Should you get the new shingles vaccine?

This week, I’ve given two senior ladies their second shot of Shingrix®, the “new” shingles vaccine. Next week, I have a 92-year-old man scheduled to get his first one. He has already had shingles and wants to avoid the misery of another episode.
For most seniors, insurance covers at least part of the cost of the newer shingles vaccine, Shingrix®. One lady paid only $36 for each dose of the Shingrix® vaccine, and insurance covers the entire cost for both injections for my other two patients. 
This wasn’t the case with Zostavax®, the previous shingles vaccine. While most available vaccines are at least 90% effective in most people, Zostavax® was only about 50% effective in preventing shingles in older adults. Most insurance companies refused to cover it. If you wanted Zostavax®, it cost about $240 for the one injection. 
What causes shingles? 
Shingles is caused by the same virus that causes chickenpox, called herpes zoster. Shingles is not really a “new” infection. Instead, it’s a reactivation of the herpes zoster virus. After you’ve recovered from having chickenpox, the herpes zoster virus isn’t completely killed off. Instead, it sticks around, held in a suspended state inside your nerve cells by your immune system. If your immune system weakens, it may become unable to prevent the virus from multiplying again inside your nerve cells. This creates a different type of infection: itchy blisters on your skin accompanied by burning, tingling, and pain. 
What is post-herpetic neuralgia? 
Shingles happens when the chickenpox virus invades your nerves, causing burning, tingling, and often excruciating nerve pain, called “neuralgia.” After recovering, some people will experience periodic “flares” of shingles from time to time. The painful tingling and burning from these episodes can last for months, even years. Unfortunately, most of our pain medicines do not relieve neuralgia very well, making post-herpetic neuralgia a painful and lingering reminder of a shingles infection. 
Why does this newer vaccine, Shingrix®, work better?
A compound called an adjuvant has been added to Shingrix® to help the vaccine boost your immunity to the herpes zoster virus. Adjuvants work to increase a vaccine’s effectiveness by triggering a more robust reaction to it than your body otherwise would have, which boosts your immunity to it. The better your immune system responds to the vaccine, the better protection you get from both shingles and its unfortunate result, post-herpetic neuralgia. 
Who should get this new shingles vaccine?
Anyone 60 years old and older should consider getting the new shingles vaccine. That’s because older adults are much more likely to have a severe shingles infection or painful complications like post-herpetic neuralgia. 
What’s different about this new shingles vaccine?
The new vaccine, Shingrix®, is over 95% effective in preventing shingles when compared to Zostavax®, which is only about 50% effective. Instead of only one shot, Shingrix® is a course of two injections spaced 2 to 6 months apart. Each contains an adjuvant, which is a compound added to boost your immune response to the vaccine.
Where can I get the Shingrix® vaccine?
Your local pharmacy is your best bet. Shingrix® is billed through private insurance or through Medicare supplemental insurance under Part D, which covers medications. Most pharmacies have Shingrix® available and have staff that can administer the vaccine to you as well.
How much does Shingrix® cost?
That depends on your insurance. Without insurance coverage, expect to pay just over $300 for the entire series of two injections. 
Here are 5 Things To Know About Shingrix® Vaccine:
1. It’s more effective than Zostavax®. 
Shingrix® is over 95% effective in preventing shingles. The older vaccine, Zostavax®, was only about 50% effective for the prevention of shingles. 
2. You will need 2 shots.
For best protection against shingles, you’ll need 2 shots of Shingrix® spaced 2 to 6 months apart. Don’t forget to schedule your second vaccination.
3. If you have already have had shingles, Shingrix® can help.
Shingrix® helps reduce or prevent painful episodes of post-herpetic neuralgia, whether or not you have already had shingles.
4. It doesn’t matter if you have already had Zostavax®.
You can get vaccinated with Shingrix® even if you already have received Zostavax®.
5. It’s less expensive.
Even though they wouldn’t pay for the older vaccine Zostavax®, insurance companies are much more willing to pay for Shingrix®. For example, two of my patients this week have their insurance covering the entire cost. My other patient is only paying $72 for the complete series of two shots.
 
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website TheMedicationInsider.com for daily tips on how to take your medicine safely. 2020 Louise Achey
 

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