Newly approved for sale to people 60 and over, Zostavax isn’t 100-per-cent effective – but if you do get shingles after receiving the shot, it tends to be a milder outbreak
Chicken pox is one of those childhood illnesses that never really lets go.
Once the initial infection has passed, the bug responsible – the varicella-zoster virus – goes dormant and takes up permanent residence in certain nerves.
If your immune system weakens, especially as you age, the virus can reactivate to produce a painful, unsightly rash with fluid-filled blisters known as shingles. What’s worse, the pain can linger for months, even years, after the rash and blisters have healed, a condition known as postherpetic neuralgia.
Now, however, a new vaccine is available to keep this nasty virus under wraps. Merck Frosst has won Health Canada’s approval to market the vaccine, called Zostavax, to those 60 and older. It has been sold in the United States since May, 2006.
“I would anticipate that a lot of people are going to want to get this vaccine,” said Shelly McNeil, a vaccine researcher and adult-infectious-disease specialist at the Queen Elizabeth II Health Sciences Centre in Halifax.
Each year, about 130,000 Canadians suffer a bout of shingles, most of them older individuals. About 20 per cent of us eventually will be stricken, Dr. McNeil said.
Zostavax is made with a live attenuated – or “weakened” – virus that can prompt the immune system to boost its defences against the bug without causing the illness. The vaccine must be stored at -15 C to keep the virus alive. That will likely limit the number of family physicians initially offering the shots because their offices lack proper refrigeration facilities.
The vaccine isn’t 100-per-cent effective. Studies in people over 60 suggest it cuts the chances of developing shingles by 50 per cent. But if you do get shingles after receiving the shot, it tends to be a milder outbreak. “The real benefit of this vaccine is likely to be a reduction of the long-term pain from postherpetic neuralgia,” Dr. McNeil said.
The vaccine isn’t cheap. The company has set a list price of $150. (The cost could be somewhat higher for patients.) None of the provinces currently intend to foot that bill as part of their publicly funded vaccinations programs, although some private health-insurance plans may cover it.
“It’s not a small amount of money, but if you talk to people who have had shingles, most of them would try to cough up $150 so it doesn’t happen to them again,” Dr. McNeil said.
Time to pop vitamin D
Vitamin D winter will soon be upon us. That’s the time of year when the sun’s rays are too weak to make vitamin D naturally in our skin. The period roughly falls from mid-
October to early March in cities at the same latitude as Toronto. It lasts even longer farther north.
The so-called sunshine vitamin can also be obtained by eating certain foods such as fatty fish and fortified milk products. But we don’t tend to consume enough of them, and our vitamin D levels usually plummet for a substantial chunk of the year. A growing body of medical research suggests these low levels of vitamin D could leave us vulnerable to a host of health problems, including bone loss, heart disease, diabetes and many types of cancer.
For that reason, the Canadian Canada Society urges Canadians to pop a pill containing 1,000 international units of vitamin D a day during the fall and winter. The society also suggests that some people – such as those with dark skin or over the age of 50 – take supplements year-round.
Two new studies, released this week, further drive home the message that vitamin D plays a vital role in keeping us healthy.
One study, from the University of Michigan’s school of public health, showed that young women with vitamin D deficiency are at an elevated risk of developing high blood pressure as they age. The other study, by researchers at the University of Colorado and Massachusetts General Hospital, indicates that insufficient vitamin D levels put older folks at increased risk of dying from heart disease.
Risks of prostate therapy
Men who are given hormone therapy for the treatment of advanced prostate cancer are at heightened risk of developing a variety of heart ailments, new research suggests.
The study authors hope the findings will help alert doctors to the potential downside of the widely used therapies.
Cancer experts have long known that the male sex hormone testosterone fuels the growth of prostate tumours. So, in cases of advanced and metastasized prostate cancer, doctors often use various means to keep testosterone in check.
The hormone therapies include: surgical removal of the testicles, which are the main source of testosterone; injections of gonadotropin-releasing hormone agonists, which reduce testosterone production; and anti-androgen pills, which help block testosterone from getting to the prostate tumour.
In the new study, researchers followed the heart health of 30,000 Swedish men receiving one or more of the hormone therapies. The results, presented in Berlin at a joint meeting of the European Cancer Organization and the European Society for Medical Oncology, revealed elevated rates of heart problems, ranging from arrhythmias (abnormal heart beats) to heart attacks.
“For all the hormone therapies, we saw an increase in risk, but it was less with the anti-androgen pills,” said lead researcher Mieke Van Hemelrijck, a cancer epidemiologist at King’s College London.
She noted that treatment options are limited for men with advance prostate cancer. That means hormone therapy may still be the best bet for many of these patients, despite potential heart troubles. But if doctors are at least aware of the risks, they can monitor patients for early signs of heart disease while it is still treatable, she said.
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