Anyone who s had chicken pox (varicella zoster, a member of the herpes family of viruses) has a one-in-three chance of developing shingles many years later, and the risk only increases with age. Yet although the FDA approved a vaccine (Zostavax) for the virus in 2006 and, this March, approved its use for those age 50 and over, very few at-risk adults have been vaccinated. Adults over 60 are most vulnerable to shingles, but in 2009, only 10 percent of this population was vaccinated.
Shingles typically causes an itchy or burning pustular rash on the arm, leg, or chest only on one side that lasts for about a week, but it can result in lasting scarring and pigment changes. It also infrequently involves the eye, which can permanently impair vision. Not only does the risk of shingles increase with age, complications do too, such that older patients are more likely to experience postherpetic neuralgia, nerve pain that can last for months. The vaccine reduces but does not eliminate the risk of the outbreak and, even more so, the risk of postherpetic neuralgia.
So why aren t more adults getting inoculated? The vaccine, it turns out, is not so easy to come by. Its manufacturer, Merck, has been unable to produce quantities sufficient to meet even modest demand. These shortages have forestalled marketing campaigns as well as public health initiatives to build greater awareness of the need for the vaccine. Furthermore, while most insurers will cover shingles vaccination for adults age 60 and over, the CDC has yet to recommend the vaccine for those in their 50 s; thus people in that age group must typically shoulder the $160-plus price tag themselves.
Meanwhile, Merck is spending $1 billion to increase production and has built a new manufacturing plant, although it won t be fully operational until 2013. ACSH's Dr. Gilbert Ross is hopeful that these efforts will at last increase the availability of the needed vaccine; shingles complications, and the lasting damage they can cause, are serious and, he stresses, can be largely avoided.
