Shingrix is the new and highly effective vaccine against shingles (herpes zoster) infection that we have written about several times before. You want to get it if you are 50 or over, regardless of whether you have had Zostavax, the prior vaccine that we gave to many of you, or have had shingles infection in the past. Essentially everyone over age 50 has experienced a chicken pox infection and therefore harbors that virus, which results in shingles infections when it breaks out of its dormancy.
Side Effects to Consider
The vaccine requires two shots, separated by 2 to 6 months. The CDC (Centers for Disease Control and Prevention) reminds us that side effects are common. Sore arm and local reactions requiring ice and analgesics are frequent. And about 1 person in 6 (by latest count) develops systemic symptoms, including moderate fever (101F), muscle aches and pains, and feeling out of sorts, bad enough to result in missed work for 2 days and occasionally 3. But no one dies and the benefit is great (well over 90% effectiveness). Also, while the flu vaccine can be administered at the same time as Shingrix, we may want to avoid that so as not to confuse the issue of adverse reactions.
So we suggest to everyone that you think about your schedule for the days following your appointment with us before taking the shot. We will be happy to schedule an appropriate visit time for you just for the shot, after we are assured of adequate supplies.
Shingrix has been in short supply. We have tried to have enough for anyone who wanted at any time, but the back order is from one month to several months and orders are not fully filled. Pharmacies are having comparable availability problems. We had hoped to be adequately stocked for routine administration by early October, but that is not going to happen. And we cannot now be positive when we will. Glaxo-Smith-Kline (GSK), the manufacturer, should be ashamed of itself for this incompetent rollout of Shingrix. They continue to advertise, but can’t produce the product.
Nevertheless, please remember that shingles is not an imminent danger like a flu epidemic. And many of you have had Zostavax, the original shingles vaccine, and so have some and perhaps excellent immunity. So long as we get to everyone in an orderly fashion over the next six to nine months, all will end well.
For now we have to concentrate on completing the two-shot series within six months for the small number of members to whom we gave the initial shot this spring and summer. As soon as supplies are secure, we will let you know and restart a much more active immunization program.
Billing and Payment Details
Essentially all commercial insurance (Blue Cross, Harvard Pilgrim, Tufts, United, etc.) cover Shingrix, most without a copay. We bill the insurer. For Medicare, your Part D covers Shingrix, but the exact amount of coverage depends on your plan. And you need to pay Orchard Health Care first for the shot, since we cannot bill Medicare Part D, and then get reimbursed from your Part D plan. Our staff fills out a form for you and submits it to ease your paperwork burden. The front-end cost you pay us is $210 per shot (there are two in the series). You can also get Shingrix at many drugstores, where they just charge you the copay portion since they can then bill your Part D and be paid the majority of the cost. The end result is the same in terms of your net cost, so far as we have been able to find out through extensive investigation. Life should not be this complex.