Frequently Asked Questions About Shingles and the New Shingles Vaccine

Prepared by Vivian J. Woodard M.D.
B.A. Cum Laude in Biochemistry and Molecular Biology from Harvard College Graduate of Harvard Medical Board Certified in Internal Medicine
Emmanuel Christian Health Center Internal Medicine & Adult Vaccines
918 Rolling Acres Rd., Suite 1, Lady Lake, FL Phone: (352) 259-1991

- What is shingles (herpes zoster) and why is it such a big deal?
Shingles is a reactivation of the chickenpox virus (a.k.a. herpes zoster virus) which lies dormant in the nervous system for years after an acute case of chickenpox. It produces a painful blistering rash which can affect any part of the body. Shingles can lead to a disabling chronic pain syndrome known as postherpetic neuralgia. Shingles around the eye can cause blindness or permanent eye damage. According to the Centers for Disease Control (CDC), about 1 out of 3 people will have a case of shingles in their lifetime. Each year about 1 million people get shingles.

- Who gets shingles, and why?
Over 90% of persons age 60 and older have had chickenpox. As we age our immune system weakens, allowing the herpes zoster (chickenpox) virus to reactivate. If you live to age 80, your chances of having had a case of shingles at some point are 50%.

- The older shingles vaccine versus the new one, how do they compare?
An aging immune system is less responsive to traditional vaccines such as live shingles. vaccine. Zostavax released in 2006 contains a weakened live herpes zoster (shingles) virus given as a one-time dose. Shingrix is a 2-dose non-live vaccine released in November 2017. Shingrix uses newer recombinant technology to reproduce an inactive portion of the herpes zoster virus which is combined with an adjuvant (an ingredient added to boost the immune system response).
Overall effectiveness of Zostavax in persons 60 years and older was 51%, with vaccine being less effective as age increased (18% effective for 80 years and older). We also now know that immunity from Zostavax wears off over time, and after about 5 years many people have lost the benefit of the live vaccine.
Shingrix was overall 91.3 % effective in preventing shingles for persons 50 and older, with equal effectiveness regardless of age (91.4% effective in persons over 80). The effectiveness of Shingrix remained at the same level for the 4 years of the study. It is not yet known how long this high level of effectiveness will last. To answer this question, the manufacturer plans to follow the vaccine recipients in their studies for a total of 10 years. More local and bodily side effects are expected from the new vaccine compared to Zostavax. This is probably due to the adjuvant component. Shingrix also requires a 2nd dose given 2 to 6 months after the first dose in order to achieve maximum effectiveness.

- Who should take the new shingles vaccine?
SHINGRIX is a vaccine licensed by the FDA for prevention of herpes zoster (shingles) to be given to any adult aged 50 years and older. The CDC, on the other hand, has not recommended the new shingles vaccine for immunocompromised persons or persons on high-dose immune suppressive therapy. If you have active cancer, an immune system disease, or are on high-dose immunosuppressive therapy, ask your doctor if the new shingles vaccine is advisable for you.

- Should someone who already had Zostavax (Zoster Vaccine Live) take the new shingles vaccine Shingrix? If so, how long after the live vaccine should they wait before taking the new shingles vaccine?
Persons who have previously taken Zoster Vaccine Live (Zostavax) should also have the new Herpes Zoster subunit vaccine (Shingrix). CDC advises that the age of the person and the elapsed time since receipt of Zoster Vaccine Live be considered when deciding the timing for taking the new vaccine. Since the older Zoster Vaccine Live is known to be less effective in adults over 70 years, CDC recommends that persons over 70 who have previously taken Zoster Vaccine Live could be considered for the new shingles vaccine less than 5 years after their dose of Zoster Vaccine Live.

- Is the new shingles vaccine covered by insurance?
Most Medicare D and commercial insurance plans now cover the new shingles vaccine. Some plans require deductibles and co-pays. We have seen a difference in Medicare D co-pays depending on the prescription plan. Medicare D Co-pays as of August 2018 range from $0 to $171 per dose of Shingrix. If you have Medicare D prescription plan or commercial insurance, our billing staff can check your coverage for Shingrix vaccine at no obligation to you. You can also call the customer service number on your Medicare D prescription card. For those with no insurance coverage Emmanuel Christian Health Center offers Shingrix on a self-pay basis.

- Is there a shortage of the new shingles vaccine?
Many private doctors and pharmacies now stock the new shingles vaccine Shingrix. As of late August 2018, demand for Shingrix has exceeded supply, causing rationing and delays in vaccine orders. The manufacturer of Shingrix estimates delays and shortages of the vaccine supply will continue at least through the end of 2018. Some providers may not have the vaccine in stock when you want it, but we currently have it. If you have trouble finding Shingrix (OR any VACCINE) feel free to call our office, Emmanuel Christian Health Center, at (352) 430-0262. We will make sure you get the vaccines you need.

918 Rolling Acres Road, Suite One, Lady Lake, Florida 32159
Phone: 352-259-1991 | Fax: 352-259-5540 | Email

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