Q: Should a 65-year-old who has never had chickenpox be vaccinated against it?
A: In someone who has never had chickenpox, the vaccine would protect against a disease that is far more serious in adults than it is in children, said Dr. Mark Lachs, director of geriatrics for the NewYork-Presbyterian Healthcare System and professor of medicine at Weill Cornell Medical College.
After childhood chickenpox, the varicella virus is never eliminated from the body but lies dormant in nerve roots. Decades later, it may reactivate along the nerve pathway and cause the very painful rash called shingles, and later, in many cases, a persistent pain called postherpetic neuralgia, or PHN.
Therefore, for most people older than 60, the Centers for Disease Control and Prevention recommends the shingles vaccine.
It safely reduces (but does not eliminate) the risk of both shingles and PHN in those who have had chickenpox, Lachs said.
In someone who never had chickenpox, he said, the concern is not shingles but adult chickenpox, which has “fatality rates 25 times higher than in children."
Such a person should instead be vaccinated against a primary infection with the varicella virus, Lachs said.
The vaccine differs in strength from the one for shingles and is given in two injections, a month apart.