Shingles Vaccine (Zostavax) If You Are Younger Than 60: Should You Be Vaccinated?

My older sister contracted a case of shingles several years ago. She was in her mid-fifties, and she had a painful outbreak on her torso with effects that lingered for weeks. Last year my mother, at the age of 85, contracted a nasty case of shingles on her back. Months later, she still complains about occasional pain from her bout with shingles even though the red blisters have long since disappeared.

I'm in my mid-fifties now, and my family medical history convinced me that I have a greater-than-average risk of contracting the disease called herpes zoster, or "shingles." It's a painful skin rash caused by the dormant virus that once gave you chickenpox. Like my sister and mother, I had chickenpox when I was young. After watching the misery these two close relatives went through with shingles, I didn't want to risk a flare-up of the dormant chickenpox virus even though I had read and heard that the shingles vaccine is only recommended for those over 60 and that insurance carriers will not pay for the vaccine if you are younger than 60.

Only one company manufactures shingles vaccine as of 2009, using the trade name "Zostavax." Zostavax was licensed by the U.S. Food and Drug Administration in 2006. Inoculation with this vaccine doesn't guarantee complete immunity from a future outbreak, but it has been found to have a 50 percent level of effectiveness for all those studied over age 60, and a 68 percent level of effectiveness for individuals aged 60- 69. In other words, it was most effective for the youngest group studied.

In my situation, I felt the risk/benefit analysis clearly indicated that the vaccine was worth a try. I obtained a prescription from my personal physician in early 2009, got the shot, and did not experience any side effects whatsoever.

Do you wonder why this vaccine (which has an estimated bulk cost of $150-$155 per dose in addition to the cost of having the injection administered) isn't paid for by insurers for those younger than 60? I did some online research as I debated whether to seek reimbursement from my insurer despite their stated refusal to cover it. I found that the reason insurers don't cover my age group for this vaccine is because the clinical trials necessary for licensing were conducted only on people age 60 or older. Since there have not yet been studies performed on the efficacy of the shingles vaccine on people younger than 60, the vaccine has not been recommended for routine use on people younger than 60.

I decided not to spend the time it would take to formally argue the matter with my insurer, but I have no doubt that getting the vaccine was the best course of action for me. The peace of mind it has provided was worth the out-of pocket expense.

All vaccines carry a risk of side effects in some people that can range from mild to severe; if you have a family history of shingles similar to mine, however, you may decide that you don't want to wait until age 60 to get the shingles shot. Discuss it with your doctor.

UPDATE January, 2011: ABC News reports that the manufacturer of Zostavax has completed additional clinical trials and has asked the FDA to recommend the vaccine for people aged 50 to 59 in addition to those over 60. See Shingles Hard to Bear, Vaccine Hard to Get ; Katie Moisse/ABC News Medical Unit, January 23, 2011.

Sources:

Zostavax (Herpes Zoster Vaccine) Questions and Answers, U.S. Food and Drug Administration.

Prevention of Herpes Zoster: Recommendations of the Advisory Committe on Immunization Practices (ACIP).

Q: Who should receive the shingles vaccine?Aparajita Singh, MD, MPH. Cleveland Clinic Journal of Medicine, January, 2009.

Shingles Disease Questions and Answers (Herpes Zoster); Centers for Disease Control and Prevention, Department of Health and Human Services.

Is it Possible to Give Shingles to Someone Else? Erich Rosenberger, M.D. February 12, 2009.