How long after shingles can a person get vaccinated?
BY KEITH ROACH, M.D.
DEAR DR. ROACH: I am 81 years old and was diagnosed with shingles at the end of October 2020. After taking famciclovir, I am healing, but still have a scaly rash and shooting pains on the right side of my head where the shingles occurred. I was told that the pain could last for a year or more. Is this true? The initial outbreak was on my scalp, forehead, brow and eye area. I did see my ophthalmologist and was fortunate that the shingles did not get into my eye, just on my eyelid.
I also saw my physician, who recommended I get the shingles vaccine in February 2021. My eye doctor disagrees and said to wait six to nine months. What is the recommended time span between the onset of shingles and getting the vaccine? How long does the vaccine protect someone? Once you have the vaccine, can you ever get shingles again? — L.H.
ANSWER: Both your doctors are right. Your regular doctor who recommended a four-month time span is correct, but your eye doctor, who said six to nine months, is right also. In fact, the vaccine may be given at any time after the shingles lesions are healed (crusted over). Getting shingles again within a year is very unlikely, so it is fine to wait up to a year after the bout of shingles.
The length of protection seems to be long. But this is still a new vaccine, and it is unclear how long the protection will last.
Unfortunately, no vaccine is perfect — even our best vaccines. Some people will get shingles despite getting the vaccine. Fortunately, the vaccine is even better at preventing the worst complication of shingles, persistent pain called postherpetic neuralgia. Trials have shown 89% to 100% protection against this terrible complication. In people in their 80s, it can indeed last up to a year and occasionally longer.
DEAR DR. ROACH: My 34-year-old son who has Crohn’s disease told me he is using pure 91% bottled alcohol to cleanse his hands because of possible contact with coronavirus when he has to go out. He is being careful especially since he is being treated with Remicade. I want to know if this alcohol use is safe for him. Doesn’t isopropyl alcohol get absorbed into the bloodstream? Could this poison him? I asked him to stop using it too, since it will make his hands cracked and dry for winter. — Anon.
ANSWER: Hand sanitizers may be made from wither isopropyl alcohol (rubbing alcohol) or ethanol (the kind in alcoholic drinks). Both can be absorbed to some extent through the skin, but the amount absorbed through the hands is not enough to cause toxicity. However, using isopropyl alcohol as a fever reducer all over the body CAN cause enough absorption into the body to cause toxicity. It is not recommended.
You are quite right that any alcohol can remove the skin’s natural protective layers and make the hands dry and susceptible to cracking. Rather than using plain alcohol, I recommend using a commercial hand sanitizer product that contains emollients to protect the hands. There are many brands.
DR. ROACH WRITES: Several of my colleagues wrote to correct my recent column: the outer shell of bone is called cortical, while the inside, where the bone marrow is, is called cancellous.