► What is shingles?
Shingles is a viral skin condition caused by reactivation of the chickenpox virus. It manifests itself by pain and the appearance, often in the thorax, of blisters that can itch. In most cases, the disease heals within two to three weeks. “But it can cause complications, mainly post-herpetic pain, pain like electric shocks,” reports Daniel Floret, professor emeritus of pediatrics and former vice-president of the technical commission for vaccinations at the High Authority for Health (HAS). «These complications, more frequent when one is elderly or weakened, can persist for months or even longer and be very disabling. »
It is to prevent these situations that Health Insurance has decided to reimburse the shingles vaccine for people aged 65 and over as well as for immunocompromised people over 18 years of age.
► How effective is the vaccine?
Already recommended since March 2024 by the HAS, the Shingrix vaccine, from the British laboratory GSK, replaces Zostavax, withdrawn from the market. “It was the vaccine that had been recommended for ten years, but it was little used because its effectiveness was quite limited and we did not really know up to what age it protected, Daniel Floret explained. It was also a live attenuated vaccine, which could not be used on immunocompromised people, unlike the new vaccine which is inactivated. It is also undoubtedly more effective, with protection that is maintained in older people. »
► Why doesn’t France vaccinate against chickenpox?
Unlike Germany, Switzerland, Italy and Spain, France does not recommend vaccinating infants against chickenpox. But since the virus causing the disease is the same as that causing shingles, shouldn’t the recommendations be reviewed?
“This is a point that has been much discussed because, initially, it was thought that widespread vaccination of children against chickenpox would ultimately increase the frequency of shingles, tell Daniel Floret We said that having a significant circulation of the virus in the population was a good thing, because it made it possible to stimulate the immune system of people who had had chickenpox, the virus remaining in the resting phase in the nerve ganglia. Ultimately, this was not demonstrated. »
Reluctance also came from the fact that chickenpox, when contracted young, is mostly benign, which is not likely to convince parents to vaccinate their children. However, with less than 95% vaccination coverage, the risk would be to shift the disease to adolescence or adulthood, where it is more serious. So many arguments which no longer hold up in the eyes of learned pediatric societies, now in favor of vaccination from 1 year of age. Especially since there are now combined MMR-V vaccines, immunizing against measles, mumps, rubella (compulsory since January 1, 2018) and against chickenpox. According to Daniel Floret, “the use of such a vaccine in France would surely facilitate acceptability”.
