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Experts: Price may block singles vaccine
By LAURAN NEERGAARD, AP Medical Writer 44 minutes ago
WASHINGTON - Cornelia Jefferson vividly recalls the excruciating pain that shingles caused her mother and brother. So when her doctor got a supply of the new shingles vaccine, the retiree jumped at the chance — without knowing if her insurance would pay or she would be stuck with a bill for more than $150.
"We have built a Jaguar, and we‘re going to leave it in the garage," laments Dr. William Schaffner, a vaccine expert at Vanderbilt University who advises the government on immunization issues.
To the dismay of doctors, that also means Medicare won‘t reimburse them for actually administering Zostavax, an extra $15 or so they‘ll have to pass up or charge directly to patients.
But the shingles vaccine isn‘t just for those old enough for Medicare. It was approved for sale to people 60 and over. Next month, when the government‘s vaccine advisers issue the first official guidelines on Zostavax‘s use, doctors will debate whether those even younger also should be immunized if they‘re at high risk of shingles.
More than ever before, vaccines aren‘t just for kids. In addition to Zostavax, whooping cough booster shots were recently recommended for adults up to age 64, and a cervical cancer vaccine hit the market aimed at adolescents and those in their 20s.
The cervical cancer vaccine is the priciest, at more than $300 for a three-shot series, but only a small number of adults qualify for it. Millions are candidates for Zostavax — making the one-dose shingles shot, priced around $150, the big test case to see if doctors can get more adults interested in immunizations.
"She couldn‘t stand for clothes to even touch her," recalls Jefferson, of Franklin, Tenn. Her brother had a tooth pulled before discovering his yearlong pain was actually shingles penetrating nerves in his head. "If this vaccine will prevent that, it‘ll be great."
Zostavax doesn‘t treat active shingles, but boosts a patient‘s immunity to prevent the chickenpox virus from re-emerging. Studies by manufacturer Merck & Co. Inc. found the shot cut cases of shingles in half, and that shingles cases that still occurred were far less painful. But the vaccine is made with a live virus, so it‘s not for people with HIV or other conditions that weaken the immune system.
It‘s the law, responds Kelman: Congress set up a provision that allows Medicare recipients free vaccination against flu, pneumonia and in some cases hepatitis, with their doctors paid $15 for each jab to cover time and expenses. But the law makes clear that other vaccines used to prevent disease must be treated as prescription drugs, with no doctor fee, he says.
EDITOR‘S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
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