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Author Topic: Once again, shingles vaccine topic.  (Read 1603 times)

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Offline mitch777

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  • Posts: 3,582
Once again, shingles vaccine topic.
« on: July 06, 2014, 09:15:37 PM »
Just was wondering how long it's been, if at all, that there was a general consensus about the safety of us hiv+ folks getting this vaccine.

Most of what i read by searching seems to indicate that those with a cd4 count > 200 and an UD VL should be relatively safe with the vaccine. Maybe a 5% chance of actually coming down with a case of shingles because it is a live one after all. My memory sucks but I think the CDC is behind the times?

I'm thinking that I should be pushing my doc about this. It's been about 3 or 4 years since I last asked and he once again wasn't on board with the concept.

I also seem to remember that those who are hiv+ have a far greater chance than those who are neg. The longER term side effects seem painful and I'm concerned.

Any consensus here? Like I said, bad memory. Sorry, no links. Tired pup tonight.
31 years hiv+ (oct. 2013) with a curtsy.

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Re: Once again, shingles vaccine topic.
« Reply #1 on: July 06, 2014, 09:31:25 PM »
M,..

I am planning to discuss this once again, with my Primary care or ID Doctor ( who by the way was not on board with it either) at the next appointment.

I've had shingles at least 3 times, ( last time Oct 03) So, if there is a possibility of preventing it in the future , Why Not !

I'm over 60, tcells are over 400 VL -Undetectable. I think I meet the criteria, and it doesn't matter whether you've had shingles in the past, you can still get the vaccine, from what I've read on it.

I don't know if the VA offers this, but if they give me the go ahead, I will get it from Walgreens without hesitation.

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline Lou-ah-vull

  • Member
  • Posts: 949
Re: Once again, shingles vaccine topic.
« Reply #3 on: July 06, 2014, 11:40:29 PM »
My new ID doctor says that a consensus is emerging that the shingles vaccine is suitable for those of us with relatively normal immune systems and so-called undetectable levels of virus.  There has not been a recommendation or definitive statement.  There has not been research on the undetectable, healthy immune system HIV+ community (and there most likely will not be.)  I am 58 and apparently there is an insurance issue (at least with Humana) in people under 60.  There is a shortage of shingles vaccine in Louisville right now..so I am holding.  I take valcyclovir daily to hopefully prevent a third occurrence of shingles.  I feel comfortable with trying the vaccine and it would be nice to take those two blue pills out of my "pill pile" each day (not to mention the $25 a month copayment.)

Gary
Diagnosed Oct. 2005
10/05:  367 (26.2%), 24556 VL
01/06:  344 (24.6%), 86299 VL
04/06:  374 (22.0%), 87657 VL
05/06:  Began HAART 05/15/06, Combivir/Kaletra
07/06:  361 (27.8%), 1299 VL
10/06:  454 (32.4%), 55 VL
01/07:  499 (38.4%), UD
02/07:  Switched to Atripla 2/8/07
04/07:  566 (37.7%), UD
08/07:  761 (42.3%), UD
06/08:  659 (47.1%), UD
01/09:  613 (43.8%), UD
07/09:  616 (47.4%), UD
01/10:  530 (44.2%), UD
07/10:  636 (48.9%), UD
01/11:  627 (48.2%), UD
07/11:  840 (52.5%), UD
01/12:  920 (51.1%), UD
07/12:  857 (50.4%), 40
10/12:  UD
01/13:  710 (47.3%), UD
07/13:  886 (49.2%), UD
01/14:  985 (46.9%), UD
06/14:  823 (47.2%), UD

Offline wolfter

  • Member
  • Posts: 4,628
Re: Once again, shingles vaccine topic.
« Reply #4 on: July 07, 2014, 07:09:13 AM »
I too don't remember what we decided the last time we discussed this.  I don't recall why, but my doctor wasn't on board with me getting the vaccine either. 

Shingles is another bullet I've managed to dodge.  Bill must have been an elite controller of sorts as he never had low CD4s or a high VL.  Even after 20 years.  Just had a weird thought; was I being given daily injections of his elite controller genes?  Sorry, off topic.

Anyways, he came down with a horrid case of them in the early 90's while nursing me.  Wracked with AIDS, with an imminent demise, I managed to not contract them.  Seems he was in misery for about a week waiting on the meds to work.

I too will ask my doctor.  Probably shoot him an email so I can always refer back to it
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline mitch777

  • Member
  • Posts: 3,582
Re: Once again, shingles vaccine topic.
« Reply #5 on: July 07, 2014, 11:19:37 AM »
Thanks Ray. That was one of the links I found. Several other basically said the same thing but with less detail about the study.

Gary, that's just awful that your insurance company would have an issue with someone younger than 60. I'm glad to hear your doc seems to be up to speed on the latest info at least, even if the data is somewhat limited at this point.

I'm curious if many here have had the vaccine while being poz and if so, did anyone come down with shingles because of it.
31 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

  • Member
  • Posts: 3,582
Re: Once again, shingles vaccine topic.
« Reply #6 on: August 04, 2014, 04:57:32 PM »
Well, I brought up some of the newer research with my doc last week and he caved.  :)

Got my vaccine shot today. Keeping my fingers crossed that I will not be amongst the few who come down with it.
31 years hiv+ (oct. 2013) with a curtsy.

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Re: Once again, shingles vaccine topic.
« Reply #7 on: August 04, 2014, 05:53:40 PM »

Got my vaccine shot today. Keeping my fingers crossed that I will not be amongst the few who come down with it.

Good luck with it !!  I will discuss this one more time with my ID in September, and my primary in December, and hopefully both will give the go ahead !

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,774
  • 31 Years Poz
Re: Once again, shingles vaccine topic.
« Reply #8 on: August 04, 2014, 05:59:49 PM »
Sorry, no vaccine for me.  I have had shingles, not once, but twice and any possibility that the vaccine could give me shingles, is a no go for me.  I always thought I was pretty lucky, until I drew draft lottery number one, in the summer of 1972.  I think I'll dodge this possible bullet and take my chances.

Joe

Offline leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: Once again, shingles vaccine topic.
« Reply #9 on: August 04, 2014, 06:29:34 PM »
it would be nice to take those two blue pills out of my "pill pile" each day (not to mention the $25 a month copayment.)
get your script changed to 1 daily 800mg  ;) will that lessen the copay? It would sure lighten the pill burden

I've had major bouts of shingles 3 times, and have a recurring outbreak in my left hand (probably had outbreaks over 50 times!). As long as I stay adherent to my daily acyclovir, I don't have any outbreaks. With that kind of track record, there's no way I'm taking this vax.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline mitch777

  • Member
  • Posts: 3,582
Re: Once again, shingles vaccine topic.
« Reply #10 on: August 04, 2014, 07:09:18 PM »
Can't blame any of you. I never had Shingles and if this vaccine itself doesn't cause any issues I'm willing to take the risk. My last CD4 count was well over 900.

Assuming I don't have a bad reaction it is about 60% effective and should I come down with a case the the duration is said to be significantly less in the more recent studies I've read. Will search for the link.

btw- The woman who gave me the shot at CVS had a raised eyebrow.
31 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

  • Member
  • Posts: 3,582
Re: Once again, shingles vaccine topic.
« Reply #11 on: August 05, 2014, 06:04:21 PM »
I never thought to ask but in the (hopefully) unlikely event that this vaccine actually causes shingles I'm wondering how long it would take before symptoms would show up?
31 years hiv+ (oct. 2013) with a curtsy.

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,774
  • 31 Years Poz
Re: Once again, shingles vaccine topic.
« Reply #12 on: August 05, 2014, 06:44:20 PM »
I never thought to ask but in the (hopefully) unlikely event that this vaccine actually causes shingles I'm wondering how long it would take before symptoms would show up?

I would think just a few days.  With my onsets I would get this tingly feeling, wrapping around my chest and no matter how fast I got it treated, it ran the full course.  I would get a script for Acyclovir, or whatever they use to treat it, so you have it if you need it.

Joe

Offline leatherman

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  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: Once again, shingles vaccine topic.
« Reply #13 on: August 05, 2014, 07:06:35 PM »
script for Acyclovir, or whatever they use to treat it,
acyclovir or valcyclovir

What Is the Difference Between Acyclovir and Valacyclovir?
http://www.wisegeek.org/what-is-the-difference-between-acyclovir-and-valacyclovir.htm
Quote
A major difference between acyclovir and valacyclovir pertains to their bioavailability, or how efficiently they are absorbed into the bloodstream after ingestion. Valacyclovir tends to be absorbed more slowly than acyclovir, regardless of whether it is administered as a topical solution, by mouth, or via intravenous (IV) means. These two drugs are also broken down by the body at different rates. Acyclovir is metabolized my quickly, meaning that it must be taken more frequently than valacyclovir. The latter drug may be a better option for patients taking large numbers of medications, because they do not have to remember to take this medication as often.

i too am one of the unlucky ones in that treatment has never really done much to shorten or alleviate the symptoms during an outbreak. For me though the med has been a great propholayxis against new outbreaks. interestingly enough Acyclovir has also been found to inhibit HIV viral replication - in effect being a mild HIV antiretroviral.

http://www.aidsmeds.com/articles/hiv_acyclovir_herpes_2351_17008.shtml
http://www.thebody.com/content/art50920.html
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline mitch777

  • Member
  • Posts: 3,582
Re: Once again, shingles vaccine topic.
« Reply #14 on: August 05, 2014, 08:34:35 PM »
Thanks guys. I should have thought of this sooner.

Waiting 9 days now for my ID doc to send in a script for a med change and I'm losing faith with his ability to follow up on anything this past year or so. I'm sure my PC would act quickly.

I also don't want to sound as if I'm being a hypochondriac here either but I guess an ounce of prevention...



31 years hiv+ (oct. 2013) with a curtsy.

Offline tednlou2

  • Member
  • Posts: 4,972
Re: Once again, shingles vaccine topic.
« Reply #15 on: August 07, 2014, 12:23:20 AM »
Dr. Gallant just answered a question about all the labs and vaccinations we should get.  Here is what he said about the shingles vaccine.


"Shingles vaccine (Zostavax); Recommended if your CD4 count is over 200 and you’re over 60, and sometimes given if you’re over 50."


http://hivforum.tumblr.com/

Offline Handydan

  • Member
  • Posts: 9
  • Since 1994
Re: Once again, shingles vaccine topic.
« Reply #16 on: August 07, 2014, 12:39:21 AM »
I've had shingles many times and it's no picnic so I asked my ID about it and he said no. I try to manage my stress level and keep Acyclovir on hand. Haven't had a problem for 2 years and counting.
I'm still here!

Offline Torchwood

  • Member
  • Posts: 58
Re: Once again, shingles vaccine topic.
« Reply #17 on: August 23, 2014, 09:11:13 PM »
I've had shingles once. It sucked. I'm 43 now. 1788 CD4 count and undetectable. I plan on getting the vaccination along with my annual flu shot.
Discovered 4/2006
VL: 1600
CD4: 1005
Started Complera 10/2011
VL: 48,500
CD4: 570
1/17/12
VL: Undetectable
CD4: 890
4/12
VL: Undetectable
CD4: 895
11/12
VL: Undetectable
CD4: 1193
4/12
VL: Undetectable
CD4: 1461
11/13
CD4: 1273
VL: Undetectable
5/14
CD4: 1788
VL: Undetectable

Offline mleatherboy

  • Member
  • Posts: 6
Re: Once again, shingles vaccine topic.
« Reply #18 on: August 24, 2014, 12:57:14 AM »


http://www.aidsmeds.com/articles/hiv_zostavax_shingles_1667_22067.shtml

Thank you for that. A good friend of mine had shingles around his leg a year or so ago. It's come back a few times. I was shocked to learn that he couldn't get a vaccine because of being HIV positive. I don't quite recall if the doctor flat out refused him (or if he tried to argue to get one) or if it was just recommended or told he can't. He's in his 50's or so, not quite sure what his CD4 is actually (although I believe he just got lab work done) but he's undetectable at least. I'm glad that I can share this with him and hopefully he gets the vaccine.

Offline harleymc

  • Member
  • Posts: 228
Re: Once again, shingles vaccine topic.
« Reply #19 on: August 28, 2014, 07:24:32 PM »
For the folks who have shingles multiple times, ie their immune system can't recognise the herpes zoster, it's really questionable that challenging their immune sytem again with a different strain of the virus would do any good. This is not like the flu, we aren't catching a fresh strain of herpes zoster each winter.




Offline leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: Once again, shingles vaccine topic.
« Reply #20 on: August 28, 2014, 09:37:53 PM »
since the Simpsons are still playing, that thread is bleeding over into this one!


"Hey, look, Homer. I'm coming down with a case of shingles
S16E16
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline wolfter

  • Member
  • Posts: 4,628
Re: Once again, shingles vaccine topic.
« Reply #21 on: September 18, 2014, 08:02:07 PM »
I'm updating what my doctor said today about the vaccine.  He doesn't routinely suggest it as it is a live vaccine and it's possible to actually cause a case of them.  We're at no greater risk than the general public and unless he feels there's a specific situation, he doesn't suggest it.

He also never suggests it for someone under 60 or for someone with less than 350 CD4s. 
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline Basquo

  • Member
  • Posts: 3,260
Re: Once again, shingles vaccine topic.
« Reply #22 on: September 18, 2014, 09:21:26 PM »
I got the shingles last week. Very localized, but very painful. I went to the clinic just to confirm the diagnosis. The treatment is valacyclovir (valtrex) which I already take and have a backstock of, so I used that. Valtrex used to cost me a bunch but since it's generic now I don't have a copay. I'm going to ask my doctor about the shot. I don't think insurance will cover it but at least if I get it through my doctor it will count towards my deductible.

Offline Jmarksto

  • Member
  • Posts: 513
Re: Once again, shingles vaccine topic.
« Reply #23 on: September 18, 2014, 09:28:31 PM »
I got the vaccine during my last apt with my doc.  He was ambivalent about it, but did note that he would recommend it when I turned 60.  He also didn't think insurance would pay for it until I was 60 -- but I just received my insurance settlement for my last apt and they did cover it ($180).  I figured if I was going to get it at 60, I might as well get it at 54 and get 6 additional years of benefit.
03/15/12 Negative
06/15/12 Positive
07/11/12 CD4 790          VL 4,000
08/06/12 CD4 816/38%   VL 49,300
08/20/12 Started Complera
11/06/12 CD4   819/41% VL 38
02/11/13 CD4   935/41% VL UD
06/06/13 CD4   816/41% VL UD
10/28/13 CD4 1131/45%  VL 25
02/25/14 CD4   792/37%  VL UD
07/09/14 CD4 1004/39%   VL UD

 


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