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"Seniors helping Seniors meet the challenges in retirement"


Doctors recommend shingle vaccine for seniors



By Mary Jimenez

The shingles vaccine has been out since 2006, and so far it's been well-accepted by seniors.

"If you're old enough, it's the best strategy to prevent the illness," said Dr. Robert Penn, chief of infectious disease in the department of medicine at LSU Health Sciences Center.

The shingle vaccine, Zostavax, is manufactured by Merck and was approved by the Food and Drug Administration in May 2006. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted to recommend it in October 2006 for people age 60 and older.

According to Merck, 1 million doses of the vaccine have been sold.


Shingles is a painful skin rash, often with blisters that lasts from two to four weeks. For about one in five people, severe pain post-herpetic neuralgia can continue even after the rash clears up.

At least 1 million people a year in the United States get shingles, according to the Centers for Disease Control and Prevention.

"Shingles is most common in people older than 55, but the older you are the higher at risk you are for it," Penn said. "It's also common in immune suppressed systems."

Zostavax is a single-dose "live" vaccine, meaning it still contains tiny amounts of the live cells of the virus.

But getting shingles from the shot has not been a risk, said Penn.

"The most common side effects we've seen have been mild discomfort at the site where the shot was given," he said.

The shot is not, however, recommended for immunocompromised individuals like those who are HIV positive or taking chemotherapy.

Executive director at the Caddo Council on Aging believes many seniors still don't know it's available or that it's covered by the Medicare Part D drug plan and many private insurances.

"The (Medicare) Part D co-pays are a little different for each plan," said Mike Patton, a pharmacist at Kroger's Mansfield branch, and one location which is offering the vaccine. "And if they are using Part D then we can use (Medicare) Part B to pay for the administration cost."

If your Part D plan does not cover the vaccine, you can ask for an "exception," suggests one Medicare help columnist for seniors "Ask Marci," with SeniorJournal.com. Your doctor will have to write a letter stating the vaccine is medically necessary.

For others age 60 to 64, the cost is fairly expense, $209.30 at Kroger Pharmacies, but Patton says many private insurances also cover the vaccine.

"They may have to pay for the vaccine themselves but most private insurances are paying the reimbursement," Patton said. "I'd recommend calling your insurance company and asking first."

Seniors should ask their doctors if they are good candidates for the vaccine and where to get it.

Taking the vaccine at an age younger than 60 would be a personal decision about how to spend your health dollars, Penn said.

"Many healthy people will never have an episode of shingles," Penn said.

Few doctor's offices will have the vaccine onsite because of its requirements for storage.

"The vaccine is live and requires a subzero freezer to store and it has to be reconstituted before it's given," said Dr. Robert Savory of Family Medicine and Geriatrics in Shreveport, who recommends the vaccine to his geriatric patients. "Your doctor will likely write a prescription and then you can take it to a pharmacy that is providing the vaccine."

The vaccine is good news for baby boomers, many of whom have had the chickenpox, a prerequisite in getting shingles, which is caused by the same virus, varicella zoster.

What happens is after you recover from chickenpox, the virus does not leave your body, but continues to live in some nerve cells. When it's activated, it produces shingles, according to the CDC.

"We don't know exactly what triggers an outbreak but one of the most important factors seems to be something that reduces the body's immune control over the virus like another illness or medications," Penn said. "Depending on which nerve its settled is where you have the outbreak."

Usually people only have one episode of shingles, said Penn, but a few people will get it again and in a minority it can be very serious and debilitating.


"The chances of it being serious go up the older you are when you get it," he said.

Studies on the vaccine show it reduces the risk of getting shingles by 50 percent and it reduces the risk of getting a more serious case by two-thirds.

"For those reasons we think the vaccine is useful," Penn said.

Since 1995 children have been given the chickenpox vaccine, which is different then the shingles vaccine, but researchers still believe this will reduce the number of shingle cases as younger generations get older.

"The information we do have so far looks like it will reduce the risk (in these individuals)," Penn said.


Republished by SeniorArk with permission of the author

* Images added by SeniorArk


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