National medical researchers and policymakers OK’d a new shingles vaccine last fall, promising remarkable protection rates in every age group against a menacing virus that most often strikes older adults, causing nerve inflammation, and a debilitating painful rash.
Doctors are urging people over 50 to seek out the vaccination, suggesting that even those who already have been inoculated with a less effective version get vaccinated again.
“It is really a great advance,” says Dr. Joanne Levin, medical director of infection prevention at Cooley Dickinson Hospital in Northampton. She points out the new vaccine, Shingrix, has a 90 to 97 percent effective rate, compared to the older vaccine, Zostavax, that is only half as effective.
The Federal Food and Drug Administration approved Shingrix in October and the Centers for Disease Control and Prevention in Atlanta voted to make it the preferred vaccine, recommending it for everyone over age 50.
Unlike Zostavax, Shingrix is not made from a live virus, so there are fewer side effects and risks to patients, says John Nikitas, a pharmacist at Amherst Pharmacy. It is manufactured from a non-live piece of the virus and a chemical that boosts the immune system making it easier to store and cheaper to make, Nikitas says. Shingrix is administered in two doses, typically over two months, he says. Each dose costs $150 wholesale, but what patients will be charged depends on their insurance coverage, he says. Nikitas had not yet received any requests for it as of late last week. The Zostavax vaccine also costs $300.
While Zostavax has been available to patients on a walk-in basis at many pharmacies, the CDC’s Advisory Committee on Immunization Practices has not yet approved the Shingrix vaccine to be administered by pharmacies. That means a patient must get a prescription for it, pick it up at the pharmacy and have the dose administered at the doctor’s office.
Whether or not it is covered by insurance depends on the plan, says Nikitas, advising people to check their policies.
But whatever the cost, Shingrix promises strong protection against a nasty illness that can linger for weeks. “It seems to not have a significant downside,” Levin says of the new vaccine.
Shingles is caused by the varicella-zoster virus, also known as the chicken pox virus. After an individual has had chicken pox, the virus lies dormant in the nervous system where it can sit quietly for many years. And then, seemingly out of nowhere, it can reactivate and travel back out through the nerve roots to the skin where it emerges as a blistering rash, Levin says.
One out of every three people develops shingles in his or her lifetime.
“No one knows why it reactivates,” she says. “It might be because people’s immune systems are slowly declining with age.” Though it is possible for younger patients to get shingles, as well, it is uncommon. Most of those who get it are over 50.
A shingles episode can last from two to four weeks — sometimes there is a rash but no pain — and the individual might develop a fever, headache and swollen glands, Nikitas says.
In extreme, but rare cases, the virus can attack the eyes, casing blindness. In some instances, in people with compromised immune systems, the virus can cause inflammation in the brain and even death, he says.
“Shingles is pretty painful. … and based on your age, it could be more of a concern.” He says it carries a higher risk for the elderly who would likely be confined to bed with it, which in turn could lead to increased weakness and other related conditions.
Since the new vaccine’ s release, it has been on back order, says pharmacist Marc Nathman, the pharmacy manager at Stop and Shop on King Street in Northampton. He received his first shipment of the vaccine last week.
Other local pharmacies contacted by the Gazette in Hampshire and Franklin counties, including several branches of CVS, Rite Aid and Walgreens, did not have the vaccine in stock. The pharmacist at the CVS inside Target at the Hampshire Mall in Hadley, said that shipments should be arriving there by the end of February.
Nathman says he is finding there is significant public interest in the new vaccine. “We have had a good amount of calls. Every other day we have a patient come up and ask about it.”
Lisa Spear can be reached at Lspear@gazettenet.com.