Putting a pause on the shingles virus until age 60

Dr. Keith Roach

DEAR DR. ROACH: At what age do you recommend the shingles vaccine? I'm 56 and my doc is recommending it, but I've heard that people frequently have negative side effects. I'm doing everything I can to stay well and out of the doctor's office during coronavirus.

Would you recommend I wait until next year, when we've all (hopefully) been vaccinated against the coronavirus? If I need to do this now, I'd like to get it done before we add the flu to the mix. I honestly would prefer to wait until this time next year. -- S.C.

ANSWER: The new subunit shingles vaccine (Shingrix) may be given starting at age 50. There is no rush to get it for you. Shingles tends to be worse in older people, as the major complication of post-herpetic neuralgia is much more likely for people in their 70s and 80s than for those in their 50s and 60s. It lasts much longer in older people. You can certainly wait until you are 60.

Doctor's offices are doing all we can to keep our patients safe during the pandemic, but there is still a risk. I am not certain that a vaccine will be available in the next year. I would love to be proven wrong, but vaccine development and safety testing is a slow process. No vaccine has ever been developed in less than four years, and while many groups are working very hard, and some vaccines have completed phase 2 studies, the phase 3 studies that look at effectiveness are time-consuming. Any coronavirus vaccine must have convincing evidence of safety and effectiveness before it can be widely recommended, in my opinion.

DEAR DR. ROACH: Many years ago, I drove a friend to visit her husband in the hospital. He was 80 and had taken a fall in their yard (no broken bones). When we got there, he was sitting upright in bed, his legs extended with his ankles resting in the cushioned cuffs of a small machine that was about the size of a foot massager. As I remember it, the cushioned part rocked from side-to-side, lifting first one leg and then the other a few inches. The object was to keep the blood circulating in the legs.

I am now 77 myself, with wonky knees, and I think I could use such a machine while resting my legs on an ottoman. I've searched online but cannot find one. What I did find was a similar machine that moves from side to side in a fishtailing motion. Am I misremembering what I saw? Would this machine have the same effect on circulation, or would the swishing movement exacerbate the osteoarthritis in my knees? -- S.G.

ANSWER: The intermittent pressure device you saw years ago is a way to try to prevent blood clots from forming in the legs, especially in people at high risk who are unable to walk. It is not as effective as medication. It is used in people who cannot tolerate an anticoagulant, such as people who have had a major bleed.

These devices do not help arterial circulation, nor would they help or hurt your knee.