Friday, March 25, 2011

Are You 50 Years Old? Get Your Zostavax Shot!

A good deal of family medicine is focused on prevention, which is different from screening.  In an ideal world, we prevent (all) diseases & illnesses before they manifest themselves.  This is primary prevention.  For instance, washing  hands helps prevent spread of the common cold and other communicable diseases.  So does wearing condoms (well, the latter, anyway).

Most of the time when we speak of screening, we're talking about looking for disease at an early stage where we have better chances of effecting a cure (this is secondary prevention).  For instance, when a patient turns 50 years old, assuming no other risk factors, we typically recommend a screening colonoscopy, looking for pre-cancerous polyps.  And at any visit, we ask about tobacco use, hoping to find those who do and convince them to stop before it's too late, eg Alzheimer's disease, cancer, COPD, erectile dysfunction, stroke, etc.

I mention this because the Food & Drug Administration just (yesterday) approved the use of Zostavax vaccine to prevent shingles starting in those 50 years and older.  If Zostavax sounds familiar, it's because it's already approved (since 2006) for use in anyone 60 years and up.  In fact, a recent study demonstrated a 45% relative risk reduction in shingles in those who received the vaccine compared to those who didn't.  Only 152 individuals needed to receive the vaccination in order to prevent a single case of shingles.  And a major reason to prevent shingles is to minimize the risk of complications, eg post-herpetic neuralgia, a debilitating chronic pain state.

Given that most family physicians and internists are overworked, I'd suggest you bring up this topic and request your immunization rather than risk developing shingles while waiting for your doc to find out about this new indication.  And while you're at it, don't forget to ask for your screening colonoscopy!

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