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Family Medicine

Answer 4
  1. Persons aged ≥ 60 years. Herpes zoster vaccine is currently recommended for all persons aged 60 years and older. Approximately 90% of the adult population is at risk for herpes zoster infection (shingles), and for persons older than 85 years, the lifetime risk of developing this infection is approximately 50%.3 In the United States, approximately 1 million cases of herpes zoster infection occur annually. In older or debilitated patients, complications from herpes zoster infection can lead to hospitalization and decreased activities of daily living. Booster doses of herpes zoster vaccine are not recommended at the present time. The vaccine not only decreases the incidence of herpes zoster infection (and therefore fewer patients experience complications such as postherpetic neuralgia), but it also reduces hospitalizations associated with infection.3 Once diagnosed with herpes zoster infection (shingles), patients can be treated with antiviral therapy, steroids, tricyclic antidepressants, anticonvulsants, opioids, or lidocaine patches.

    3. Stankus S, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgia. Am Fam Physician 2000;61:2437-44, 2447-8.

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