member got shingles in the face, eye and ear area. He was left with reduced vision and hearing and some scars on his face. I got the shot. Monona Rossol
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