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Ontario and some other provinces pay for people between the age of 65 and 70 to get the shingles vaccine, but everyone over the age of 50 should consider getting the vaccine even if means paying for it yourself, a University of Toronto medical expert says.

“I think it’s worth considering paying out of pocket for early protection from this painful rash and its potential long-term complications,” writes Dr. Marla Shapiro , the Toronto Star's weekly column created by U of T medical experts.

Read previous Doctors' Notes columns from U of T medical experts

Shingles occur when the chickenpox virus, which can remain latent for decades, is reactivated – usually when people are over the age of 50, writes Shapiro, an associate professor in U of T's Faculty of Medicine and a family physician. Shingles are a rash, often on the chest or neck, that is made up of painful red blisters. The rash usually breaks out along the distribution of a nerve root called a dermatome, on one side of the body, writes Shapiro.  

About 13 per cent of people with shingles develop a chronic pain syndrome called postherpetic neuralgia, with significant pain that can be difficult to control. The pain is often described as burning or stabbing pain, sometimes with an altered sensation response to stimuli. "For example, lukewarm water might feel like it’s scalding hot or a cool breeze could feel agonizing," Shapiro writes. 

Getting a vaccine helps. Not only does the vaccine reduce the incidence of illness, but for those who do develop shingles, having had the vaccine can make it less likely thay you will develop postherpetic neuralgia, Shapiro writes.

This month, a new, adjuvanted vaccine called Shingrix became available. Shapiro writes that in studies, all people who got the vaccine, regardless of their ages, received the same level of protection – 90 per cent and greater.

“I believe immunization is one of the most important strategies we offer patients in primary care," wirtes Shapiro. "If you get vaccinated, we can’t always guarantee you won’t get shingles, but if you do, we know it will be milder and your risk of developing postherpetic neuralgia will be lower.”