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Shingles vaccine effective, but underused

Consumer Reports News: January 13, 2011 12:21 PM

Two new studies out this week have good and bad news on the shingles vaccine. One, in the Journal of the American Medical Association, found that it cut the risk of the painful condition (caused by a recurrence of the virus that causes chickenpox) by 55 percent. But the other, in American Journal of Preventive Medicine, found that less than 7 percent of adults 60 or older got the vaccine in 2008, despite clear recommendations.

The JAMA study, which looked at the records of 75,761 vaccinated and 227,283 unvaccinated members of Kaiser Permanente in Southern California, found that the vaccine was effective in all age groups, including the very old, and those with diabetes, heart, kidney, liver, lung, or other chronic diseases. That’s good news, since some chronic conditions can increase the risk of developing the disease, and of having serious complications from it, including a hard-to-treat complication called postherpetic neuralgia, which can cause debilitating pain that can last months, even years.

In the second study, researchers at the Centers for Disease Control and Prevention looked at a national survey conducted in 2008, two years after the vaccine was approved. It found that only 6.7 percent of adults 60 and older had received it. Blacks and Hispanics were least likely to be immunized. If all eligible people received the vaccine, it could prevent a quarter of a million cases of shingles a year, the researchers wrote.

Part of the low vaccination rate may stem from the high cost of storing and handling the vaccine. And supply shortages may have limited interest from doctors and led the manufacturers to promote it less forcefully. But perhaps the biggest obstacle is that Medicare has made getting the shot cumbersome, by treating it as a prescription drug rather than a medical service. As a result, people 65 and older often have to get their doctor to write a prescription for the vaccine and then find a pharmacist who is certified to give the shot. Or they have to bring the vaccine back to their doctor.

If you have private insurance that covers the vaccine, you can bypass the Medicare issue by getting the shot before you turn 65. Recently passed health-care reform legislation may eventually provide some help, since it includes asking the agency to reconsider its policy of treating the shingles vaccine as a drug.  Meanwhile, our consultants say that the benefits of the vaccine still make the hassle of getting it worthwhile, even for people on Medicare.

—Kevin McCarthy, associate editor

See our recommendations on adults vaccines.

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