Shingles Vaccine: Get It, If You Can Get It

In May the U.S. Centers for Disease Control and Prevention made its recommendation official: Americans 60 and older should get the first-ever vaccine to prevent shingles. For now, though, the shots may not be available.

That’s because shipments of the Merck product, first introduced in 2006, are running up to 14 weeks behind schedule. “We are continuing to take orders, and filling them by order date as the product becomes available,” says Merck spokeswoman Deb Wambold. Though the company is working hard to get production up to speed, Wambold says, it’s not clear when that will happen. Company salespeople are continuing to talk to doctors about the shot, called Zostavax, but Merck has suspended print ads promoting it to consumers.

Nearly 1 million Americans receive medical care for shingles or its complications each year, according to the U.S. Agency for Healthcare Research and Quality. The condition is a viral, often blistering, rash that appears on one side of the face or trunk. It can be very painful. The rash usually goes away in a few weeks, but in one in five sufferers the pain persists for months or even years. For all those 60 and older, the Zostavax shot halves the risk of developing shingles; for those only in their 60s, the risk is reduced by 64 percent. And those who do get the rash in spite of vaccination are less likely to experience debilitating long-term pain.

Shingles is caused by the chickenpox virus, Varicella zoster. After a person recovers from chickenpox—and nearly all U.S. adults have had it—the virus remains dormant in the nerve cells, and can reawaken many years later as shingles.

This relationship to the common childhood illness is at the root of Zostavax supply problems. Both the shingles vaccine and the chickenpox vaccine, Varivax, also a Merck product, use weakened Varicella zoster virus. That’s the ingredient in short supply, and Merck is prioritizing the chickenpox vaccine to receive available quantities. Introduced in 1995, the chickenpox shot is required for school entry in many states. Demand for the shot has risen sharply since mid-2006, when the CDC recommended kids get a second dose to offset waning immunity.

CDC epidemiologist Rafael Harpaz, M.D., suggests patients age 60 and up ask their doctors about getting the shingles vaccine, if only to get the ball rolling. “The risk of getting shingles, in the population that we’re talking about, is about 1 percent a year,” Harpaz says. “So a delay of three months means taking a chance of a quarter of a percent that you’ll get this.” Without vaccination, about half of those who reach the age of 85 will have suffered a bout of shingles.

Low supply isn’t the only barrier to getting a shot. At full price, the shingles vaccine costs from $150 to $300. Most but not all private insurers cover it, and enrollees may pay a share of the cost. The Medicare situation is a bit more complicated. Unlike flu and pneumonia vaccines, which are covered with other outpatient services under Part B at no charge, the shingles vaccine is available only through Part D prescription drug plans. Medicare requires all Part D plans to cover the vaccine. But enrollees need to check availability with their plan and also find out which physician or pharmacist they should go to in order to get the shot at the lowest cost.