"The groundwork of all happiness is health." - Leigh Hunt

Pandemic and value constraints on shingles vaccine use

March 20, 2024 – Since its introduction, the Shingrix vaccine has been hailed as a breakthrough in shingles prevention.

But the trail to widespread adoption has been plagued by obstacles, from pandemic-related disruptions to insurance complexities. The consequences will be seen within the vaccination numbers: in response to a study, only about 30% of adults eligible for Shingrix received it Government Accountability Office 2022 Report.

Health experts advocate its use and emphasize its unparalleled effectiveness in protecting against the painful disease.

“Shingles is one of the most common infectious causes of disability worldwide, and we now have a vaccine that shows immediate and strong efficacy against it,” he said Kenneth Koncilja, MD, a specialist on the Cleveland Clinic Center for Geriatric Medicine. “But since publication there has been a very blurred situation for a number of reasons, which complicates matters.”

Shingrix, a two-dose shingles vaccine approved by the FDA in 2017, was touted as a rather more effective alternative to its predecessor, Zostavax.

The CDC It is estimated that about one in three people within the United States develop shingles. Of these, around 10 to 18% suffer from nerve pain or postherpetic neuralgia (PHN) – a burning pain within the nerves and skin – This can take years after the rash has cleared up. Other possible complications include serious eye, heart and neurological problems and even death.

It can also result in a virtually 30% increased risk of cardiovascular events reminiscent of heart attack or stroke, in response to a study published within the journal Journal of the American Heart Association.

While Zostavax reduced the danger of shingles by 51%, Shingrix's effectiveness increased to 97% in people ages 50 to 69 and 91% in those over 70. It can be about 90% effective in stopping postherpetic neuralgia across all age groups, in comparison with 67% in people ages 50 to 69Comp.

However, in 2017, the concept of a second dose of vaccine was daunting for a lot of, compounded by the out-of-pocket costs.

“This was long before COVID-19, and many people at that point didn't even know what the term 'booster' meant,” Koncilia said.

A major obstacle was high prices. Many Medicare Part D prescription drug plans required a copayment for the shingles vaccine. According to a 2019 Report to Congress from the Medicare Payment Advisory Commission, the vaccineThe required two doses could cost greater than $400 if a Medicare beneficiary didn't meet their deductible.

That modified in 2023, when Congress Cost sharing for vaccines has been abolished endorsed by the CDC Advisory Committee on Adult Immunization Practices. This policy applies no matter whether individuals have Part D drug coverage or a Medicare Advantage plan, including the shingles vaccine.

“The cost was high and there was a Deficiency earlysaid Tina Ardon, MD, a family physician at the Mayo Clinic in Jacksonville, FL. “Some people could only get one shot.”

Concerns about possible unwanted side effects served as an extra deterrent. According to the CDC, the vaccine may cause patients to experience arm pain, redness and swelling on the injection site, fatigue, muscle pain, headache, chills, fever, stomach pain or nausea. These unwanted side effects may last 2 to three days.

The COVID pandemic added one other layer of complexity, driving vaccine hesitancy and driving down vaccination rates. For adults with business coverage Claims about vaccine administration They were reportedly 15% lower in December 2020 than in December 2019 and 62% lower in April 2021 than in April 2019.

“Does the vaccine work? Yes, it works incredibly well,” said Dr. Timothy Brewer. Professor of Medicine within the Division of Infectious Diseases on the David Geffen School of Medicine at UCLA. “It's really great to have a vaccine for this population that works so well. I hope acceptance improves.”