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Dear Dr. : I recently read that the shingles vaccine is effective for only six years. Is this true? Is there a booster? I have never seen this statement in any other information I have read on the subject.

Answer: The shingles vaccine is a relatively new vaccine, and it is not known with certainty how long its protection will last.

Several studies have suggested that the protection becomes lessened at about eight years after vaccination, but ongoing studies are necessary before deciding whether a booster shot would be recommended. For now, no booster is recommended.

I want to remind people who are taking acyclovir or similar medications (such as Famvir and Valtrex) that, if possible, these should be stopped a day before receiving the shingles vaccine and not restarted for a week afterward, since the medication might interfere with development of protective immunity.

Dear Dr. : For about 30 years, I have heard I should avoid contact with aluminum for sustained good health. Is there science or proven studies of adverse health effects behind these recommendations? Or is avoiding contact with aluminum in deodorant or cookware an incorrect or unsupported assertion that someone once made and that has taken on momentum, periodically resurfacing in articles and in emails?

Answer: I am aware that exposure to some heavy metals is bad for us and must be avoided - for example, lead from paint chips could be eaten by children or pets, or lead dust when sanding can be inhaled.

What about aluminum?

Answer: Aluminum is a light metal, not heavy, and it rarely builds up to toxic levels in the body. In the vast majority of cases where it does, it is in people with abnormal kidney function.

This is because aluminum is poorly absorbed, and when it is, the body has an effective way of getting rid of aluminum - through the kidneys, where 95% of aluminum is excreted. Even in the case of injected aluminum, such as in some vaccines, the amounts are minute and the body is able to rapidly excrete it, provided a person’s kidney function is adequate.

In the case of people on hemodialysis, aluminum from diet, medication, and in dialysis fluid can build up in bones. Once this is recognized (usually via a blood test showing high levels of aluminum, before and after a chelating agent), aluminum can be removed through chelation therapy.

True aluminum overload occurs almost exclusively in dialysis patients and is increasingly uncommon due to better purification of dialysis fluid. There is no need to avoid aluminum pans or foil, as these do not raise blood aluminum levels. They don’t give off aluminum to food readily nor are any particles well-absorbed.

As far as deodorant use, the preponderance of current evidence states that there is not a risk of breast cancer from aluminum-containing antiperspirants. For people who want to be as cautious as possible, there are aluminum-free antiperspirants, such as Tom’s products.

Dr. Jennifer Franchuck is a primary care physician at Camarena Health in Oakhurst. Health-related questions can be sent to her at: AsktheDoc@camarenahealth.org.

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