Do you remember having chickenpox? Herpes zoster (HZ),
commonly known as herpes zoster, is a rash caused by the reactivation of the
varicella-zoster virus .
Having passed this disease, the pathogen remains inactive in
the nervous tissue, but over the years it can reactivate and cause shingles. In
addition, the onset of HZ can cause postherpetic neuralgia, a chronic
neuropathic pain that inflames the nerves and is not relieved by conventional
pain relievers. Although it is the most common complication, HZ also causes
skin infections or muscle paralysis .
In terms of prevention, the first vaccine to fight the
infection, Zostavax, which Shingrix joined in 2017, was approved in 2006. The
first is made from a weakened virus and is injected once, and the second is
made from protein. it is present on the surface of the viral agent and requires
two injections .
The main difference between the two is the degree of
immunization they produce: Zostavax reaches around 60% -70%, while Shingrix
reaches around 90%. This greater efficacy has opened up new possibilities in
the HZ approach, an idea in which Javier Diez Domingo, Head of Vaccine Research
at the Foundation for Health Promotion and Biomedical Research of the Valencian
Community (Fisabio), and Javier López Jiménez, Head of Hematology and
Hemotherapy at the Ramón I-Cajal Hospital in Madrid .
After administration of the vaccine, patients may experience
discomfort in the area where the vaccine was administered or even a mild fever.
However, experts say that these side effects cannot be compared to those caused
by shingles .
In this sense, Shingrix means "before and after,
affecting the quality of life of patients," says Dr. Diez Domingo, who
participated in vaccine research studies. This expert points out that about
half of people over the age of eight have an HZ infection. It is estimated that
some 200,000 cases are reported annually in Spain, especially among people over
fifty years of phase and people with weakened immune systems.
Specifically, according to Dr. Diez Domingo,
"immunosuppressed people have a higher incidence of HZ because a decrease
in their defenses contributes to the reactivation of the virus." For this
reason, access to an effective vaccine is of special importance to them.
Although vaccination is indicated for people over fifty
years of age, the age at which the incidence begins to increase, it is up to
the public health authorities to decide who should be vaccinated. And since
immunosuppressed people are those who express the greatest urgency for the
drug, the Public Health Commission, which represents all the autonomous
communities and the Ministry of Health, recently approved a recommendation to
click on patients with hematopoietic stem cells. transplantation - immature
cells that produce blood - and solid organ transplantation, for people with HIV
who receive certain treatments for rheumatological and non-rheumatological
diseases and who are in a situation of greater immunosuppression.
In this sense, Dr. López Jiménez explains that the ability
to have the Shingrix vaccine is very important for patients who have undergone
hematopoietic stem cell transplants, since the incidence of herpes zoster in
this type of patient is about ten times greater than in patients. the general
population. In fact, specialists are routinely administering antiviral drugs to
prevent the development of HZ; When you stop taking it, there is a risk of a
painful rash.
The expert also points out that these patients have a high
incidence of herpes zoster neuralgia, which "can have serious
complications." On the other hand, Dr. Diez Domingo points out that it
would be convenient to start vaccinating a healthy population over 65 years of
age.
In conclusion, vaccination against shingles should be a
priority in adults with immune problems and, over time, should be administered
to the entire healthy population between the ages of 60 and 65. This is advised
by the expert Fisabio, who emphasizes the need to have enough vaccines to be
able to carry out this type of public health action, and also have an adequate
budget.
Maximum efficiency
"With the new inactivated vaccine, we are achieving
greater immunization efficacy and a longer response time," says Dr. López
Jiménez about the effectiveness of Shingrix. In general, the drug contributes
up to 90% of the immune response in patients over fifty years of age, but, in
addition, the expert highlights the resistance of the antibodies in the medium
and long term.
This increased immunity is also reflected in more
immunosuppressed populations. For example, in patients with autologous hematopoietic
stem cell transplantation
