The shingles vaccine is generally safe and well tolerated by patients, according to a new study.

Shingles, which affects more than 1 million people each year in the United States, is a painful contagious rash caused by the dormant chickenpox virus, which can reactivate and replicate, damaging the nervous system.

Elderly people are especially at risk because immunity against the virus that causes shingles declines with age.

In this study, researchers looked at data from more than 193,000 adults 50 and older who received the shingles vaccine, also known as the herpes zoster vaccine, over two years. There was a small increased risk of local reactions (redness and pain) from one to seven days after vaccination. This finding matches the results of clinical trials.

The shingles vaccine did not increase the risk for cerebrovascular diseases; cardiovascular diseases; meningitis, encephalitis, and encephalopathy; Ramsay-Hunt syndrome; or Bell's palsy, the researchers said.

The study was published online April 23 in the Journal of Internal Medicine.

The study supports the vaccination recommendation from the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices "and reassures the general public that the vaccine is safe," study author Hung Fu Tseng, a research scientist with the Kaiser Permanente in Pasadena, Calif. said in a Kaiser news release.

Few people received the vaccine, which was licensed in 2006, the news release said. The CDC recommends it for healthy people aged 60 and older.

Taiwanese researchers have found that shingles or herpes zoster attack could lead to a significantly higher risk of multiple sclerosis (MS) three months later.

Varicella Zoster virus that causes herpes zoster- a painful, blistering skin rash - has been also associated with MS.

MS is an autoimmune disease that affects the brain and spinal cord, leading to inflammation and nerve damage as the body's immune cells attack the nervous system.

In the study conducted by Herng-Ching Lin and colleagues at Taipei Medical University in Taiwan, 315,550 adults with herpes zoster and a control group of 946,650 subjects were tracked and then evaluated for MS occurrence during a one-year follow-up period.

They found that the group with herpes zoster had a 3.96 times higher risk of developing MS than the control group.

The study also noted an interval of approximately 100 days between a herpes zoster event and occurrence of MS.

The findings were published in The Journal of Infectious Diseases.

Repeat cases of shingles may be more common than suspected, contends a new study that challenges the long-held belief that people only get shingles once in a lifetime.

People with shingles develop a specific type of rash and sometimes severe pain. The condition is caused by the herpes zoster virus.

Researchers at the Olmsted Medical Center in Rochester, Minn., analyzed the medical records of nearly 1,700 patients, aged 22 and older, diagnosed with shingles between 1996 and 2001.

Over an average follow-up of eight years, the shingles recurrence rate was more than 5 percent. That's the same percentage of first cases that would be expected in the same age group in the general population, according to the authors of the study published in the February issue of the journal Mayo Clinic Proceedings.

"And that's only within eight years. As you continue to follow these patients throughout their lives, it's likely the recurrence rate will be much higher than 5 percent," lead author Dr. Barbara Yawn, director of research at Olmsted, said in a journal news release.

It's known that women are more likely than men to get shingles, and this study found that they are also more likely to experience a recurrence of the disease.

The researchers also concluded that pain during the initial episode of shingles appears to be the most important predictor of recurrence. Patients with pain that lasted more than 30 days after the initial onset of shingles were more likely to experience a recurrence, especially in the first three to four years after the initial episode.

Older age did not appear to be a risk factor for recurrence.

The herpes zoster vaccine, which reduces first-time occurrences of shingles by 50 percent, may help prevent a second episode in patients, the researchers suggested.

"Until now, we haven't been able to tell patients their risks of getting zoster a second time. This study offers another piece of information for patients and doctors who are discussing the likelihood of recurrence and considering a prevention strategy," Yawn said.

A study published in CMAJ (Canadian Medical Association Journal) says that acute herpes zoster, or shingles, interferes with all health areas for people with the condition, including sleep, enjoyment of life and general activities.

Herpes zoster is a reactivation of the chicken pox (varicella-zoster) virus which results in pain and a rash with small blisters. It occurs in people who have had chicken pox and is most common in people over the age of 50, although younger people can have the condition. The lifetime risk of developing shingles is about 30%, but may increase as life expectancies increase.

Policymakers are being asked to consider implementing vaccination programs for the herpes zoster vaccine which is available as a preventative tool but more information is needed about the impact of shingles.

The MASTER study (Monitoring and Assessing Shingles Through Education and Research) was conducted in Canada to provide an in-depth understanding of the impact of shingles. The multi-centre study involved outpatients recruited through general practitioners or specialists across Canada.

"Acute herpes zoster significantly affected quality-of-life and functional status," writes Dr. Marc Brisson, Laval University, with coauthors. "Sleeping, enjoyment of life, general activities, mood, normal work and quality-of-life domains of pain/discomfort and usual activities were particularly diminished. This was consistently observed across all age groups."

The discomfort of shingles can also persist for months after the acute phase, with 24% of people in the study developing pain (postherpetic neuralgia) after the rash healed. The risk increased for older people.

The researchers conclude that this study reinforces "the need for effective prevention strategies, such as vaccination, and additional early intervention to reduce the burden of herpes zoster and postherpetic neuralgia."

Older people who practice tai chi may be better equipped to fight off the virus that causes shingles or, if they do get the disease, may have a milder case of it, researchers say.

Shingles, a painful nerve condition, is caused by the virus that causes chickenpox. The virus, varicella-zoster, can linger in the body for many years after a case of chickenpox and then emerge as shingles. The disease generally affects people older than 50, as their level of antibodies to the virus decreases.

Tai chi, the centuries-old practice from China, is considered a martial art, but it includes aerobic activity, relaxation and meditation. It has been found in the past to strengthen people’s immune systems.

In a study paid for by the National Institutes of Health, researchers took 112 volunteers ages 59 to 86 and split them into two groups. One was given 40-minute tai chi lessons three times a week for 16 weeks. The other was given health-counseling classes.

The researchers, led by Dr. Michael R. Irwin of the University of California, Los Angeles, found that the people who did tai chi improved their immunity to varicella-zoster. They also found that when the volunteers were vaccinated later against the virus, the tai chi practitioners had a better response to the vaccine. The study appears in the current issue of The Journal of the American Geriatrics Society.

The finding that the exercise significantly raised the volunteers’ immunity to the shingles virus suggests that it may also offer help fighting off other viruses, the study said.