PDF David Brownstein, MD
August 9, 2010
I frequently get asked by my patients, ” Should I take the shingles vaccine?” Shingles is a consequence of the chicken pox virus which becomes reactivated and causes a rash. Associated with the rash can be a painful condition called postherpetic neuralgia. A vaccine that avoids the onset of postherpetic neuralgia would be a worthy item.
Zostovex is a vaccine that contains live, attenuated chicken pox virus (varicella-zoster). It is the same vaccine given to children to prevent chicken pox, only it is approximately 14 times stronger in the adult version. It has been approved by the FDA for the prevention of shingles in adults 60 years of age or older. The [U.S. CDC's] Advisory Council on Immunization Practices has recommended Zostovex as a prevention of postherpetic neuralgia.
As previously mentioned, a vaccine to prevent postherpetic neuralgia sounds good. Is it effective? An article in The American Academy of Family Practice (6.15.07. Vol. 75, No. 12) summarized the research on this vaccine. The article reports a 50% decline in shingles and a 66% decline in postherpetic neuralgia with the use of Zostovex. The authors conclude that Zostovex “…is an effective vaccine that should be offered to patients who are 60 years and older.” But, further review of the data provides a much different picture.
For the prevention of shingles, 3.3% of unvaccinated persons developed shingles compared to 1.6% of vaccinated people. The “50%” claim that the article touted is the less-than-accurate ‘ relative risk’ level (calculated by the following formula–1.6/3.3). The more accurate ‘absolute risk’ shows a 1.7% decline (3.3-1.6) (source).
For the prevention of postherpetic neuralgia, the manufacture of the vaccine, Merck, touts a 39% decline with the use of the vaccine. Further analysis of the data might lead you to a different conclusion. Approximately 0.4% of unvaccinated persons versus 0.14% of vaccinated people developed postherpetic neuralgia. The 39% decline is the less-than-accurate ‘relative risk’ (0.14/ 0.4). If we looked at the more accurate absolute risk, we come up with a decline of 0.26% of postherpetic neuralgia in those that were vaccinated. The vaccine costs approximately $200.00.
So, for $200.00, we get a 0.26% decline in developing postherpetic neuralgia. I don’t think a 0.26% decline is anything worth spending nearly $200.00. What can you do? Keep your immune system strong to prevent shingles in the first place. Eat a good diet free of refined foods. In my practice, I have found Vitamin C IV’s very helpful for those that develop shingles/postherpetic neuralgia. Also, NAET, an acupressure treatment, has been very helpful for treating shingles and postherpetic neuralgia. Lastly, Vitamin B12 shots have also been very effective at eradicating postherpetic neuralgia.
More From vaccinationcouncil
Recent article on the profitable set-up for this vaccine:
http://insidevaccines.com/wordpress/2010/07/30/a-…
You’ve got a typo on the name of the vaccine! Should be Zostavax.
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If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.
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This is getting a bit more subjective, but I much prefer the Zune Marketplace. The interface is colorful, has more flair, and some cool features like ‘Mixview’ that let you quickly see related albums, songs, or other users related to what you’re listening to. Clicking on one of those will center on that item, and another set of “neighbors” will come into view, allowing you to navigate around exploring by similar artists, songs, or users. Speaking of users, the Zune “Social” is also great fun, letting you find others with shared tastes and becoming friends with them. You then can listen to a playlist created based on an amalgamation of what all your friends are listening to, which is also enjoyable. Those concerned with privacy will be relieved to know you can prevent the public from seeing your personal listening habits if you so choose.
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The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.
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Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.
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The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.
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