Q: I was quite unwell with nausea and vomiting the day after having the Shingrix® vaccine, and my upper arm was swollen and very painful for more than a week. I’m considering not getting the second shot because of these side effects. What are your thoughts?
A: There is evidence that Shingrix® is associated with more side effects than the older shingles vaccine (Zostavax®). However, studies suggest that Shingrix® provides better and longer-lasting protection against shingles, which can occur if the chicken pox virus most people have during childhood reactivates decades later. This reactivation is common in seniors because immunity wanes with age. If you develop shingles, you are likely to suffer a painful blistering rash—plus, about 20 percent of people who develop shingles experience localized pain and discomfort, called postherpetic neuralgia (PHN), for months or even years after the rash heals.
As well as the side effects you mention, some people have reported fatigue, fever, chills, and muscle pain after Shingrix®, but there is some evidence that the way Shingrix® is administered may be a factor in whether or not you experience these adverse events. The vaccine should be given into the muscle, whereas Zostavax® is injected subcutaneously (just below the surface of the skin). Data from the Centers for Disease Control and Prevention have suggested that some healthcare providers may not be fully aware of the administration guidance for Shingrix®. It’s worth mentioning this when you have your second and final dose, and I do recommend that you proceed with this, to ensure that the vaccine fully protects you against shingles and its complications.
Vaccine side effects—beyond the inevitable soreness where you receive an injection—are quite unusual, and the fact you reacted badly to your
first dose of Shingrix® does not necessarily predict similar side effects from the second shot. But just as a precaution, take acetaminophen (Tylenol®) after you receive the shot, and also try to avoid scheduling activities the day after, so you can recover if needed.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Q: I’ve heard red wine is good for heart health, but does grape juice offer benefits, too?
A: Some of the benefits associated with red wine are believed to be derived from resveratrol: a plant substance present in the skin and seeds of grapes. There is some evidence that resveratrol may increase levels of the HDL (“good”) cholesterol that can lower the risk of atherosclerosis (narrowed arteries) and reduce high blood pressure, both of which increase the risk of cardiovascular disease. Since resveratrol also is present in grape juice (particularly juice made from red and dark purple Concord grapes), it follows that favoring grape juice over red wine might be a worthwhile heart-healthy choice if you don’t drink alcohol or are looking to cut back on your intake. One of the major advantages of drinking grape juice instead of wine is that you don’t have to worry about alcohol’s damaging effects on your physical and mental health.
Fran C. Grossman, RD, MS, CDE, CDN
Nutrition
Q: I’m trying to stay as active as possible despite painful osteoarthritis in my knee. Would it be beneficial for me to wear a brace to support my knee while exercising?
A: If pain from arthritic joints is impeding your efforts to exercise, a brace can be a useful means of support. An elastic sleeve-style brace can provide a degree of compression that helps ease mild pain, while more severe arthritis may require a semi-rigid brace that shifts your weight away from the joint.
The type of brace that best suits you and the circumstances in which you may benefit from wearing it, are highly variable. This means it’s best to consult with your doctor or a physical therapist who is experienced in fitting these devices, rather than purchase one over the counter. If you do decide to try wearing a brace, I recommend you wear it only during activities that require additional joint support, since becoming too reliant on it could weaken the muscles and tendons around the joint.
David Thomas, MD
Physical Medicine and Rehabilitation
The post Ask the Experts: Shingrix Side Effects; Grape Juice; Knee Brace with Osteoarthritis appeared first on University Health News.