Dear Dr. Roach: I am conflicted about getting a shingles shot. When I was young, I had a mild case of chickenpox. Last year, I contracted a mild case of shingles. I had decided previously not to get the Zostrix shot. I recently asked my doctor about the shingles shot and he said it was not necessary, since I had already had shingles.
Should I get the vaccine? Does the severity of chickenpox correlate to the severity of shingles?
M.C.
I strongly recommend the new shingles vaccine, Shingrix, for healthy adults over age 50, whether or not they have had shingles or chickenpox in the past. The vaccine is very effective at preventing shingles and its dreaded complication, post-herpetic neuralgia.
The risk of developing a second case of shingles within a year of the first case is low, so it is reasonable (but not necessary) to wait a year before getting the new vaccine. It is two doses, spread two to six months apart. Muscle pain, swelling, redness and fever are common after the shot, but usually do not last more than a day or two.
These recommendations are in accordance with those of the U.S. Centers for Disease Control and Prevention, which can be viewed at .
Dear Dr. Roach: Should people with fibromyalgia get the shingles and flu vaccines?
S.S.R.
In 2012, the U.S. Institute of Medicine (now the National Academy of Medicine) concluded that there was no mechanistic evidence for an association between fibromyalgia and MMR, influenza, hepatitis B or DTaP vaccines. They didn鈥檛 look at the existing shingles vaccine, let alone the new one, but it is unlikely that the shingles vaccine would make fibromyalgia flare. The benefits of vaccines greatly outweigh the risks in the general population and in people with fibromyalgia.
Dear Dr. Roach: Why does every article mention the formal name of drugs, and then the popular name? For example, you recently mentioned 鈥渁pixiban (Eliquis).鈥� Could the world still function with only one name per product?
G.N.R.
Every drug has not just two, but usually three names: a precise chemical name, which can be very long and unwieldy; a generic name; and an optional brand name, which varies based on the manufacturer and the country.
The brand name is the one that most people know, as it is the one usually advertised to both the public and physicians. This column is published in several countries, so I always list the generic name in addition to the most usual brand name. Also, generic names often give clues to the type of medication. For example, a drug ending in 鈥�-pril鈥� is an ACE inhibitor, used to treat high blood pressure and heart failure, and for prevention of diabetic kidney disease. I encourage my medical students and residents to use generic names. Generic names are lowercase, while brand names are capitalized.
I will put a few examples on my Facebook page, facebook.com/keithroachmd, for people who are interested. The world will still continue to function, even if you don鈥檛 read the post.
Dr. Roach is unable to answer individual letters, but will incorporate them in the column when possible. Email questions to [email protected].
