Podcasts about zostavax

TWiV notes the passing of Klaus Conzelmann, then reviews reverse-zoonoses of 2009 H1N1 pandemic influenza A viruses and evolution in United States swine, and reduction in dementia incidence in recipients of Zostavax. Hosts: Vincent Racaniello, Alan Dove, and Rich Condit Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Support science education at MicrobeTV ASV 2025 Reverse zoonoses of 2009 H1N1 in US swine (PLoS Path) Zostavax reduces dementia (Nature) Letters read on TWiV 1207 Timestamps by Jolene Ramsey. Thanks! Weekly Picks Rich – Certain Roller Coasters May Help Small Kidney Stones Pass Alan – Analog and Asimov's science fiction magazines Vincent – Science Under Threat in the United States: How scientists and institutions should respond Listener Pick Charles – Why Techdirt Is Now A Democracy Blog (Whether We Like It Or Not)

In an effort to give both sides of the story, mainstream media gives too much weight to anti-vaccine stories, which may be anecdotal or supported by weak, “predatory journals” with […] The post The Status of the Anti-Vaccine Movement appeared first on WORT-FM 89.9.

Loại vắc-xin mới Shingrix vượt trội hơn so với vắc-xin cũ Zostavax trong việc ngừa bệnh giời leo và các biến chứng liên quan. Cần lưu ý điều gì để tiêm phòng hiệu quả?

In Re Zostavax

The pain from shingles has been described as aching, burning, stabbing or shock-like. It's painful, comes with a number of complications and is extremely common. - Rasa sakit akibat herpes zoster digambarkan sebagai rasa sakit terbakar, menusuk, atau seperti syok. Ini menyakitkan, disertai sejumlah komplikasi dan sangat umum terjadi.

Episode 109: Shingles vaccine before 50 Prabhjot and Dr. Arreaza discuss the indications and contraindications of the zoster recombinant vaccine (Shingrix®). Shingrix is now FDA-approved to be used in people younger than 50 years old. Magic mushroom as a therapy for alcohol use disorder. Introduction: “Magic mushroom” as a potential treatment for alcohol addiction By Hector Arreaza, MD. Addiction is one of the biggest challenges in medicine. Patients with addictions are at risk of adverse events or even death from overdose but also are at risk of withdrawal when trying to quit. As medical providers, our goal is to assist our patients to stop using substances that may be toxic and cause detrimental effects on their health in the short and long term. It is not easy to help patients overcome the discomfort, cravings, and even life-threatening symptoms that result from withdrawal. Out of the many addictions, alcohol use disorder is one of the most destructive addictions, and the harms from it go beyond the personal effects, as it affects families, communities, and the whole nation. It is a serious public health issue. It is estimated that 15 million people (12 and older) in the US have alcohol use disorder, and about 140,000 people die every year from alcohol-related causes. Many patients would like to stop drinking, but the withdrawal symptoms may be more than just discomfort and may become unbearable and even fatal. Today I want to share the news published on August 24, 2022, on JAMA and many news outlets regarding the potential use of Psylocibin as an adjunct therapy to quit drinking alcohol. This was a double-blind randomized clinical trial that compared Psylocibin with diphenhydramine. Psilocybin is also known as “magic mushroom”. Participants were offered 12 weeks of psychotherapy and were randomly assigned to receive psilocybin vs. diphenhydramine during 2-day-long medication sessions at weeks 4 and 8. There were 93 participants. The percentage of heavy drinking days during a 32-week period after the first dose of medication was 9.7% for the psilocybin group and 23.6% for the diphenhydramine group. So, patients in the Psylocibin group had decreased heavy drinking, and the mean alcohol consumption was also lower. Blinding was an issue during the study because many participants could guess which medication they were receiving. Some participants described “flying over landscapes, seeing [their] late father and merging telepathically with historical figures.” The bottom line of the study is that administration of Psilocybin in combination with psychotherapy produced a significant reduction in the percentage of heavy drinking days over and above those produced by active placebo and psychotherapy. These are exciting news for those who are trying to quit alcohol, and it provides a foundation for additional research on psilocybin-assisted treatment for AUD. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice. ________________________________________________________________________________________________________________ Shingrix before 50. By Prabhjot Kaur, MS4, Ross University School of Medicine. 1. What is Shingrix? It's a recombinant zoster vaccine to protect against Herpes Zoster (Shingles) in adults over 50 years old. 2. What is Herpes Zoster? Prabhjot: It's a viral infection that is caused by the Varicella-Zoster virus, which also causes chickenpox. Chickenpox, also called varicella, can happen in children and adults. After a person is infected with chickenpox, the virus remains dormant in the dorsal root ganglia, which are the clusters of neurons along the spinal column. As the person grows older, or his or her immunity decreases due to conditions such as an infection, malignancy, or pregnancy, the dormant virus becomes reactivated. Prabhjot: When the virus reactivates in adults, it presents with a painful, blistering, itchy rash over the specific dermatomes. The rash mostly occurs on the torso, face, or upper extremities, and it is usually only on one side of the body. Arreaza: A common belief in the Latino culture (since our audience sees a lot of patients of Latino descent) is that if the rash crosses the midline of your body and it makes a circle around your chest, you will die. If you, as a doctor, get that question from a patient, the answer is: herpes zoster normally affects the root ganglia on one side of the body. If your patient has bilateral herpes zoster, you must rule out immunodeficiency. The rash may be preceded or followed by pain, burning, numbing, or tingling of the skin. Some patients might even have fevers, chills, fatigue, and photosensitivity. One of the most common complications of shingles is postherpetic neuralgia, which is a long-lasting pain after the blisters and rash have resolved. 3. What is the role of the vaccine? Prabhjot: Shingrix® can reduce the risk of shingles and its complications, such as postherpetic neuralgia. Shingrix is recommended for everyone over 50, even if they have already had shingles, received Zostavax® (discontinued in 2019), or received the varicella vaccine. Arreaza: Good point. Let´s talk a little bit about varicella in adults. Patients who have received the varicella vaccine as a child can still receive Shingrix. Let's remember the chickenpox vaccine (varicella vaccine) became available in the United States in 1995. Normally, a serology test for varicella is not required for people to receive the varicella vaccine as adults, except in certain patients who are planning immunosuppression in the near future. In such cases, if varicella immunity is not reactive, they should be vaccinated against varicella (live attenuated virus) if the immunosuppression can be delayed. Prabhjot: What if the patient is already immunosuppressed? Arreaza: If the patient is already immunosuppressed, the decision is not simple. The varicella vaccine is contraindicated, but some clinicians may recommend Shingrix for the potential protection against primary varicella. Post-exposure prophylaxis with antiviral therapy or immunoglobulin in case of exposure is possible. 4. How is Shingrix given? Prabhjot: Shingrix is given in 2 doses, and each dose is given 2-6 months apart. Its immunity stays strong for at least 7 years. Like most vaccines, the most common side effects of the Shingrix vaccine are redness, tenderness, swelling, and discomfort at the vaccine site. Shingrix is deemed to be safe for most people over 50 but not given to pregnant women, people with active shingles, and or with a severe allergy to the vaccine. Arreaza: Shingrix is generally avoided in patients with a known history of Guillain-Barré syndrome (GBS) due to a probable association between Shingrix and GBS. This association was not seen with Zostavax, so in case of history of GBS, Zostavax is an option. 5. Effectiveness. Prabhjot: As for its effectiveness, according to the CDC, Shingrix is 97% effective in preventing shingles in adults 50 to 69 and 91% in adults older than 70. If one is immunosuppressed and has a weakened immune system, the vaccine was effective, ranging between 69%-91% in preventing shingles. 6. New update: Prabhjot: New updates have been made to expand the vaccination of the population under 50 as well. On July 23, 2021, the FDA approved the vaccination for adults over the age of 18 who are at an increased risk or will be in the future due to immunodeficiency or immunosuppression. Such immunodeficiency could be secondary to a disease, malignancy, or therapy such as chemotherapy. Just like the prior recommendation, it is recommended for these individuals to receive two doses of Shingrix for the prevention of shingles and its complications. However, the interval between the two doses can be shortened from the recommended 2-6 months to 1-2 months if the person will be going through intense immunosuppression in the upcoming months. This shortened interval will prevent vaccination during an intense immunosuppressed state. The second dose must not be given before one month. 7. When to get vaccinated? Prabhjot: Ideally, one should get vaccinated before starting immunosuppressing therapy; if this cannot be possible, then one should aim for vaccination when their immune response is likely to be the strongest. For example, if it's an immunity-changing disease such as malignancy, the vaccine would be ideal in the beginning stages, and if a person will receive chemotherapy, it would be ideal to vaccinate before starting chemo. 8. Few recommendations from CDC: For Hematopoietic cell transplant: Administer Shingrix at least 3-12 months after transplantation. It is important to consider the vaccine is recommended 2 months before the prophylactic antiviral therapy is discontinued. Since the prophylactic antiviral therapy is also protecting against shingles, the vaccine is preferred to be injected while the antiviral therapy is going on. Arreaza: For allogeneic HCT (when donor is another person), Shingrix should be given a little bit later, 6-12 months after transplant, prior to discontinuation of antiviral therapy. Acyclovir, famciclovir, and valacyclovir will not neutralize the effectiveness of Shingrix because the vaccine is not a live virus vaccine. For cancers: It is ideal to administer Shingrix before chemo, immunosuppressive medications, radiation, or splenectomy. If that is not possible for some reason, administer the vaccine when the patient is stable and not acutely suppressed. For patients on long-term immunosuppressive therapies, administer the vaccine when the immune response is most likely the strongest or right before starting the next cycle of therapy. For patients with HIV: Prabhjot: Shingrix is recommended for patients with HIV due to the high risk of shingles. Immune response to the vaccine may be improved while the patient is on antiretroviral treatment. Bottom line: Shingrix is now recommended not only for those over 50 years old but also for those who are 18 and older and are immunosuppressed or will be on immunosuppressive therapy. This new change will benefit those who are receiving treatment and those who are awaiting treatment. Keep in mind to use the vaccine to prevent shingles and its complications. ________________________________________________________________________________________________________________ Conclusion: Now we conclude our episode number 109, “Shingles vaccine before 50.” We are used to giving Shingrix to patients older than 50, but we were reminded today that it is also indicated in patients older than 18 who are or will be immunosuppressed. Shingrix should be given in 2 doses 2-6 months apart. Your patients may not notice it, but by giving this vaccine, you are PREVENTING a painful rash that can have long-term effects. This week we thank Jennifer Thoene, Hector Arreaza, Prabhjot Kaur, and Arianna Lundquist. Audio edition by Adrianne Silva. Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! ________________________________________________________________________________________________________________ References: Bogenschutz MP, Ross S, Bhatt S, et al. Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. Published online August 24, 2022. doi:10.1001/jamapsychiatry.2022.2096. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2795625. Osborne, Margaret. Psychedelic ‘Magic Mushroom' Ingredient Could Help Treat Alcohol Addiction, Smart News, Smithsonian Magazine, https://www.smithsonianmag.com/smart-news/psychedelic-magic-mushroom-ingredient-could-help-treat-alcohol-addiction-180980658/ “Shingles Vaccination.” Centers for Disease Control and Prevention, page last reviewed: 24 May 2022, https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html. “Clinical Considerations for Use of Recombinant Zoster Vaccine (RZV, Shingrix) in Immunocompromised Adults Aged ≥19 Years.” CDC.gov, 20 Jan. 2022. https://www.cdc.gov/shingles/vaccination/immunocompromised-adults.html. “Shingles.” Mayo Clinic, 17 Sept. 2021, https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054. Royalty-free music used for this episode: Salsa Trap by Caslo, downloaded on July, 20, 2022 from https://freemusicarchive.org/music/caslo/caslo-vol-1/salsa-trap/. Space Orbit by Scott Holmes, downloaded on July 20, 2022 from https://freemusicarchive.org/music/Scott_Holmes/.

In this Healthed lecture, Infectious Diseases Physician, Prof Tony Cunningham AO explains which immunocompromised patients should be given the recombinant (Shingrix) vs the inactivated (Zostavax). Prof Cunningham also describes how immunocompromised patients fit into one of three basic categories. Each of these categories warrants a different degree of caution, and each warrants a different approach to vaccination choice.  See omnystudio.com/listener for privacy information.

En este video revisamos las vacunas actualmente disponibles para la prevención de los brotes de herpes zoster y de neuropatía postherpética así como encefalitis; específicamente revisamos la seguridad y eficacia de las vacunas Zostavax y Shingrix así como el paciente ideal para cada una.Checa el video aquí: https://youtu.be/u6Eo4vCTDzsVisita nuestra tienda en línea para comprar nuestros libros y material educativo:https://bit.ly/3i6eAnGSi necesitas una consulta aquí nos puedes encontrar:http://bit.ly/3aUSt12Ayúdanos a encontrar los mejores hospitales para estudiar:https://bit.ly/36o82LXUnete al equipo de Mecenas en YouTube desde 1 dolar al mes: http://bit.ly/2O1AtsXSupport the show

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Post Herpetic Neuralgia (PHN), the most common complication of Herpes Zoster (also known as Shingles, which is caused by reactivation of the Varicella Zoster Virus). PHN is defined by pain that is typically burning or electrical, and may be associated with allodynia or hyperesthesia in a dermatomal distribution. Pain from PHN is typically sustained for at least 90 days after the rash. PHN is caused by nerve injury due to the inflammatory response induced by viral replication within the nerve. Epidemiologic studies have found that PHN occurs in about 20% of patients who have Herpes Zoster. With the relatively recent development of the preventative vaccine Shingrix (which has been found to be 97% effective in preventing Herpes Zoster) it is anticipated that the total prevalence of Herpes Zoster and PHN will decrease. However, research has repeatedly demonstrated that immunocompromised patients are at a significantly increased risk for Herpes Zoster and PHN (20-100 times increased risk of development of PHN). As of today, the Advisory Committee on Immunization Practices has not cleared immunocompromised patients to receive the Shingrex (or Zostavax) vaccine; therefore for multiple reasons PHN will most likely continue to be a prevalent diagnosis. Treatment options for PHN include physical modalities (TENS, desensitization), topical medications (including Lidocaine 5% patch, and Capsaicin), oral medications (including Gabapentin, Pregabalin, Tricyclic Antidepressants), and procedures. Listen as the doctors review Herpes Zoster, PHN, and a recent research article evaluating the effect of the Erector Spinae Plane Block in regards to prevention of PHN once Herpes Zoster has already developed. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek counsel with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve. References: 1. Zeng-Mao Lin, MD, Hai-Feng Wang, MD, Feng Zhang, MD, Jia-Hui Ma, MD, PhD, Ni Yan, RN, and Xiu-Fen Liu, MD. The Effect of Erector Spinae Plane Blockade on Prevention of Postherpetic Neuralgia in Elderly Patients: A Randomized Double-blind Placebo-controlled Trial. 2021;24;E1109-E1118. 2. Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep 2018;67:103–108.

Mammalian meat allergy is the most common reason patients carry an Epipen in the Northern Beaches of Sydney This important condition can have a spectrum of clinical presentations from rashes to full-blown anaphylaxis Those who have been bitten by ticks in the past can develop an allergic response to vaccines made with mammalian products such as Zostavax, Flucelvax Quadrivalent, medications such as heparin and other products such as porcine prosthetic heart valves Repeated tick bites potentiate the allergy but if no further tick bites occur, it can settle over 18-48 months Lifetime tick bite avoidance is key   Host: Dr David Lim | Total time: 33 mins Guest: Clinical A/Prof Sheryl van Nunen, Allergist; Visiting Medical Officer, Department of Clinical Immunology and Allergy, Northern Beaches Hospital Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next one See omnystudio.com/listener for privacy information.

We finish our top 20 from 2019: bleeding risk with different DOACs (https://www.ncbi.nlm.nih.gov/pubmed/30512099), whether higher doses of ibuprofen are better than low (https://www.ncbi.nlm.nih.gov/pubmed/31383385), a comparison of Shingrix with Zostavax (https://www.ncbi.nlm.nih.gov/pubmed/30361202), and whether exercise really prevents falls (https://www.ncbi.nlm.nih.gov/pubmed/30592475). Plus, an update on the COVID-19 epidemic.

In this episode, Dr. Justin Gatwood, who is a health services researcher and Assistant Professor at the University of Tennessee College of Pharmacy in Nashville, TN, shares about a new national initiative between UTCOP and Kroger to help increase shingles vaccine rates. Two shingles vaccines are licensed and recommended in the United States. Zoster vaccine live (ZVL, Zostavax) has been used since 2006, and recombinant zoster vaccine (RZV, Shingrix), has been used since 2017, and is recommended as the preferred shingles vaccine. Discussion points · Overview of the Kroger/UT vaccine program that focuses on Shingrix dose completion: justification, approach, and expected impact · How this project contributes to the larger role of pharmacy and pharmacists in providing public health services · Parallel projects at UT focusing on improving vaccination rates in adults by leveraging community pharmacists · Lessons learned from addressing and expected challenges of expanding vaccination in community pharmacies Host - Hillary Blackburn, PharmD, MBA www.pharmacyadvisory.com https://www.linkedin.com/in/hillary-blackburn-67a92421/ @talktoyourpharmacist for Instagram and Facebook @HillBlackburn Twitter

Vitiligo is not the only condition that can lead to depigmentation; there are other conditions that dermatologists see less commonly that can result in vitiligolike depigmentation, such as photolichenoid dermatitis. Consider underlying diagnoses such as human immunodeficiency virus when treating patients with photolichenoid dermatitis. Dr. Vincent DeLeo talks with Dr. Nada Elbuluk about the common causes and clinical presentation of photolichenoid dermatitis. Dr. Elbuluk emphasizes the importance of screening for underlying medical conditions by describing a case of a photolichenoid eruption in a patient with undiagnosed HIV. “It’s fascinating to see patients like this who remind us that depigmentation or pigmentary changes can be associated with underlying medical conditions,” advises Dr. Elbuluk. “Keeping that kind of differential in the back of our minds is really important so we don’t miss important underlying diagnoses such as HIV.” *   *   * Help us make this podcast better! Please take our short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 *   *   * We bring you the latest in dermatology news and research: 1. Patients taking TNF inhibitors can safely receive Zostavax Investigators found no confirmed varicella infection cases at 6 weeks. 2. AAD-NPF pediatric psoriasis guideline advises on physical and mental care Topics in this guideline for pediatric psoriasis include systemic and topical treatments, management of comorbidities, and quality of life. 3. Expert reviews strategies for diagnosing, treating onychomycosis The ideal treatment for onychomycosis would not pose a systemic risk to the liver, heart, or other organs, and would not require lab monitoring. *  *  *   Things you will learn in this episode: Common histopathologic findings of photolichenoid dermatitis include a dense bandlike lymphocytic infiltrate in the superficial papillary dermis abutting the upper dermis, which can be accompanied by an interface change at the dermoepidermal junction. NSAIDs and sulfamethoxazole-trimethoprim are the most common medications that cause photolichenoid eruptions, particularly in patients with HIV, among others. Patients with HIV who have photolichenoid eruptions typically have advanced HIV or AIDS with a low CD4 count. Taking a photosensitizing medication is not required to develop a photolichenoid eruption in patients with HIV. Biopsy patients who have photolichenoid eruptions can confirm that there is no underlying medical condition. “When our patient came in, actually we were worried more about discoid lupus,” Dr. Elbuluk describes. “So as part of that [work-up], we ordered an ANA.” Laboratory workup should include HIV and a hepatitis panel. Consider HIV when seeing a patient with a photodistributed eruption that is more lichenoid or presents with depigmentation. Ask screening questions about sexual history and order bloodwork. “This is a really good case and example of how we, as dermatologists, can be so instrumental in diagnosing internal disease,” Dr. Elbuluk adds.   Guest: Nada Elbuluk, MD (formerly of the department of dermatology at New York University; currently with the University of Southern California, Los Angeles) Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie *  *  *   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm

Hey Medicare Nation! www.TheMedicareNation.com If you are turning 65 or still working on  an employer group insurance plan, you may need assistance in finding the Medicare plan that fits YOUR unique needs. You may have a loved one in a nursing home or in an assisted living facility, who is not receiving proper care. Call me! You can hire me as a consultant to assist you with Medicare issues! Call 855-855-7266 or eMail me at Support@TheMedicareNation.com Tell me the situation and I'll personally get back to you! Today, I am speaking to you about Shingles Vaccines! There are two Shingles vaccines licensed in the United States available. The first one is the "Zoster Vaccine Live," also known as "Zostavax." Many of you probably have received this vaccine, which is a "Live" vaccine and the CDC reports it as being 51% effective against Shingles. The second vaccine is the "Recombinant Zoster Vaccine," also known as "Shingrix" has been used since October of 2017. The CDC reports the Shingrix vaccine is about 91% effective against Shingles. The cost of the Shingles vaccine is covered under Medicare "Part D." You can look up the Zostavax vaccine or Shingrix vaccine in your plan's formulary, or you can call the customer service number on the back of your identification card. Every plan can have a different cost for either vaccine, so it is important you check with your plan, prior to getting the vaccine. There are side effects that can be associated with either vaccine. Go to the CDC website to learn more about Shingles and the vaccines  www.cdc.gov/vaccinesafety Learn more about how Shingles is transmitted, the sign & symptons and treatment for Shingles here: www.cdc.gov/shingles I'm not a doctor! If you have any health related questions regarding shingles and/or vaccines, due your own due diligence or contact your health care provider for more information. Thank you for listening to Medicare Nation! If you are part of my “Sandwich Generation,” Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a “Smart Phone,” and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other “Baby Boomers.” I want to educate as many of you as I can about Medicare! I certainly can use  your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!    

Episode 5: A Shot of HealthToday we focus on four adult immunizations: tetanus, pneumonia, shingles, and influenza.Tetanus - a tetanus (Td) booster is needed every 10 years or less. Every adult should get Tdap once to protect against pertussis (whooping cough). Tetanus can be acquired from a skin puncture by rusty metal, and is also present throughout the environment, especially in soil.Pneumonia - pneumonia is a lower respiratory tract infection / infection of the lungs. It can be caused by Pneumococcus bacteria, which has a thick outer shell that makes it more difficult for our immune system to fight. Generally pneumonia vaccines are started at age 65. They are given earlier for patients with a decreased immune system, compromised respiratory system (such as in asthma or COPD), and some other conditions. PCV 13 is the vaccine generally given first at age 65, and PPSV23 is given 1 year later. If given before age 65, they are given 8 weeks apart.Shingles - shingles is caused by the chicken pox virus. After clearing chicken pox, the virus is dormant near the spine in nerve roots. Later in life, especially in situations of immune compromise, the virus can reactivate and cause shingles. The rash will affect one dermatome of the skin, which is the area of the skin supplied by nerves from a single nerve root. The older vaccine for shingles, known as Zostavax, was a live vaccine. Because it was live, certain populations couldn’t receive it. It also had lower efficacy, especially in older adults. The newer vaccine, Shingrix, is not live and has better efficacy.Influenza - influenza is a viral infection that largely affects the airways and is worrisome when it causes viral pneumonia. Symptoms include fever, cough, body aches, runny nose, and headaches; this can progress to shortness of breath and difficulty breathing. We recommend the influenza vaccine yearly for everyone. Influenza can be life threatening even to healthy individuals. Yearly flu vaccines reduce mortality and severity of influenza infections.Health Pearl: Tasty Lentil TacosFollow us on Facebook and Twitter:If you like what you hear, please rate, review, and subscribe to our podcast. Please help us spread the word!

A heartwarming conversation with Marion Ross, the unforgettable Mrs. C from "Happy Days."

We now have two vaccinations to protect against herpes zoster — a live-attenuated vaccine (Zostavax) and the new recombinant subunit vaccine (Shingrix). While the live-attenuated vaccine has been available for more than a decade and a CDC-recommended vaccine in older adults, only one in three eligible patients have received it.  Based on the results of two recently published studies, the new recombinant subunit vaccine appears to provide substantially improved efficacy and duration. Guest Author:  Katherine Montag Schafer, PharmD, BCACP Music by Good Talk

Disgruntled Dan's Conclusions  1) Shingrix – Reduces the incidence of Herpes Zoster Infections RRR of 97%; NNT of 36 over 3.7 years -Are the results too good to be true? -No long-term efficacy data yet.... 2) Shingrix – Requires 2 intramuscular injections spaced 2-6 months apart -Adherence may be an issue - will one dose be effective?  -Second dose can still be given outside of the 2-6 month window without restarting the series  3) As per the Advisory Committee on Immunization Practices it is safe to provide the Shingrix vaccine to those previously immunized with Zostavax – space a minimum of 8 weeks apart. -Can provide the flu vaccine simultaneously with Shingrix  4) No contraindication to providing Shingrix to the immunocompromised.  -Trials have been completed in HIV infected and haematopoietic stem cell transplant recipients and thus far have been shown to be safe but the clinical efficacy in these patient populations is yet to be evaluated. 5) Cost  -Shingrix ~$150/injection - ~$300 per series -Zostavax ~200+/injection   References  1) Morrison, V.A. et al. Long-term Persistence of Zoster Vaccine Efficacy. Clin. Infect. Dis. 60, 900–909 (2015). 2) Schmader, K. E. et al. Persistence of the Efficacy of Zoster Vaccine in the Shingles Prevention Study and the Short-Term Persistence Substudy. Clin. Infect. Dis. 55, 1320–1328 (2012). 3) Oxman, M. N. et al. A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults. N. Engl. J. Med. 352, 2271–2284 (2005). 4) Cunningham, A. L. et al. Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older. N. Engl. J. Med. 375, 1019–1032 (2016). 5) Grupping, K. et al. Immunogenicity and Safety of the HZ/su Adjuvanted Herpes Zoster Subunit Vaccine in Adults Previously Vaccinated With a Live Attenuated Herpes Zoster Vaccine. J. Infect. Dis. 216, 1343–1351 (2017). 6) Lal, H. et al. Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults. N. Engl. J. Med. 372, 2087–2096 (2015). 7) Bharucha, T., Ming, D. & Breuer, J. A critical appraisal of ‘Shingrix’, a novel herpes zoster subunit vaccine (HZ/Su or GSK1437173A) for varicella zoster virus. Hum. Vaccin. Immunother. 13, 1789–1797 (2017). 8) GSK. Product Monograph: Shingrix. (2017). 9) Albrecht, M., Hirsch, M. & Mitty, J. Vaccination for the prevention of shingles (herpes zoster) - UpToDate. (2017). Available at: https://www.uptodate.com/contents/vaccination-for-the-prevention-of-shingles-herpes-zoster?search=shingles&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4. (Accessed: 19th February 2018) 10) Keilly, J., et al. Rx Files:A Summary Herpes Zoster Vaccine (ZOSTAVAX). 11) Canada. National Advisory Committee on Immunization & Public Health Agency of Canada. An advisory committee statement (ACS) - National Advisory Committee on Immunization (NACI) : update on the use of herpes zoster vaccine

TNP delivers a 'explosive' discussion with radioactive pharmacist Dr. Tim Burke. (LOL)  Nuclear pharmacy is a role often talked about in nontraditional pharmacy but rarely discussed in detail. Dr. Tim Burke gives much needed insight into the field, how it fits his personal life, and how he manages to be a Michigan and Arkansas fan?! Transcript:  Interview Summary   Matt: Welcome everyone. Matt Paterini here with The Nontraditional Pharmacist, part of The Pharmacy Podcast Network.  I'm joined today by Dr. Tim Burke. Really excited to have Tim on the show today because Tim is a nuclear pharmacist and I think a lot of times in the nontraditional pharmacy world, we see nuclear pharmacy pop up on the list, yet I don't think a lot of people know what nuclear pharmacy is, what it entails, and what it's all about (myself included). I'm excited to hear Tim's story today. Tim we really appreciate you coming on the show today.   Tim: Yeah thank you very much for having me on here. I hope it's not glistened up too much right now, but I think we'll be able to walk our way through it. I'm happy to be here and talk a little about nuclear pharmacy and let more people know about some of the opportunities that are out there besides the traditional pharmacy roles that we think of.   Matt: Awesome. That's exactly what we're looking for and what I think people listening to the show are looking for. Let's start with kind of a basic question we like to ask all of our nontraditional guests. Give us a little bit of background on your path through pharmacy, how you started, where you've been, and how you've gotten to where you are today.   Tim: Well, when I graduated from high school I didn't really know necessarily when I wanted to do. Like a lot of high school grads, you go off to college and I knew I was into science but didn't really know what direction I wanted to take from there. Went down to Baylor University thinking that I wanted to be a forensic scientist, and it was right when the CSI craze was all the rage. That sounded pretty interesting to me, saw a couple of autopsies and found out that was wasn't for me. I realized that I needed to go into something else.   I had a cousin who was at the University of Texas Pharmacy School at the time, and he told me all about pharmacy and the opportunities that were out there and so I was like well, you know, I've [already] been taking those kinds of classes. I'll try and go that route. While I was there, my parents moved from Michigan down to Arkansas, so I went there for pharmacy school and was fortunate enough to go to a school where we had a Nuclear Pharmacy Program.  There is Dr Nicki Hilliard, who if you say her name in the nuclear pharmacy world, everybody knows her. Not to mention I think she's actually the APhA President Elect. And so she's obviously made her mark in the pharmacy world. She was the one who got me interested in it. I did an internship with General Electric (GE) healthcare up in Grand Rapids, Michigan between my P2 and P3 year and loved every minute of it. But nuclear pharmacy is kind of a small niche to get into, there's not a whole lot of turnover. So I had to pay my dues, do a little bit of retail work for a year and a half, and then when GE came calling, I decided that that was a good route for me to go and have been there for about seven years now and loved every minute of it.   Matt: Wow. That's that's awesome. So you've spanned some geographic space down from Arkansas up to Michigan. Where does that where does that leave you in terms of sports affiliations?   Tim: Well, you know I nearly planted myself in front of my Michigan flag that says “those who stay will be champions”, because I know you guys obviously are all U of M Grads and you'd probably appreciate that, and that's always been my childhood team. So I'm a big fan of the Wolverines, but I will say I was disappointed when they took Arkansas off the schedule for 2018 and 2019 for the Home and Home, because I was ready to wear my Razorback Red in The Big House.   Matt: Yeah we definitely would have appreciated the Michigan flag. It's good to see that Maize and Blue kind of spreads throughout the country, we like seeing that.   Why don't you give us a little bit of an overview of nuclear pharmacy in general? I think just some general background on what is nuclear pharmacy? I think when other pharmacists think of nuclear pharmacy, we think of radioactive substances and things of that nature. But give us some detail around what exactly it is.   Tim: Sure. The nitty gritty and the easiest way to describe it is, we compound radioactive pharmaceuticals, and the majority of those pharmaceuticals are for diagnostic imaging only. There's not a whole lot of therapeutic application in what we do. But there is some. The main isotope that we use is called Technetium and that is what we use for the majority of our diagnostic imaging, but we also do have some applications like I said that are therapeutic. We can use I-131 and we put that in capsules that a patient can actually swallow, and that can ablate their thyroid, take care of thyroid cancer, things of that nature. There are a couple other drugs out there as well that we can use for therapeutic applications but mostly you're going to be hearing about diagnostic. The biggest one and I would say probably 75% of nuclear pharmacy's compound is some sort of cardiac imaging agents. The particular one that we make at GE is called Myoview, but if you've ever had someone in your family, like a grandparent or someone you might know that has had a stress test done on their heart, Myoview in all likelihood could have been the agent that was used to image their heart. So we compound those radio-pharmaceuticals, send them to the hospitals to where they're going to be administered, and then the nuclear medicine technologist there are actually the ones that inject them into the patient, and perform the scans with the cameras and everything. But we work in a lab, making all of these things and then send them out with a fleet of couriers. It's all over the state really, to deliver these products to the hospitals so they can use it and make their diagnoses.   Matt: Technetium! That sounds something like it's from the future, that sounds crazy.   Tim: It's not that scary. It really isn't. We obtained this activity from generators, is what they're called, and the parent isotope of Technetium is called Molybdenum. We call it Molly. And you also hear me refer to Technetium as just Tech. But we allude these generators and pretty much what happens is we take a saline solution that goes through this generator and all of the Technetium binds onto this aluminum column that you can see that runs through the generator. When we have students at our pharmacy, we've got a cut out of an old generator that doesn't have any activity inside of it. And they can actually see this column, which the saline rinses that technetium off of. What occurs is anion exchange. So we're getting our chemistry back here a little bit. But the chloride ions from the sodium chloride swaps with the Technetium ion. And what you end up with on the other side, in your evacuated vial is pretty much radioactive saline. So there is no color to it, it just looks like a normal, regular old solution. But if you had it unshielded around a Geiger counter, you'd definitely be getting a lot of activity.   Matt: That's so interesting. It sounds a lot more, you mentioned lab work. You mention a lot of the techniques that you're talking about sound to me a lot like research focused almost or kind of more industry focused? Is it more so related to that than a practicing pharmacist? Do you see any comparisons with more of the research side of things?   Tim: A little bit. There's definitely a little bit of crossover there, but this is very patient specific. You're drawing up a dose for a patient, at a particular time, and it's intended for that one person. There might be some crossover between research, but this is patient oriented, it's just that you don't get that patient-pharmacist interaction. We are on our own site, where we compound all of these things. It's not a hospital or anything like that. So from that aspect, I guess you could say that we're in a lab, and it's kind of for chemistry nerds, we enjoy it, we love it, but it is for a particular patient. A lot of the times there is a patient name actually associated with the dose that you're dispensing. So it's kind of a hybrid. It's a little bit of both worlds there.   Matt: Okay, that makes a lot of sense. Walk us through a little bit of your day-to-day responsibilities. You said it's kind of a hybrid of lab work but it's patient focused, so what do your day-to-day responsibilities look like? Take us through a typical day as a nuclear pharmacist.   Tim: Part of that has to do with what shift you're working. This is one of the big things that turns people off to nuclear pharmacy, is you do have to work some night shifts. So kind of that that third-shift work that a lot of people don't necessarily want to work. For some people, they find a lot of benefit in it, and other people think that it's not the greatest. But for us, it works out really well because say there's a hospital that needs a dose at seven o'clock in the morning. Well, that dose has to be made, compounded, packaged up, shipped out with one of our drivers, and get to the hospital before 7:00 a.m. So obviously we have to make that well before the dose is going to be administered. And that's usually going to be in the middle of the night. A lot of people ask me you know, why don't you just make the day before? The problem with that is, we've got sterile compounding restrictions, where a lot of these drugs are only good for say 6 to 12 hours. And so if they're only good for 6 to 12 hours, we can't make it that far in advance. The other problem is we're working with radioactive substances that decay over time, and because they decay over time, Technetium has a six hour half-life. If we want to make a dose for a patient that's going to be 12 hours later, we need four times the activity to prepare that dose at the time and we're preparing it, versus when it's actually going to be administered to the patient. And so it's not very cost effective for us to make something that far in advance because we're using so much more activity for a dose, because it's so far into the future.   Matt: So it sounds like some later shifts and the schedule can vary. How does that affect work life balance? Do the shifts change from week to week? And how does that fit in with your personal life?   Tim: Well like I said, some people look at it in a positive way, other people look at it in a negative way. That third shift is actually probably our most active shift. That's when we're compounding the most, it's when we're making the most doses, you're staying very involved while you're there. And so it's not like a third shift that you might think of where the store is dead and you're just struggling to stay awake. It's nothing like that. It's when we probably do 80% of our compounding and dose drawing. So because of that, you're staying active, you're doing other things, and so you don't even really think about what time it is, short of when you have to drive in. Obviously nobody likes driving in at midnight.   But the other shift that we have is kind of a typical first shift, it's from about 8:00 am to 4:00 pm. Now of course this is going to vary from pharmacy to pharmacy. You have some pharmacies that might be open from 3:00 am until 3:00 pm. Some pharmacies that might be open from midnight until 5:00 p.m. the next day. So it really can vary from site to site. But because of that, there are going to be two shifts that you could be working, depending on if you've got lots of pharmacists because you're busy, there might be two or three different types of shifts that you could work. But for myself, I feel like it works out very well for my work-life balance. I've got two kids at home, a wife, and dogs and to know that even if I'm working third shift, I can be home for supper. You can have all that family time. But if you're working first shift, you're getting out at 4:00 pm or 5:00 pm and you can do those same things. When kids grow up, I'm not going to have to worry about whether or not I can make a soccer game or a band concert or something like that. So from that perspective, I do think it provides a little bit more family-friendly shift than say you're 9-7 or 9-9 that you might be working in the retail world.   Matt: Yeah, work-life balance is so important. I think going through pharmacy school and even post-graduate pharmacy practice, it's not emphasized a lot. So it's good to hear that you keep that in consideration. And it's really a big part of how you work in your professional and your personal responsibilities. So on that note, for your personal and professional goals moving forward, how does the role that you're in right now help you to achieve those? Are you where you want to be? And what's next or in the future for you?   Tim: Right now, I'm very happy with where I'm at. I work with two other pharmacists that are great. I couldn't have two better partners out there, one of which is my pharmacy manager. The other one is the pharmacist that I switch shifts with every couple of weeks, working third or working first shift. So I'm very happy where I'm at right now. Works great for my family life like I say. But there are ways that you can kind of climb the ladder in nuclear pharmacy, just like you could in any other area of pharmacy. One of the things that my partner does, is he what's called our radiation safety officer. He is the one who keeps track of all of our equipment, making sure that things are reading efficiently, are constantly the way they should be. He has all the responsibilities with limits on how much activity we can be releasing into the public, things of that nature. So there's more responsibilities that I could gain over time. There's also management possibilities out there, too. You've got pharmacy managers just at a particular site like you would at a retail pharmacy. You've also got district managers who might be over 5 to 10 to 15 pharmacies, depending on the size of your district and figuring out all sorts of things associated with that. There's so many factors in nuclear pharmacy that just don't even show their face in any other type of pharmacy setting, whether it be, do you guys have been big enough generators to have the activity you need to get your runs out? Do you have enough drivers to supply to all the different areas of the state that you're driving to? There's quite a bit to think about that you never really would have thought of as being a pharmacy role, it's almost more of a business-type role than it is pharmacy.   Matt: Interesting. Yeah. I think a lot of a lot of roles are like that, and you know on the surface you can say what nuclear pharmacy is, but there's so much behind the scenes that people don't know. And different facets of the business really, the practice side of things, the operations, the business and everything that goes along with it. So it sounds like there's a lot of different roles within nuclear pharmacy. What's the landscape look like currently, in terms of the job market? Are there opportunities available? And what does it look like moving forward?   Tim: Right now, I would say there are job opportunities out there. But if you're someone who might want to stay exactly where you grew up and things of that nature, it's going to be a little bit tougher to find because this is a pretty specialized niche. There's also training that has to be done on top of it, too. So you have to make yourself marketable to be able to be a nuclear pharmacist. If someone out there has training versus someone that does not, obviously a pharmacy is going to be more interested in hiring that person who is what they call an “authorized user” with the Nuclear Regulatory Commission (NRC), which is a regulatory body we have to deal with. But I would say there is plenty of opportunity out there if you're willing to relocate. That's a huge factor I would say, just because the state of Michigan, at least with GE, we only have two pharmacies in the whole state. And then if you include all of the other companies, you know independents, etc., there might be six to eight pharmacies. There's just not nearly as many as you know your CVS or Walgreens that are on most of the street corners that you can find a job at.   So, from that standpoint it is a little bit tougher to get into. But like I say, you can make yourself more marketable. I think there's a lot of advancements that are going on with nuclear pharmacy and there's even some other roles besides the pharmacy setting that I've told you about, that you can use your nuclear pharmacy education as well. And that would be more of your what they call PET aspects. What we do is SPECT. PET involves using a cyclotron and typically is going to be inside of a hospital. I think U of M might even have one, and so you can use your nuclear pharmacy degree there as well. There is a little extra training involved with that. There's a lot of opportunity out there, but there's going to have to be a little bit of give and take with where you're willing to work and what kind of role you'd like to have.   Matt: Where would people go, pharmacy students and pharmacists, go to do some more research and learn more?   Tim: Well, the three big universities that have nuclear pharmacy programs are Purdue (probably the number one for proximity for us), but also University of Arkansas, and New Mexico is another big pharmacy school. All three of those are probably your top three for finding information about nuclear pharmacy. There's also a website called Nuclear Education Online (www.nuclearonline.org) and that is a collaboration between the University of Arkansas as well as New Mexico, and they've got a whole program that you can actually do most of your didactic training to become an authorized user online. So you don't actually have to go to a class and do all these things, because beyond that, you do have to get more training hours on-site at a nuclear pharmacy. So that's how you get all of that hands-on training as well. But there is that website and you can do all of it online, do it at your own pace. It was actually a resource that I used while I was at the University of Arkansas. And I did a lot of those classes while I was doing rotations during my last year of pharmacy school. So you kind of knock everything out all at once.   Matt: So a lot of resources available and we'll be sure to share those with our viewers so that they know where to go to learn more information. But what advice would you give students or pharmacists that are looking to make a career transition? What advice would you give to them if they're looking to pursue nuclear pharmacy?   Tim: Well for students I feel like it's a lot easier. You're out, you're young, you've got a little bit more flexibility, you might not be somebody who's already got a family and established in a job and everything. But for students, I would definitely recommend checking out Nuclear Education Online, I think that's a great place to start because there's just not that many pharmacy schools out there that offer this kind of information. So to go to a resource like that would be really beneficial. They get to see a lot of pictures of what we use, the shielding that we use, how we compound things. It's very informative there. There's also links off of the University of Arkansas, that might even go over to Purdue University's website, of more pharmacists like myself that have been interviewed and talked about what they do, and probably more extensively than what I've gotten into. We certainly could get a lot more in-depth if we wanted to. But that would be a great starting point for students, and I would say if you if you're interested in it, get it done, get yourself marketable, because that way if you realize that retail or the hospital or a clinical pharmacy setting isn't necessarily for you, you've already taken the steps to be able to do this kind of role.   As for pharmacists that are already established in a job, I've had a few inquire already about this job and what all is required of you in order to become a nuclear pharmacist and that tends to be the biggest roadblock is that you've got to do all this didactic work, and then on top of that you have to have 500 hours of actual work at a nuclear pharmacy before you can even apply to the Nuclear Regulatory Commission (NRC) to become an authorized user. And so when they hear that, and know that they also need to hold down their other job, because obviously a lot of people can't just stop working, that makes it a little bit tougher. So I will admit there can be some roadblocks, but no more difficult than going back to school to change what you wanted to do to begin with and how many people are doing that these days. So it's certainly a manageable thing, but I understand it's a little bit more difficult for them.   Matt: Very true. very true. Well thanks for the insight into nuclear pharmacy Tim. We like to talk a little bit with our nontraditional guests about their take on the pharmacy profession in general, because we think you have a unique perspective on the field of pharmacy, doing something different than a lot of other pharmacists. So what are your thoughts on the field of pharmacy in general and the future of the profession?   Tim: You know, really I feel like the possibilities could be endless. It seems like even since I'm graduated, and I've only been out since 2009, I think we were able to do flu shots, but beyond that, I don't really think there was much going on in the way of immunizations. Now we're doing Zostavax, DTap, we're doing all these different things. And then also many states are allowing us to use our clinical judgment. We're able to make therapeutic substitutions if we get an error from an insurance company, we can substitute with the product that they'd prefer, just like they would at a hospital with their formulary. I think the more that we're allowed to use our clinical knowledge, the more ways that pharmacists could be used. We're a great resource to the public. We're a lot more accessible than doctors are a lot of the time. So I feel like really, we could do anything and then now too, they've got residencies that are going up to three years. You're talking about a lot of higher education right there. And so I think it's just a matter of State Board of Pharmacies and things of that nature allowing us to use that knowledge, and then really we could go anywhere.   Matt: Well there you have it. Scientific, specialized, and radioactive is Dr. Tim Burke. Tim, we certainly appreciate you joining us on The Nontraditional Pharmacist. We'll be sure to share the resources that you've shared with us with our viewers. Everyone please connect with Tim at The Pharmacy Network on The Nontraditional Pharmacist. Tim thanks again, we appreciate it. And we will talk to everyone next time on The Nontraditional Pharmacist.   Tim: Absolutely. Thank you very much Matt, I appreciate you having me on   See omnystudio.com/listener for privacy information.

Alex Lawson from Social Security Works will tell us about President Trump's plan to gut Social Security. The Nation's Zoe Carpenter will explain why Trump is a bigger threat to the environment than we thought. And attorney Troy Bouk will tell us about the dangers that have been associated with the shingles vaccine known as Zostavax. Subscribe to our podcast to get the full show. Just go to www.rofpodcast.com sign up!

Hosts: Vincent Racaniello, Alan Dove, and Rich Condit The TWiV team takes on an experimental plant-based poliovirus vaccine, contradictory findings on the efficacy of Flumist, waning protection conferred by Zostavax, a new adjuvanted subunit zoster vaccine.   Become a patron of TWiV! Links for this episode Tribunal orders release of PACE trial data (Valerie Eliot Smith) Our request for PACE trial data (virology blog) GM mosquito release on ballot (NPR) Florida Keys Mosquito Control District on TWiV #111 Cold chain and virus free plant based polio vaccine (Plant Biotechnol J) Disappointing flu vaccine effectiveness (CBC) ACIP votes down use of LAIV (CDC) LAIV as effective as inactivated flu vaccine (Ann Int Med) Flumist does work (NPR) Declining effectiveness of zoster vaccine (J Inf Dis) Efficacy of adjuvanted subunit zoster vaccine (NEJM) Risk of zoster from vaccine (J Inf Dis) Image credit: ViralZone Letters read on TWiV 403 This episode is brought to you by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completel free if you sign up at curiositystream.com/microbe and use the promo code MICROBE. This episode is also brought to you by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more. Listeners can save $100 on a Drobo system at drobostore.com by using the discount code Microbe100. Weekly Science Picks Alan - To Scale: The Solar SystemRich -  Route 66 Goes SolarVincent - Race for a Zika Vaccine by Siddhartha Mukherjee Listener Picks Bohdan - Penn and Teller on VaccinationsBill - Connections, Episode 1 Send your virology questions and comments to twiv@microbe.tv

Welcome Medicare Nation! Today we’re talking about Shingles. I recently had shingles and my eyes were opened to how painful it is. It’s really a terribly painful illness, so I wanted to give you some facts and tips to help you diagnose your symptoms early.         What is Shingles?   A virus that is a type of herpes zoster virus. You can only get shingles if you’ve had chicken pox. The virus stays dormant in your spine and attach itself to some of the nerves in your spine. Then something comes along and activates it when you have a lower immune system. If you are on auto-immune suppressing drugs, you are more susceptible to the virus.   Increased stress can also trigger an outbreak of shingles.       What are the symptoms?   A blistery rash that generally starts around your back and wraps around your side. I got a blister on the palm of my hand. About a week before the outbreak, you can begin having pain from the nerve endings being affected.    Patches of blisters will grow and then they are painful. You can have headaches and other pain that goes along with it.   The virus starts coming down your nerve path and it becomes extremely painful. The pain is similar to neuropathy pain.       Treatment?   Because I sought treatment within 48 hours of the onset of symptoms, I was able to take an anti-viral medication. This caused the pain to being to lessen over the next few days.   Anti-Viral medications   Acyclavir Valacyclavir     Lidocaine can be given to block the pain. Advil.,Motrin will also be given to lessen pain.       Anybody can get shingles. More likely to occur in older folks because the immune system is naturally weaker.   50% of people over the age of 60 to get shingles.     Shingles is contagious. It is contagious when the blisters are broken open and oozing. Direct contact with open blisters should be avoided.   Shingles Vaccine - given to people 60 and over - Zostavax. There is a 51% chance of not getting the virus when you get the vaccine.    Who should NOT get the vaccine? -People with allergies to gelatin If you are allergies to neomycin If you have a weekend immune system from AIDS or other illness If you have leukemia or lymphoma If you are pregnant    Info about Shingles Vaccine:    Medicare Advantage plans will require a co-pay. Find out what it costs with your plan by calling customer service with you plan.   Original Medicare - you will pay 20%   Medigap - you won’t pay anything     There is no season for shingles. Anyone can get it at any time.   You can find out more about shingles here.   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)     Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com