Health

Ask the GP: Don't link Covid jab to shingles

There is no evidence that Covid vaccines trigger shingles
There is no evidence that Covid vaccines trigger shingles There is no evidence that Covid vaccines trigger shingles

Q. A MONTH after my second AstraZeneca jab, I started exhibiting 'spots' on the back and right side of my head, my ear and neck. My GP told me this was shingles. I was given amitriptyline and painkillers but have now stopped taking these. I still have a very sensitive right ear and neck. My 63-year-old neighbour had shingles after her first AstraZeneca jab - is it a coincidence? I am 70.

RP

A. SHINGLES OCCURS when the chickenpox virus (which is known medically as the varicellazoster virus) becomes reactivated after being locked in nerve cells close to the spinal cord following the infection.

This reactivation usually occurs following a drop in immunity. This leads the virus (now called herpes zoster) to travel along the nerves and cause painful blisters on the skin.

These can appear anywhere on the body. One in four of us over the age of 50 will suffer shingles - it is much less common in younger people because as we age our immune system weakens.

There is usually an obvious trigger such as a bout of flu or pneumonia, or stress, surgery or chemotherapy - i.e. things that can affect our immunity.It is common to experience burning, itching and discomfort for some weeks or months afterwards.

This is due to damage to the nerves (known as acute post-herpetic neuralgia) and it can be very distressing.

The standard treatment is a low-dose antidepressant, such as the amitriptyline you were prescribed, which helps suppress the symptoms of the nerve damage.

At present, there is no published evidence that Covid vaccines trigger shingles, although in time we will learn more.

However, the fact that shingles is so common in people in your and your neighbour's age range means it is more likely to be a coincidence that you both suffered from it, rather than the jab causing the shingles.

A persistent cough is irritating and disturbs sleep
A persistent cough is irritating and disturbs sleep A persistent cough is irritating and disturbs sleep

Q. MY HUSBAND has had cough for several months which only takes hold in the late evening. He feels as if he has catarrh in his throat and several prescriptions haven't helped. It is very irritating for him and disturbing his (and my) sleep. What might this be?

CM

A. YOUR HUSBAND'S symptoms suggest he has chronic rhinosinusitis, where the lining of the nose and sinuses becomes infected or inflamed - most often due to allergy - not least as his symptoms are worse in the evening and at night.

This is typical of allergic rhinosinusitis because the usual triggers are common household allergens such as dust or animal dander (have you recently acquired a cat, perhaps?).

Even people with no previous allergies can sometimes develop this type of allergy response following a severe cold - possibly because the allergic tendency has somehow been 'switched on'.

It could also be non-allergic rhinosinusitis, where the cause may be a previous infection irritating the sinus tissue.

The coughing is the result of the lining of the nose and sinuses becoming inflamed and secreting more mucus, causing the congestion or 'catarrh' your husband has.

Your GP has prescribed two medications in attempts to treat this already - acetylcysteine and a nasal spray (I imagine the latter contains a steroid).

It is not clear to me why the first of these was given, as this is a treatment to clear mucus from the lungs in conditions such as bronchitis, and unless the catarrh is affecting his lungs more than his nose, this will not have helped.

The nasal spray hasn't worked either, so I would suggest using more potent steroid nose drops - ideally, betamethasone. These must be applied at least twice daily, with the head in a downwards and forwards position.

This should help alleviate the symptoms after a few weeks, before your husband switches to a milder steroid nose spray, such as the one I suspect he tried first.

Even non-allergic rhinosinusitis usually improves after this - hopefully relieving your husband's symptoms and both of your disturbed nights.

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