Younger lupus patients at risk for shingles

In a risk-versus-reward analysis, many patients with lupus or other autoimmune diseases are better off getting a shingles vaccine, said OMRF scientist Eliza Chakravarty, M.D.

“A 25 year old with lupus has the same risk of getting shingles as a healthy 80 year old,” said Chakravarty. Currently, the shingles vaccine is licensed for people 50 years of age or older.

The researcher and clinician recently spoke at the annual New York University Advanced Rheumatology Seminar Series about the use of shingles vaccines in lupus patients. Lupus is a chronic disease in which the immune system becomes unbalanced and begins attacking the body’s own tissues, causing inflammation and organ damage.

About half a million Americans get shingles each year and anyone who had chickenpox is at risk for the disease. Symptoms of shingles include burning, pain or tingling on one side of the body, followed by a rash and the formation of small blisters. Though the rash usually forms from the spine around to the side and front of the body, it can also involve the face, ears, eyes and mouth. Risk for the disease increases with age, she said.

“It’s a very painful condition,” she said. “There are medications that can help, but it’s better not to get sick in the first place.”

The worry of some rheumatologists is that patients with compromised immune systems, including those with autoimmune diseases, will contract the illness from the live-virus vaccine, she said.

“We did a small study where we vaccinated 10 lupus patients and 10 healthy controls with the shingles vaccine and monitored their response,” she said. “None of the people who received the vaccine got anything that resembled a blister or shingles.”

Chakravarty said researchers are planning to do a follow-up study in patients with rheumatoid arthritis and seeking grants so they can do larger studies with younger lupus patients.

“Shingles won’t kill anybody, but it’s a painful disease nonetheless, and it disproportionately strikes autoimmune disease patients,” she said. “Our goal is to help them avoid that pain.”