New shingles vaccine 97% effective for middle-aged

Shingles is a painful rash that is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you have had chickenpox, the virus lies inactive in the nerve tissues near your spinal cord and brain. Shingles is the result of reactivation of the virus. For most patients, an episode of shingles is self-limited.

Susan Locke

According to the CDC, the infection strikes about 1 million people in the U.S. each year, and nearly one in three adults will experience an incidence of shingles in his lifetime. About 2 percent of patients over 60 can go on to develop post-herpetic neuralgia, which is defined as pain which persists beyond four months after the initial onset of the rash.

Now the preferred vaccine…

A new shingles vaccine Shingrix is now recommended as the preferred vaccine over Zostavax for the prevention of herpes zoster and post-herpetic neuralgia. The CDC recommends two doses of Shingrix (separated by 2-6 months) for adults over the age of 50.

The vaccine should be given:

• Whether or not you have had a previous shingles outbreak
• Whether or not you have had a prior dose of Zostavax
• To patients with chronic medical conditions

It can be used in patients who are taking low-dose immunosuppressive medication, have recently recovered from an immunocompromising illness, and in patients who may become immunocompromised. It should not be given during an acute episode of herpes zoster or within two months of receiving Zostavax.

Even if you do not recall ever having chicken pox, 99 percent of adults age 50 and older have been exposed to the varicella zoster virus and persons born after 1980 are considered immune to varicella.

…because it works so well

• In adults 50-69, Shingrix was 91 percent effective in preventing post-herpetic neuralgia. Over the age of 70, 89 percent effective.
• In adults 50-69, Shingrix was 91 percent effective in preventing post-herpetic neuralgia. Over the age of 70, 89 percent effective.

Side effects of the vaccine are mild. Most patients get a sore arm and some get redness or swelling at the injection site. Occasionally people feel tired, have muscle aches, shivering, fever, stomach pain, or nausea. Symptoms may last 2-3 days. Severe allergic reaction is very rare.

Modest cost, readily available

The total cost of the vaccine is $200-300. No prescription is needed. It is recommended that you check with your insurance or Medicare plan regarding reimbursements.

Medicare Part D covers the vaccine, although there may be some cost to you depending on your plan. Since this is a pharmacy benefit, most plans require that you get vaccinated at the pharmacy, not at your doctor’s office. Medicare Part B does not cover this vaccine.

Contact your insurer to find out if this vaccine is covered under “prescription” or “medical”:

• Prescription coverage requires you to get the vaccine at your local pharmacy.
• Medical coverage means that you can get your prescription at your doctor’s office.