Shingles

[Golden sunsets]

Well you folks have given me a talking point with my PCP. Thanks.


Sent from my iPhone using Early Retirement Forum

 

[O2Bfree]

My mom got shingles in February 2015 when she was 85. She'd been planning to get the vaccine, but put if off too long. The rash spread from the middle of her back around to under her breast. The attack included flu-like symptoms that left her with a dangerously low sodium level. She ended up in the hospital for a week while the doctor carefully brought the level up again. She's still suffering from nerve pain.

I'm getting the vaccine soon as I hit 60.

 

[Nemo2]

DW called our doctor this morning...they're faxing a prescription for her to the pharmacy....as soon as the pharmacy calls to say it's in she'll pick it up and go to the docs, (no appointment required), to have it administered.

Upon our return from our next trip it'll be 'rinse & repeat' for me.

Thanks everyone for the input.

 

[ivinsfan]

My mom got shingles in February 2015 when she was 85. She'd been planning to get the vaccine, but put if off too long. The rash spread from the middle of her back around to under her breast. The attack included flu-like symptoms that left her with a dangerously low sodium level. She ended up in the hospital for a week while the doctor carefully brought the level up again. She's still suffering from nerve pain.

I'm getting the vaccine soon as I hit 60.

So at 85 even if she got a vaccine at 60 or 65 it would not be as effective, I'm reading that for the vaccines out right now the window of good effectiveness is about 10 years. I'm planning on a booster in my early 70's.

 

[Just_Steve]

When I was 50 my Dr wanted to give me the Shingle vaccine but insurance co said they don't pay for it until 55 so when I turned 55 I got it plus the pneumonia vaccine.

 

[eytonxav]

There is no magic age for shingles. Risk increases with age, but there isn't some sharp knee. Here's some data.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636742/



To break that down, annually -

0.86 for those aged ≤19
4.47 per 1000 person overall
8.46 among adults ≥50 years
10.46 among those aged ≥60 years
12.78 for patients ≥80 years

A link there gives more detail:



So 50's is ~ 2.6x more likely than those under 50.
In your 60's ~ 3.3x ~ 4.1x ( they broke that down into 5 year groups) more likely than those under 50.
In your 70's ~ 4.8x more likely than those under 50.

It certainly increases with age, but it's not like it would be rare for those under 50 to get it compared to someone in their 60's 70's.

-ERD50

My comment was not shingles specific, but more responding to what kcowan was implying that our bodies start to break down with various ailments at 70.

 

[ERD50]

...

I'm getting the vaccine soon as I hit 60.

Why wait? -ERD50

 

[ERD50]

So at 85 even if she got a vaccine at 60 or 65 it would not be as effective, I'm reading that for the vaccines out right now the window of good effectiveness is about 10 years. I'm planning on a booster in my early 70's.

But it has only been FDA approved for 10 years, so that would likely be the earliest she would have got it (I guess unless she was in a study group?).

from wiki:

The zoster vaccine was approved and licensed by the U.S. Food and Drug Administration (FDA) in May 2006.[3][4][5]

Boosters may be required, but it looks like CDC has no specific recommendations right now?

-ERD50

 

[O2Bfree]

Why wait? -ERD50

I don't want to pay for it.

 

[ERD50]

I don't want to pay for it.

I get it. But everyone I know who has had it, would pay multiples of that price to have avoided it, or even just to have had a milder case.

-ERD50

 

[Texas Proud]

My mom got shingles in February 2015 when she was 85. She'd been planning to get the vaccine, but put if off too long. The rash spread from the middle of her back around to under her breast. The attack included flu-like symptoms that left her with a dangerously low sodium level. She ended up in the hospital for a week while the doctor carefully brought the level up again. She's still suffering from nerve pain.

I'm getting the vaccine soon as I hit 60.

Why wait... I got mine when I was 55.... maybe a year or so sooner, cannot remember exact year...

 

[Texas Proud]

Why wait? -ERD50

Man... I need to read the responses before I post...


But... I will not!!


Oh.... and I did pay for it out of pocket... one of my sisters had it and said she would have paid thousands not to have had it...

 

[audreyh1]

I don't want to pay for it.

I didn't pay for it at 55. I expected to, but Costco called my insurance company and they covered it.

 

[Teacher Terry]

Very painful and leaves scars. If it would have been worse in husband's eye he could have lost his vision so I think it is worth paying for.

 

[Meadbh]

The probability of getting shingles if you don't get the vaccine is not 100%, and the probability of not getting shingles if you do get the vaccine is not zero. This is decision making under uncertainty. I actually took a course on this while doing my MBA. It depends on how you assign weight to the outcomes.

I asked my doctor for the shingles vaccine, and he said it was recommended for people 60 and over where I live. So I will wait till then. I have definitely had chickenpox. I had it at age 22, while in medical school, and my Mom was the one who made the diagnosis. Dr. Mom!

Shingles | Immunize BC

 

[Nemo2]

I get it. But everyone I know who has had it, would pay multiples of that price to have avoided it, or even just to have had a milder case.

-ERD50

+1

 

[LauAnn]

Just last month our county health department ran a 2-day event and administered the vaccine free of charge. I'm 58 and took advantage of the event.

 

[Texas Proud]

The probability of getting shingles if you don't get the vaccine is not 100%, and the probability of not getting shingles if you do get the vaccine is not zero. This is decision making under uncertainty. I actually took a course on this while doing my MBA. It depends on how you assign weight to the outcomes.

I asked my doctor for the shingles vaccine, and he said it was recommended for people 60 and over where I live. So I will wait till then. I have definitely had chickenpox. I had it at age 22, while in medical school, and my Mom was the one who made the diagnosis. Dr. Mom!

Shingles | Immunize BC

I have only known 2 people that got shingles (assume others have gotten it but did not know).... the first was a guy in his 20s and then my sister in her mid 50s...

I decided not to wait...

 

[ERD50]

The probability of getting shingles if you don't get the vaccine is not 100%, and the probability of not getting shingles if you do get the vaccine is not zero. This is decision making under uncertainty. I actually took a course on this while doing my MBA. It depends on how you assign weight to the outcomes. ...

Yes, different people will look at that uncertainty different ways.

The way I looked at it - if I got a bad case of it, a lot of pain, and especially if it threatened my eyesight, I know I would be just kicking myself for not finding out if I could get the shot (don't assume you can't get it until 60) or for not shelling out the $200 or whatever to pay OOP. $200 will not change my life measurably, weeks/months of pain and threatened eyesight sure would.

I didn't want to risk wishing I had done it 6 months earlier. DW still hasn't got hers, I don't understand.

-ERD50

 

[audreyh1]

I didn't get the shot to avoid shingles- I might still get it. I got the shot to avoid a 6 month debilitating outcome from shingles.

 

[Corporateburnout]

Dw and I got the shot 3 years ago after seeing my brother suffer through a bad case of shingles.

 

[O2Bfree]

I get it. But everyone I know who has had it, would pay multiples of that price to have avoided it, or even just to have had a milder case.

-ERD50

Been reading more about getting the shot before age 60.

FDA: Shingles Vaccine OK at Age 50 and Up

"Why get vaccinated at age 50? That's when shingles risk shoots up. Before age 50, about two people in a thousand get shingles. After age 50, about six people in a thousand get shingles. A person's lifetime risk of shingles is about 30%.
...
The biggest drawback to Zostavax is its cost. The catalog price is about $161.50, about 10 to 20 times the cost of flu vaccine."

That's not very expensive.

But then there are articles such as these:

Shingles vaccine not cost effective before age 60 | Reuters

Shingles vaccine not cost effective before age 60

"For the new study, reported in Annals of Internal Medicine, the researchers used a computer to estimate the effectiveness of the vaccine in people 50 to 59 years.

Overall, they calculated, for every 1,000 people receiving the vaccine at age 50, just 25 shingles cases and one case of shingle-related pain would be prevented.

Typically, preventive treatments are considered cost-effective when they cost at most $100,000 per quality-adjusted life-year (QALY), that is, per year of healthy life gained. The new analysis found the vaccine cost over $300,000 per QALY."


Ask the Experts about Shingles (Zoster) Vaccines - CDC experts answer Q&As

" ACIP declined to vote to expand the recommendations for the use of zoster vaccine to include people age 50 through 59 years for the following reasons: (1) though the burden of HZ disease increases after age 50, disease rates are lower in this age group than they are in persons age 60 years and older; (2) there is insufficient evidence for long term protection provided by the vaccine; and (3) persons vaccinated at younger than age 60 years may not be protected when the incidence of zoster and its complications are highest. However, zoster vaccine is approved by the FDA for persons age 50 through 59 years and clinicians may vaccinate persons in this age group without an ACIP recommendation.
...
A long-term care resident age 80 years who received zoster vaccine (Zostavax; Merck) several years ago recently had a mild case of shingles. Is there any recommendation for administering a second dose of vaccine in such a circumstance? Are booster doses ever recommended?

The answer to both questions is no. Zoster vaccine is not 100% effective. In the key clinical trial, overall effectiveness among people age 60 years and older was 51% and decreased with increasing age. However, the vaccine was 67% effective in preventing post-herpetic neuralgia; this effectiveness did not decrease with increasing age. The duration of protection from shingles after a dose of zoster vaccine is not known at this time. However, ACIP has not recommended a second dose for anyone. ACIP recommendations for the use of zoster vaccine are available at www.cdc.gov/mmwr/PDF/rr/rr5705.pdf."

I may change my mind and get the shot sooner...or not...

 

[audreyh1]

9 years from now I figure they will know whether I should get another in my 60s or 70s.

 

[ivinsfan]

And just because they tell you have you don't "have" to get a booster doesn't mean you can't just pay for a second round yourself, if you think it's warranted.

 

[audreyh1]

And just because they tell you have you don't "have" to get a booster doesn't mean you can't just pay for a second round yourself, if you think it's warranted.

I figure in 9 or 10 years guidelines on boosters will be much clearer. That's the only way I will know whether one is warranted.