Dear Dr. Roach: Is it advisable to get the Shingrix vaccine at the same time as the annual influenza vaccine?
T.H.
It can be done, but whenever possible, you should get the new Shingrix vaccine by itself. The side effects of this vaccine are more pronounced than with most approved vaccines, and more people may not feel well and will have low grade fever, muscle aches and fatigue that can last a day or two. Anecdotally, it seems that getting multiple vaccines the same day may worsen that reaction. I advise patients to get the Shingrix vaccine on a day where they have nothing critical planned that day or the next, just in case.
If you haven’t gotten this year’s flu vaccine, get it right now. Today, if possible.
Dear Dr. Roach: I saw your recent article about a 57-year-old woman’s question about herpes, and thought it would be good to reach out to see if you could help me. I am struggling to find good information about my new condition.
A recent partner did not tell me he had HSV-2, and now I have it in my throat. I cannot find what precautions I need to take to, unlike this unscrupulous person, to protect other partners. A nurse practitioner I spoke with suggested it could be passed by saliva, so even kissing and sharing forks, for example, are risky. I’m not saying I don’t believe that, but it is gloomy news that I have been unable to verify. HSV-2 in the throat is apparently pretty unusual, and finding information specific to it is a real challenge. Can you help me, please? Do you have any advice about finding a specialist?
J.A.
Herpes simplex virus 1 normally is passed orally and causes cold sores. HSV-2 is normally passed genitally and causes genital lesions. However, either virus may infect either location, so I have often seen genital HSV-1, but only rarely seen oral HSV-2. It happens more frequently in people with compromised immune systems, but occasionally in people with no medical conditions. Unfortunately, it is possible to transmit oral HSV-2 to a partner through contact with saliva. Although the risk is much greater if you have any symptomatic lesions, it is possible to shed infectious virus even with no symptoms.
I am terribly sorry you became infected. Your partner may have never known they were infected. Many people with genital herpes are unaware they have it, never having had a breakout, or not recognizing a mild breakout for what it was.
Primary care doctors have experience with genital herpes, as do all gynecologists. There are some doctors who make care of people with herpes their focus of practice and research, such as experts in infectious diseases. I recommend consultation with an expert to discuss all your concerns.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
