Shingles vaccine in Thailand

[orientalist]

Anyone had this in Thailand or researched it? I recently had an eye infection (uveitis) likely caused by the chickenpox zoster virus. I assume a shingles jab might help prevent a recurrence although I can't find any info on this.

 

It seems the UK NHS recommends the live-attenuated Zostavax jab but the protection is only 50% for those in their 70s and doesn't last many years. Zostavax was withdrawn from the US market and the 2-shot Shingrix vaccine (protection 90%) took its place. Shingrix is recommended even for those who have had Zostavax.

 

In Thailand the Thai Travel Clinic used to offer Zostavax for 5000 baht but now has a Korean vaccine called Sky Zoster for 3600 baht. It is an "inactivated" vaccine but I can't find any efficacy statistics for it. I just wonder if it is worth it, either for shngles or zoster infection of the eye. 

[Presnock]

Went in BKK Hospital (C/M) for my yearly flu shot and dr recommended that I also get the shingles vaccine - not overly

expensive and age 75+ so I opted to get it at the same time.  No problems about 2 months ago.

[Lorry]

Sky Zoster is a live-attenuated vaccine, like Zostavax.

"A phase III trial demonstrated that NBP608 was safe and immunogenic and noninferior to ZOSTAVAX "

https://academic.oup.com/jid/article/224/Supplement_4/S429/6378089?login=false

I guess this answers your question. 

[Mavideol]

3 hours ago, Presnock said:

Went in BKK Hospital (C/M) for my yearly flu shot and dr recommended that I also get the shingles vaccine - not overly

expensive and age 75+ so I opted to get it at the same time.  No problems about 2 months ago.

the Zostavax correct ???  Shingrix not available in Thailand as I have been looking for it for quite some time

Edited November 15, 2022 by Mavideol

[Lorry]

10 minutes ago, Mavideol said:

the Zostavax correct ???  Shingrix not available in Thailand as I have been looking for it for quite some time

It's not even approved in Thailand. 

The only East-Asian countries where it's approved are China and Singapore (HK I don't know).

Whether it's actually available there I don't know. 

[internationalism]

maybe they have zostavax at the red cross, also try the other travel clinics. Or just any governmental hospital.

 

As to which is better you can write mail or call to those clinics

[orientalist]

17 hours ago, Lorry said:

Sky Zoster is a live-attenuated vaccine, like Zostavax.

"A phase III trial demonstrated that NBP608 was safe and immunogenic and noninferior to ZOSTAVAX "

https://academic.oup.com/jid/article/224/Supplement_4/S429/6378089?login=false

I guess this answers your question. 

Thanks. A  very comprehensive article, and it does mention that the vaccination helps protect against zoster-related eye infections. It's weird that a very successful vaccine like Shingrix is used in so few countries, but it doesn't look like that will change anytime soon. So I guess I'm off to the clinic next week.

[dddave]

"It's weird that a very successful vaccine like Shingrix is used in so few countries,"

 

I'm covered by the Veterans Admin. in the US. 

When I was last there I was offered Shingrix but was informed that it's a 2 dose course which must be administered 6 months apart. The 2nd dose must be from the same matched batch as the first dose and be kept refrigerated at a specific temperature.

   

This requirement must make for complicated storage and appointment protocols, maintaining stored doses and matching them to patients. 

That may be a reason why it has not been adopted more internationally. 

I could not take it as I was not planning to stay around in the US for 6 months.

Edited November 21, 2022 by dddave

[Sheryl]

On 11/16/2022 at 10:57 AM, orientalist said:

It's weird that a very successful vaccine like Shingrix is used in so few countries,

It is comparatively new, and until recently the manufacturer was unable to keep up with demand even just within the US.

 

That has since changed so now they are newly starting to look at foreign markets.

[Lorry]

4 hours ago, dddave said:

6 months apart

Actually,  2-6 months. (If 6 months,  I wouldn't have been able to get it.)

 

4 hours ago, dddave said:

The 2nd dose must be from the same matched batch

For heavens sake! I didn't know that there are places in the world more bureaucratic than my home country. 

 

4 hours ago, dddave said:

refrigerated

Yes. So you can't bring it easily to Thailand in your luggage. Not impossible, though, but I wouldn't recommend it to a layperson.

[Des1]

Just feel compelled to note, although i may be stating the obvious .. if you never had chicken pox (as a child) you cannot get shingles. Shingles is a byproduct of sort of chicken pox. If you were vaccinated for chicken pox, again, no way you can get shingles. At least this is the way I understand it. Of course I may be wrong so do the research.

[internationalism]

South korea have contracted shingrix, that despite price 2x higher as Sky Zoster. 
Price would limit popularity of shingrix, but still there would be market niche for those in risk groups. Not only for domestic market, but also for medical tourists from asia. 
As to thailand, if they just got this Sky Zoster (probably because its cheaper than zostavax) and they still will have access to zostavax, there is now not a big chance that in the near future they are going to get shingrix. 
So you have to take what is available now in thailand and get o booster of shingrix in singapre in a year or two. 
Possible only 1 shingrix, if your antibody test shows strong immunity. 
Travel clinic in mahidol uni has comprehensive doctor consultation and competent personnel. The junior doctor will consult a senior one, if they don't know answer. When i had some questions even 2 senior doctors came to consultation room for a chat. One of them was foreign, I think french. 
 

at red cross, more so at the governmental hospitals limited language might be a problem, so consultations are brief. Or even no pre-jab consultation at all, just nurse. 
 

[orientalist]

Shingrix is recommended for those who've already had Zostavax so I will do that if/when it becomes available in Thailand.

[Mavideol]

13 hours ago, Des1 said:

Just feel compelled to note, although i may be stating the obvious .. if you never had chicken pox (as a child) you cannot get shingles. Shingles is a byproduct of sort of chicken pox. If you were vaccinated for chicken pox, again, no way you can get shingles. At least this is the way I understand it. Of course I may be wrong so do the research.

and guess what, you are wrong. I had chicken pox as a kid, was vaccinated for varicella/chicken pox and was infected with shingles 3 years ago and still suffering from it

[Encid]

4 minutes ago, Mavideol said:

and guess what, you are wrong. I had chicken pox as a kid, was vaccinated for varicella/chicken pox and was infected with shingles 3 years ago and still suffering from it

Same here...

I too had chicken pox as a child, was later vaccinated, and like you was infected with shingles here in Thailand about 3 years ago.

It is extremely contagious and I infected my wife too.

We had to avoid people for several months. 

I still wear the scars although the symptoms no longer bother me.

[ozimoron]

4 minutes ago, Mavideol said:

and guess what, you are wrong. I had chicken pox as a kid, was vaccinated for varicella/chicken pox and was infected with shingles 3 years ago and still suffering from it

I believe you are correct. A couple of years ago I had cataract surgery done on both eyes only a day apart. I contract herpes in both eyes. Six weeks on hourly inflammatory and antibiotic drops. 

 

The opthalmologist told me that it was because I had chicken pox as a kid and blamed me for not telling her but the written declaration didn't mention it. Wholly incompetent.

[Seppius]

Had it three times now, first was about 10 years ago, very painful. Two weeks of Acyclovir cleared it up.

 

Then got it four months ago again strangely not so painful, but I only took one week of anti-viral, as I thought it was clearing up quickly, that was a mistake as three weeks ago hit again, still taking anti-viral. Looks like its gone, but doc said keep taking a smaller dose for longer

 

All this happened in Thailand

[KhunLA]

No, chicken pox vaccine isn't forever, and or when you get chicken pox after vaccinated, as I did, and still got a case of shingles.  Which can and did last with me for about a decade.  First day, if coming around your back to your chest, feels like you are having a heart attack, actually worse, depending on 'your' heart attack????.  Afterwards, a week or so, and it's just annoying.

 

Just my opinion, and what my docs told me, when I asked about the vaccine.   Don't waste your money, as getting shingles a 2nd time, if very rare.  If concerned, whether you had already, or not, just hang out with kids having chicken pox.

 

No better way to boost your immune system.  Much better, I was told, than an overprice vaccine, that in my doc's mind hasn't stood the test to time to be advertised as 'safe & effective', but a great money maker.

 

The onset is very easy to spot, 'a rash, much like bad sunburn', bubbled.   If have, take the meds immediately, and hopefully, will lessen the severity, and longevity of lasting discomfort.

https://www.cdc.gov/shingles/about/treatment.html#:~:text=Several antiviral medicines—acyclovir%2C valacyclovir,possible after the rash appears.

 

Dealing with the postherpetic neuralgia is a different, and good luck with that.

 

I tried some of the stronger drugs, and none really, some lessened the discomfort.   Though the experimenting process was interesting.

 

Unless experienced, self medicating isn't for everyone, take extreme care, or go to a professional.   Some of the med I took had stern warnings, since psycho drugs, some with high rates of suicide as 'side effect' ????

 

 

 

 

 

Edited November 22, 2022 by KhunLA

[Sheryl]

1 hour ago, KhunLA said:

No, chicken pox vaccine isn't forever, and or when you get chicken pox after vaccinated, as I did, and still got a case of shingles.  Which can and did last with me for about a decade.  First day, if coming around your back to your chest, feels like you are having a heart attack, actually worse, depending on 'your' heart attack????.  Afterwards, a week or so, and it's just annoying.

 

Just my opinion, and what my docs told me, when I asked about the vaccine.   Don't waste your money, as getting shingles a 2nd time, if very rare.  If concerned, whether you had already, or not, just hang out with kids having chicken pox.

 

No better way to boost your immune system.  Much better, I was told, than an overprice vaccine, that in my doc's mind hasn't stood the test to time to be advertised as 'safe & effective', but a great money maker.

 

The onset is very easy to spot, 'a rash, much like bad sunburn', bubbled.   If have, take the meds immediately, and hopefully, will lessen the severity, and longevity of lasting discomfort.

https://www.cdc.gov/shingles/about/treatment.html#:~:text=Several antiviral medicines—acyclovir%2C valacyclovir,possible after the rash appears.

 

Dealing with the postherpetic neuralgia is a different, and good luck with that.

 

I tried some of the stronger drugs, and none really, some lessened the discomfort.   Though the experimenting process was interesting.

 

Unless experienced, self medicating isn't for everyone, take extreme care, or go to a professional.   Some of the med I took had stern warnings, since psycho drugs, some with high rates of suicide as 'side effect' ????

 

 

 

 

 

 

It is posisble to get shingles multiple times.

 

"hang out with kids having chicken pox." (hard to find kids with it these days..) is terrible advice. If one does nto have sufficient (or any) prior immunity this can lead to a primary varicella infection as an adult, which is much more serious than in children.

 

 

[KhunLA]

26 minutes ago, Sheryl said:

 

It is posisble to get shingles multiple times.

 

"hang out with kids having chicken pox." (hard to find kids with it these days..) is terrible advice. If one does nto have sufficient (or any) prior immunity this can lead to a primary varicella infection as an adult, which is much more serious than in children.

 

 

Possible, but rare, unless selling the vaccine, then everyone gets it again.

 

If in TH, no prob finding kids with CP

 

Yes, much more serious as an adult, though I would have thought that was common knowledge.

 

DISCLAIMER:  I forgot what forum I was on ????

Edited November 22, 2022 by KhunLA

[Mavideol]

3 hours ago, KhunLA said:

No, chicken pox vaccine isn't forever, and or when you get chicken pox after vaccinated, as I did, and still got a case of shingles.  Which can and did last with me for about a decade.  First day, if coming around your back to your chest, feels like you are having a heart attack, actually worse, depending on 'your' heart attack????.  Afterwards, a week or so, and it's just annoying.

 

Just my opinion, and what my docs told me, when I asked about the vaccine.   Don't waste your money, as getting shingles a 2nd time, if very rare.  If concerned, whether you had already, or not, just hang out with kids having chicken pox.

 

No better way to boost your immune system.  Much better, I was told, than an overprice vaccine, that in my doc's mind hasn't stood the test to time to be advertised as 'safe & effective', but a great money maker.

 

The onset is very easy to spot, 'a rash, much like bad sunburn', bubbled.   If have, take the meds immediately, and hopefully, will lessen the severity, and longevity of lasting discomfort.

https://www.cdc.gov/shingles/about/treatment.html#:~:text=Several antiviral medicines—acyclovir%2C valacyclovir,possible after the rash appears.

 

Dealing with the postherpetic neuralgia is a different, and good luck with that.

 

I tried some of the stronger drugs, and none really, some lessened the discomfort.   Though the experimenting process was interesting.

 

Unless experienced, self medicating isn't for everyone, take extreme care, or go to a professional.   Some of the med I took had stern warnings, since psycho drugs, some with high rates of suicide as 'side effect' ????

 

 

 

 

 

you are correct on the first symptoms, feeling like and heart attack, I went to the emergency room to check my heart, it was good but doctors needed to make some extra money so they diagnosed me with a back muscle strain and gave me a cream to apply over the rash.... peace of sxxt young doctor no experience and my mistake for listening, applied the muscle cream and dear God the pain/burning has excruciating, glad the local skin doctor detected it immediately and told me to stay away from that hospital

[KhunLA]

1 hour ago, Mavideol said:

they diagnosed me with a back muscle strain and gave me a cream to apply over the rash.... peace of sxxt young doctor no experience and my mistake for listening, applied the muscle cream and dear God the pain/burning has excruciating, glad the local skin doctor detected it immediately and told me to stay away from that hospital

That's sad, as shingles should have been there first thought, especially since noticing the rash.

[Mavideol]

21 hours ago, KhunLA said:

That's sad, as shingles should have been there first thought, especially since noticing the rash.

you have no idea my friend, the fuxxxxx young doctor never heard about shingles before, had to google translate and show him  herpes zoster as i went back to ask for refund.... spoke with head management, head medical staff and they all said the same thing.... fxck off 555 and almost 4 years later still have some terrible burning pain and trying to live with it

[MrMuddle]

i had shingles last year, after surgery to remove cancer, apparently it's quite a common thing, afterwards. Got some tablets from the local GP, a few weeks later it had gone. Very paiful while it lasted though.

[KhunLA]

2 minutes ago, Mavideol said:

you have no idea my friend, the fuxxxxx young doctor never heard about shingles before, had to google translate and show him  herpes zoster as i went back to ask for refund.... spoke with head management, head medical staff and they all said the same thing.... fxck off 555 and almost 4 years later still have some terrible burning pain and trying to live with it

I feel ya ... the Neuropathic pain can be annoying as all hell.  Had it for well over 5ish years, closer to 10.   Could never narrow down any triggers for it.

 

Sis is/was a pharmacist, so I got 1000 / 10mg valiums from her, and they came in handy for sleeping, as seemed to act up at the end of the day, while trying to rest, as nerve roots do. 

 

I tried all the recommended, and then some pain/phycho meds, (pregabalin, gabapentin, amitriptyline, nortriptyline) and none gave complete relief.  As stated earlier, need to be very careful self medicating, as some crazy (suicidal) side affects. ????

[orientalist]

On 11/16/2022 at 10:57 AM, orientalist said:

Thanks. A  very comprehensive article, and it does mention that the vaccination helps protect against zoster-related eye infections. It's weird that a very successful vaccine like Shingrix is used in so few countries, but it doesn't look like that will change anytime soon. So I guess I'm off to the clinic next week.

However, when I talked to the doc at the clinic she said the vaccine wouldn't help with internal eye infections like uveitis. It WOULD help with an external infection on the skin around the eye and also reduce the pain of post-herpetic neuralgia. She thought Shingrix wouldn't be available here for several years.

[Lorry]

13 hours ago, orientalist said:

She thought Shingrix wouldn't be available here for several years.

I agree