[2010] Shingles Vaccine

[JudyS]

I had shingles about 3 years ago, and it was a very mild case, just on my shoulder toward my back, and it really didn't spread further. I wasn't at all miserable. I think I am now immuned to it? ...

The medical literature says that people with a normal immune system generally can't get shingles more than once, but I've come across several people online who say they've had it twice or more. Getting shingles multiple times (if your immune system is normal) doesn't seem very common, though.

I don't think you can get immuned to it. I had a very mild case of shingles and my chemo nurses spoted it before it started to spread and I had to stop chemo for few weeks. I was given Valtrex and it cleared up fast. But after my stem cell transplant, I cannot have the vaccination. I have to take Valtrex (now I am on Acyclovir generic) for the rest of my life so that shingles will not appear again.

Unfortunately, people whose immune systems are suppressed (including people on chemo and most people with organ transplants) have greatly increased susceptibility to shingles and other herpes infections. Once you've had a particular herpes infection, that herpes virus remains in your body for the rest of your life, and one needs either a healthy immune system or anti-herpes drugs to make sure the virus doesn't "reactivate" (start replicating again.)

Acyclovir isn't exactly the same drug as Valtrex. (Valtrex is valacyclovir.) There is recent research saying that Valtrex is absorbed better and is more effective than acyclovir, so this is something to discuss with your doctor if the shingles ever comes back (which it hopefully won't!) Valtrex is very expensive for daily use, unfortunately.


A quick question for people whose insurance covered the shingles vaccine -- are you over 60? (A few people mentioned that their insurance only covers shingles vaccine for people over 60, but not everyone mentioned whether this was the case with their insurance or not.)

The reason the vaccine is usually only given to people over 60 is that they are far more likely than other people to get shingles. If you are say, 30, there might be something better for shingles by the time you are 60. (Plus, the immunity might not last 30 years, so the vaccine would just be a waste.)

Shingles, VZV, and chronic fatigue are all topics of great interest to me, so if anyone wants to ask questions, feel free to email me!

 

[geekette]

My son (24 - yep, youngest case of shingles the doctor had ever seen) had it on his face and into his eye. It flared up six months after he had it initially when he was under severe stress.

I didn't know there was such a vaccine, but $200 seems cheap compared to what he went through. I guess it all depends on the odds though.

I also had young-onset, first case at 18! I have scars on my back from it. I'm so sorry about the facial shingles - my best friend would get shingles on her face everywhere. So miserable, I'm sorry! But, yes, I would pay $200 to never have it again. WORTH IT. He will get it again. I get it maybe once a year.

mental note to ask doc for that vaccine. I assume with my history he would give it to me even tho I am way under age for the recommendation.

 

[Icc5]

Get it at Safeway

I got it and my insurance company (Blue Cross/Blue Shield) covered it. I think it's a new benefit for 2010 and only subscribers over a certain age qualify.

I work at Safeway and talk to our main Pharmacist all the time and trust her word and instincts very much. When I asked her about the shot for me (59) she said wait till I am 60 and she will check to see if our policy covers it.
I found out several years ago with my policy to get shots at the Pharmacy when needed. Our plan usually covers the shot but won't cover if you have a Dr. give it. Not sure if this is for everything but I know that is how the flu shot worked. When I had it done at the Dr.'s office our policy covered the flu shot but not the Dr. visit which is funny because usually I don't have to pay for a Dr. visit.
I for one will get the shot at 60. My dad had shingles and really suffered. His entire back was covered and the worst part was along the spine.
Bart

 

[DebBrown]

JudyS, thanks for sharing all your knowledge. I have Meniere's and it is hypothesized that this same nasty virus could be related to these attacks as well. Since I've had a couple minor cases of shingles, I take L-Lysine every day in an attempt to control it.

Deb

 

[Judy]

A quick question for people whose insurance covered the shingles vaccine -- are you over 60?

Yes, I am. I can't find the Blue Cross shingles shot policy, so I don't know whether they would have paid had I been younger.

 

[Art]

Yes, we received the shingles vaccine last year; both Nancy and I are over 60.

For us, our insurance (independent Health) covered it with a $7 co-pay. After a brief false start in which we thought we would have to go to a local clinic to get the short, our doctor's office told us that one Friday a month they arrange for a local pharmacy to provide the vaccine on-site. Other than catching the right Friday, we had no delays in getting the shot.

The biggest issue in the timing of our shots seemed to be that the vaccine comes in a powder which must be kept refrigerated until it is dissolved and made into a solution for injection. Further, that solution must be kept refrigerated, and even then has only a 30 minute shelf life.

JudyS can tell us whether this is true or not. If it is, it would certainly help run up the cost.

Art

 

[dixie]

I am 57 and I went around and around with my insurance company, United Healthcare. They will not cover it until I am 60. I was trying to get the shot, since a friend (over 60) had a bad case of shingles.

 

[Pat H]

I'm 62 and I have to get the shot from my Dr. I didn't ask if there was an age requirement and the rep didn't ask my age. She did have my birth date though.

 

[ricoba]

I had shingles in 4th grade...so if it is stress related, what does that tell you about my childhood!!!

 

[KarenLK]

Art, I too have Independent Health and asked and asked and the Dr, in Buffalo Medical Group, kept saying the vaccine was backordered. One day last year I had a call saying they were running a clinic. I did not have to pay even a co-pay.

 

[Art]

Art, I too have Independent Health and asked and asked and the Dr, in Buffalo Medical Group, kept saying the vaccine was backordered. One day last year I had a call saying they were running a clinic. I did not have to pay even a co-pay.

Co-pays are a function of the specific contract. I happen to be on one based on my pre-retirement employment.

Art

 

[Hophop4]

Acyclovir isn't exactly the same drug as Valtrex. (Valtrex is valacyclovir.) There is recent research saying that Valtrex is absorbed better and is more effective than acyclovir, so this is something to discuss with your doctor if the shingles ever comes back (which it hopefully won't!) Valtrex is very expensive for daily use, unfortunately.

I am taking the Acyclovir twice a day where the valtrex was just once a day, I guess it is not as strong as the Valtrex. Last year the Valtrex was covered by my drug plan and I only paid my co-pay for it but the total cost of the drug was being added to my medicare drug plan and was going to put me in that donut gap so that is why I switched to Acyclovir. Now this year I found out that the drug plan will not cover Valtrex any more. I am sure my doctor would not have prescribed it if he thought it would not do the job because at the time the Valtrex was covered. So I did have a choice. But now it looks like the insurance company is dictating our medical needs again.

 

[bobby]

Yes, get it. I got mine about 4 years ago and BC/BS Massachusetts paid for it. After two friends had serious cases, I decided I did not need shingles. Plus, if you develop some immune related disease later, you might not be eligible to get it anymore, like my husband.

 

[pgnewarkboy]

My son got chickepox as an adult from someone he worked with that had shingles. Both my wife and I got the injection and our insurance covered it. My understanding is that it is not 100 percent effective as protection against shingles but in case you still get it , it will lessen the severity. Shingles in some cases is extremely painful. Getting the injection was a no brainer.

 

[swift]

I am going to have to ask my doctor about this because Shingles is something I am worried about for myself. I had the Chicken Pox as a teen and then had Bells Palsy about 6 years ago. My understanding is that the Chicken Pox, Bells Palsy and Shingles are all part of the Herpes Virus. So does having had Chicken Pox and Bells Palsy mean that I have an increased chance of having Shingles?

Now, as far as the chicken pox vaccine goes. My two older children had chicken pox when they were toddlers. My youngest son, now 12, has not had them yet. When he was born the shot just came out and my pediatrician at that time suggested that I wait to give him the shot because in his opinion they required boster shots about 20 years later and he did not feel that many 20 year olds would follow through with the boosters when as a young man they needed it most. Now that my son is 12 I am thinking it is time for him to get the vaccine.

 

[Tacoma]

I had shingles about 2 weeks ago. It was almost the end of the school year and I had three classes of HS English to finish marking plus all of their final essays before going to Edmonton to mark for 7 days. It was my first time and I am early 50's. My doctor said I could go to mark so up I went but they sent me home since I did not keep it a secret and people were worrried. My daughter had shingles three times before she was ten. She hasn't had it for about 6 years now. When I hit 60 I will seriously consider getting the vaccine.

Joan

 

[beejaybee]

$65

I received a prescription for Zostavax from my doctor and $65 was my out-of-pocket cost.

It is a very expensive shot but worth it to avoid the pain of shingles.

Judy, thanks for your medical insights into this disease.

 

[stuvan]

The biggest issue in the timing of our shots seemed to be that the vaccine comes in a powder which must be kept refrigerated until it is dissolved and made into a solution for injection. Further, that solution must be kept refrigerated, and even then has only a 30 minute shelf life.

Art

From Merck's website:

ZOSTAVAX SHOULD BE STORED FROZEN at an average temperature of –15°C (+5°F) or colder until it is reconstituted for injection. Any freezer, including frost-free, that has a separate sealed freezer door and reliably maintains an average temperature of –15°C or colder is acceptable for storing ZOSTAVAX.

The diluent should be stored separately at room temperature (20° to 25°C, 68° to 77°F), or in the refrigerator (2° to 8°C, 36° to 46°F).

THE VACCINE SHOULD BE ADMINISTERED IMMEDIATELY AFTER RECONSTITUTION, TO MINIMIZE LOSS OF POTENCY.

DISCARD RECONSTITUTED VACCINE IF IT IS NOT USED WITHIN 30 MINUTES.

DO NOT FREEZE RECONSTITUTED VACCINE.


This can be a problem for some places that administer vaccines, such as pharmacies, since many do NOT have freezers capable of maintaining +5 F or colder in the pharmacy area.

My wife and I are both over 60 and we have each had the vaccine; my wife got hers at a pharmacy, mine was administered at my clinic. My insurance covered the vaccine as a drug (she did have a prescription from her physician) when administered at the pharmacy with the usual medication co-pay, but did not cover the administration by the pharmacist. At the clinic both vaccine and administration were covered with no co-pay.

I agree, shingles can be devastating and it can cause postherpetic neuralgia pain which can persist for years. Not fun stuff.

Stu

 

[cornwall]

Shingle Shots

Has anyone gotten the shingles shot? If so, did your insurance cover the cost? I've been thinking about getting the vaccine for awhile and my Dr. did recommend it. My 88 yr old mom just got shingles and she is miserable. I plan on making an appointment as soon as I get home next week to get the shot. Any pros/cons?

Both my husband and I got shingles shots about a year ago but neither Medicare or our supplementary insurance paid for them. Even so it is wise to get them especially if you have had chickenpox as a child. No ill effects from the shot.

 

[cornwall]

Shingle Shots

Has anyone gotten the shingles shot? If so, did your insurance cover the cost? I've been thinking about getting the vaccine for awhile and my Dr. did recommend it. My 88 yr old mom just got shingles and she is miserable. I plan on making an appointment as soon as I get home next week to get the shot. Any pros/cons?

Both my husband and I got shingles shots about a year ago but neither Medicare or our supplementary insurance paid for them. Even so it is wise to get them especially if you have had chickenpox as a child. No ill effects from the shot.

 

[Passepartout]

THE VACCINE SHOULD BE ADMINISTERED IMMEDIATELY AFTER RECONSTITUTION, TO MINIMIZE LOSS OF POTENCY.

DISCARD RECONSTITUTED VACCINE IF IT IS NOT USED WITHIN 30 MINUTES.
Stu

WOW! My pharmacist told me a few days ago that he's currently undergoing training to administer shingles vaccine and that they have to buy 10 doses at a time. In other words 10/60+ year-old codger and codgerettes need to be standing by with their naked arm (or whatever) out before they can start mixing the goo. No wonder it's so expensive!

Jim Ricks

 

[stuvan]

WOW! My pharmacist told me a few days ago that he's currently undergoing training to administer shingles vaccine and that they have to buy 10 doses at a time. In other words 10/60+ year-old codger and codgerettes need to be standing by with their naked arm (or whatever) out before they can start mixing the goo. No wonder it's so expensive!

Jim Ricks

They are single doses, but they do come in a 10 pack and a single pack (with 10 diluents!). So no, all 10 of us old folks do not need to form a line for immediate injection. My guess is most immunizers will order the 10 +10 pack. I believe it has been in short supply since May.

No. 4963-00 ZOSTAVAX is supplied as follows: (1) a package of 1 single-dose vial of lyophilized vaccine, NDC 0006-4963-00 (package A); and (2) a separate package of 10 vials of diluent (package B).

No. 4963-41 ZOSTAVAX is supplied as follows: (1) a package of 10 single-dose vials of lyophilized vaccine, NDC 0006-4963-41 (package A); and (2) a separate package of 10 vials of diluent (package B).

Stu

 

[stuvan]

Both my husband and I got shingles shots about a year ago but neither Medicare or our supplementary insurance paid for them. Even so it is wise to get them especially if you have had chickenpox as a child. No ill effects from the shot.

I agree, very wise to have the vaccine. Most Medicare Part D (Rx drug) plans should cover the vaccine as a prescription drug at your pharmacy with the usual co-pays, doughnut hole, deductibles, but you will need a prescription from your doctor. The administration of the vaccine by a pharmacist may not be covered.

When this vaccine was first available, the reimbursement was a mess, since it was classified as a prescription drug (think Lipitor, Prevacid, Plavix or, dare I say it, Viagra) and not a vaccine, which would normally be administered at a clinic. I thought Medicare had rectified this, but perhaps not.

But even if it were not covered, I would have just paid for it. (Think Insurance) Vaccines are expensive, we are just all accustomed to seasonal influenza at the local pharmacy or grocery store for cheap or H1N1 for free. (Think government)

Stu

 

[sun starved Gayle]

My husband was asked by our HMO to participate in a study on the effectiveness of the shingles vaccine on people under 60. The study has ended and we just got a letter saying he received the vaccine and and not a placebo.

So the wheels are turning slowly for those under 60 for their insurance to cover the vaccine, but it does sound like the change is coming.

Gayle

 

[geekette]

My husband was asked by our HMO to participate in a study on the effectiveness of the shingles vaccine on people under 60. The study has ended and we just got a letter saying he received the vaccine and and not a placebo.

So the wheels are turning slowly for those under 60 for their insurance to cover the vaccine, but it does sound like the change is coming.

Gayle

Can I ask how old your husband is? Please start a new thread if ever your husband gets shingles. I hope no side effects.

Thank him for me for participating. I would volunteer for that.