I was not yet fifty when I tripped and fell on a jog in the park and banged my right rib cage.So that for the next 4-5 days I attributed the strangest pain I ever had to the fall. Oddly, the pain was less when I jogged which should have told me something as rib or muscle pain should have increased with the bouncing up and down.By day 7 the rash appeared.The "vir" drugs were not yet used for zoster so I self treated with prednisone and had a college rx some codiene. Fortunately the pain subsided in weeks with no significant postherpetic neuralgia but in some patients the pain can be persistent and severe .
In this week's NEJM the results of a RCT of a live attenuated VZV vaccine for adults are published.
It took 38,546 adults 60 years of age and older, and over 3 years of followup and fifty authors to let us know that the incidence of zoster decreased by 51.3 % and the incidence of post zoster neuralgia by 66.5 %. It seems safe and efficacious and hopefully will get approval from the FDA in a reasonable time frame. (this is not the children's vaccine, more virus is needed in adults to ramp up the cell-mediated immunity.) Merck could use the good press, reprising the old notion of a business doing well by doing good.
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