#Middlebury #Health
DEAR DR. ROACH: I received the first dose of Shingrix this week and had pretty severe side effects, though in the range of what can be expected: high fever (101.5), intense shivering, a severe headache and 12 hours of extreme fatigue. The entire reaction began 11 hours after the shot and ended 18 hours after that. I am 61 and in excellent health, taking only 25 mcg of levothyroxine daily.
I have a few questions that I hope you can answer. I’ve tried looking at the clinical trial results for Shingrix, but I am not qualified to understand the information as presented.
- Is it likely that I’ll have a similar (or worse?) reaction to the second shot? The package insert says one can react to the first, second, neither or both.
- Are both injections identical?
- When I had chickenpox as a child, I was way sicker than the average kid. Related?
- If I get shingles, do I have a higher risk for a severe case? – J.G.
ANSWER: Compared with the previous one-time vaccine Zostavax, the new two-dose Shingrix vaccine is much more effective. However, it does have a higher risk of side effects. You have had the most common side effect, though only 10% of people will have symptoms as bad as yours. These symptoms are caused by your body mounting an inflammatory response to the glycoprotein in the vaccine (the new vaccine does not contain a live virus). You clearly have a robust system to fight off infection.
To answer your questions in order: You are at higher risk for a similar reaction for the second shot. I would plan your day accordingly, and premedicate with Tylenol (even though it may make the vaccine slightly less effective). The second vaccine is identical to the first. I have read reports that there have been shortages of the vaccine.
Chickenpox and shingles can affect you both by the virus attacking you and by an exuberant inflammatory and immune reaction. I would guess that you are at lower risk for viral complications (such as infection of the eye, brain or lungs) but at higher risk for symptoms due to your own system, such as high fever. In many cases, the body’s response to infection can be as damaging as the infection itself.
DEAR DR. ROACH: Last year I was treated for gout and was prescribed allopurinol (100 mg) once a day. Approximately five to six months after I started taking it, I became lethargic and was not feeling myself (I am a very young 77 years old) and suddenly lost my sense of taste. I was taken off the medicine and still have little taste sensation other than citrus fruits, apples and spices. I was told that this could last for months, years or forever. Do you have any suggestions for me? I am eating as before, hoping that I will recover my taste. – N.K.
ANSWER: I certainly found that allopurinol can cause loss of taste sensation, but the Food and Drug Administration case reports don’t say how long it can last. Unfortunately, I can’t find any reliable way (or even plausible way) to increase the likelihood of getting your taste sensation back.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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