Dear Dr. Roach: I am a 79-year-old woman who received the original Zostavax vaccine around 2010. Then, when the newer, improved Shingrix vaccine became available, I was given the two-shot series in 2019. Feeling quite confident that I was well-protected, I was shocked when I was diagnosed with a very painful case of shingles in September 2021, followed by post-herpetic neuralgia hat lasted for six months. I have heard shingles can recur, sometimes more than once. My question is, should I get Zostavax again in the hope that it will maybe protect me this time around? — B.K.

Answer: You did everything right to prevent shingles but still got the infection and its complication, which doesn’t seem fair. Fortunately, this is a rare situation. Recurrent shingles happens more commonly in people with immune deficiency, women and older adults. Anyone at risk for HIV should consider getting an HIV test if they get shingles or recurrent shingles.

The live Zostavax vaccine is no longer available in the United States, even though it is available in many other countries. There are no strong data in getting another dose (or more) of the Shingrix vaccine in your situation, but you could discuss it with your doctor. Another option is having a supply of antiviral medicine such as valacyclovir (Valtrex) available to use if another recurrence happens.

Dear Dr. Roach: I am 82 and take gabapentin for arthritis, but my niece takes it for anxiety. What is gabapentin all about? — J.M.

Answer: Gabapentin was originally approved as a drug to control epilepsy, but it soon became clear that it was useful for chronic pain, especially the kind that comes from damaged nerves. But it can help with other kinds of pain, too. (It is specifically indicated by the Food and Drug Administration for the treatment of pain after shingles.)

It is also used off-label for anxiety and several other conditions, including restless leg syndrome. It takes experience and judgment to know when to use gabapentin as it has the potential for side effects, such as sedation and mood swings.

Email to ToYourGoodHealth@med.cornell.edu.