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There's now a vaccine against shingles. Should I get it?

If you're 60 or over, you should strongly consider getting the new vaccine, which was approved recently by the US Food and Drug Administration.

``Shingles is an underrecognized, serious neurological disease that can lead to an extremely painful condition called post-herpetic neuralgia," said Dr. Anne Louise Oaklander , a shingles expert and associate professor of neurology at Harvard Medical School. The new vaccine, called Zostavax, appears to reduce the risk of both shingles and the neuralgia and seems to be quite safe, said Oaklander, who has no financial ties to the manufacturer, Merck & Co.

Shingles, which affects an estimated 1 million people per year, is caused by reactivation of a herpes virus called varicella zoster, the same virus that causes chicken pox. Virtually every American adult has been exposed to chicken pox -- and therefore is at risk for shingles. After this infection, the virus hides in nerve cells, then can emerge years or decades later, typically showing up on only one side of the body along the tract of a nerve, often in a belt-like pattern around the torso or in a nerve near one eye.

The $150 vaccine is covered by some insurers and also by Medicare Part D, said Dr. Jeffrey Kelman , a chief medical officer for beneficiary choices at the Center for Medicare and Medicaid Services, the government agency that administers Medicare.

The FDA cautions that people who are allergic to neomycin or any component of the vaccine should not receive Zostavax, nor should people with weakened immune systems, because the vaccine is made from live virus. An immunization committee for the federal Centers for Disease Control and Prevention is expected to discuss guidelines for use of the vaccine in October.

Shingles can, and should, be treated -- with anti-viral drugs such as acyclovir, valacyclovir, and famcyclovir. But it's far better to prevent it in the first place, said Dr. Richard T. Johnson , a distinguished service professor of neurology at Johns Hopkins School of Medicine. ``People over 60 should definitely consider the vaccine, because post-shingles pain increases with age." JUDY FOREMAN

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