Question: I have dermatomyositis and was advised by my rheumatologist not to get the shingles vaccine because it was a live virus. Unfortunately, I came down with a bad case of shingles anyway. My regular doctor is now advising me to get the vaccine in a few months to prevent another attack, since my immune system is so compromised. I do not know if the vaccine will prevent another attack or provoke one. What is your opinion? Should I take it?

Dr. Hibberd's Answer:

The shingles vaccine is a major breakthrough in preventative vaccination for adults, and its use should be discussed with your doctor by all those over the age of 60. Shingles is the painful reactivation of the chickenpox virus, and is now preventable.

However, you would be unwise to get the shingles vaccine at this point in your life. You have already been "immune boosted" by your unfortunate recent outbreak of shingles.

I am not aware of any benefit from shingles vaccination in those who have previously suffered from shingles. Besides, this vaccine is not intended for use in immune suppressed individuals. Since your therapy for dermatomyositis involves immune suppression therapy, your rheumatologist is correct.