Splenectomy and Shingles Vaccine

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Splenectomy and Shingles Vaccine

Question:

I am 60 years old. I don't have a spleen due to an accident at age 24. I had shingles as a youngster. Should I get the shingles vaccination?

Answer:

Shingles, what doctors call herpes zoster, is the reactivation of a dormant chickenpox virus. The virus hides inside nerve cells located close to the spine. When the virus wakes up inside the nerve, it travels along the path of that nerve. It rarely spreads outside this path.

You have two potential reasons to consider getting the shingles vaccine, called Zostavax. The vaccine is approved and recommended for people 60 and older. Also, you have had your spleen removed (splenectomy) and the spleen is part of the immune system that helps fight infections.

Let's first discuss whether a person who has had a splenectomy is at higher risk of developing shingles. Studies have not shown that having your spleen removed puts you at higher risk of shingles. This is especially true if the spleen was removed because of injury or rupture from an accident.

People who have needed splenectomy as part of their cancer treatment are at a slightly higher risk of shingles, and more importantly, once the virus reactivates, it has a chance of spreading beyond the nerve to the rest of the body. This can lead to an overwhelming, life-threatening infection. However, there is no evidence yet that the shingles vaccine effectively reduces the risk of getting shingles or allowing it to spread in patients who have had a splenectomy.

Now that you have reached 60 years of age and are eligible for the vaccine, I would discuss getting the vaccine with your doctor.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Last updated:	July 20, 2009