New Shingrx Shingles Vaccine

[Downtown]

I checked with my pharmacist this afternoon. They don't have Shingrix in stock yet, but expect a shipment to arrive soon. I'm located in Austin, TX.

 

[Done]

My insurance company guaranteed they would fully reimburse me for the expense of the Shingrix shot as preventative care. Several calls later, they still can't figure out how to do it. The Costco Pharmacy system first showed that Shingrix wasn't covered so I paid, but now the insurer is attempting to have the pharmacy re-process the claim and have them refund my $156.

I guess you really can return anything at Costco.

 

[GTFan]

Why don't y'all just wait until it's covered by insurance? We're going to get it too but I'm not jumping through the pay-and-file-claim hoops hoping that it will get paid. I had my annual exam a month ago and my doc said it will be widely covered later this year, just wait and get it at next exam which is exactly what we're going to do.

 

[travelover]

Why don't y'all just wait until it's covered by insurance? ...........

Maybe because if you get shingles in the meantime, you'd regret waiting?

 

[Nemo2]

Maybe because if you get shingles in the meantime, you'd regret waiting?

+1

http://www.early-retirement.org/forums/f38/shingles-83633-9.html#post2011550

Post #170 02-12-2018 (I initiated this thread 10-01-2016)

Annual Optometrist's appointment this a.m., (eye doctor's appointment scheduled for March 09); he said that a minor adjustment might be beneficial, if it wasn't for "That F**** great scar in the middle of your cornea".

He figured that one of the possible treatments was akin to a laser 'scraping'......however, the laser apparently could reactivate the shingles.

Waiting to see what the surgeon has to say.
__________________

 

[Done]

Why don't y'all just wait until it's covered by insurance?

Fun little shingles story. My mother-in-law had a nasty case across the left side of her face, affecting an ear and half of her tongue and nose. It caused a temporary palsy, making one side of her face droop as if she'd had a stroke. She was prescribed a large antiviral pill which became lodged in her airway so I quickly performed the Heimlich maneuver. Saved her life but bruised her ribs so she was in extra pain. We gave her a bell so she could wake us up whenever she had to get to the restroom at night. I was in charge of treating her facial scabs and ended up contracting chickenpox. Apparently I'd never had that childhood disease, and in my 30's it was awful and wiped me out for a week. Poor DW was left with two very cranky patients. Good times.

You can see why I'm no fan of the disease. I've since had a mild case of shingles and was happy to hear that the new vaccine can be started at age 50. If I have to pay, so be it, but insurance did promise to reimburse.

 

[joeea]

Maybe because if you get shingles in the meantime, you'd regret waiting?

I wish the new vaccine had been available a few years ago - I would have gladly paid for it.

Having Shingles is not a lot of fun. I lost a week's worth of sleep and perhaps some time off of my life. The scars that remain still bother me on occasion.

I got mine shortly after receiving the older "weak virus" version of the vaccine. The worst part is that the immunities I built up by having Shingles are gone now. The cancer infusions I'm receiving have wiped them out.

Once my treatments are complete in another year or so, I'm hoping I'll be able to get the Shingrx vaccine then. Meanwhile, I have to take a lot of anti-viral medications.

 

[GTFan]

Of course there's always a chance, but that existed before this vaccine.

 

[nwsteve]

During a routine visit with my PC doc, I asked him about getting the new shingles vaccine-Shingrx. He agreed it would be worthwhile but did not see Medicare covering anytime soon, given the positions they had on vaccines like dTap--basically only if you had a puncture wound but no pay as preventive. Private pay insurers might be more flexible.
He did suggest that if we had any trips to Canada, it would be cheaper than the 150-160 price we hear now. No prescription required, just drop in at a pharmacy.
Do any of our Canadian members have any pricing experience on this approach?

 

[Nemo2]

Do any of our Canadian members have any pricing experience on this approach?

Our local pharmacy does not yet have stock - we were in there recently and were told they anticipated some supply "Within about a month"...no price estimate given.

 

[omni550]

CVS offering Shingrx at 9800 stores nationwide....and other major drugstore chains are, also.

https://www.cnbc.com/2018/03/16/cvs-to-offer-gsks-new-shingles-vaccine-at-stores-nationwide.html

omni

 

[timo2]

I am going to ask my Dr. about the ability to have a redo of the vaccine. I expect a negative answer. 5 years ago I was 60 and one month when I had my first shingles outbreak in my calves and feet.. I promptly got the shot as soon as they cleared up. Since then about once a year I have felt like the shingles wanted to come back (had the initial sensation, but it stopped there). But this year they came back but with a much reduced pain. I attribute the lesser symptoms to the vaccine. But the trend isn't good, as if the vaccine is wearing off?

 

[Chuckanut]

But this year they came back but with a much reduced pain. I attribute the lesser symptoms to the vaccine. But the trend isn't good, as if the vaccine is wearing off?

IIRC, it does wear off.

I will be getting the new shot later this year. I had the old one but I am sure it's efficacy has been degraded by time.

Here's some info:

https://www.canadapharmacy.com/blog/how-long-does-the-shingles-vaccine-last/

The shingles vaccine is a one-shot vaccine and is available to people 50 years or older. It lasts for approximately 5 years. Even so, it "still lowers the risk of shingles by 21 percent" [

Since the one-time vaccine lasts for about 5 years, most doctors recommend getting the vaccine at 60 years or older. However, the shingles vaccine poses a slight conundrum. The risk for shingles increases with age but the effectiveness of the shingles vaccine decreases with age too. According to Zostavax's research (the company that makes the vaccine), the vaccine reduces the risk of developing shingles by half for those in their 60s. Between ages 70 to 79, the vaccine is 41% effective. And for those who are 80 or older, the effectiveness drops below 20% [4].

 

[IMATERP]

Visited my Rhumey last week and he suggested that I should get the Shingrix vaccine.

Anyway, went to our local grocery store and the pharmacy provided the shot for $175 (free for my insurance plan.). Anyway, I received the injection...

Unfortunately, I've been recuperating from the side effects which were a little more severe than I expected. I've had a sore arm (from the injection,) and a terrible headache with some grogginess throughout the day. I'm really not looking forward to doing this again.

 

[gauss]

I am going to ask my Dr. about the ability to have a redo of the vaccine. I expect a negative answer. 5 years ago I was 60 and one month when I had my first shingles outbreak in my calves and feet.. I promptly got the shot as soon as they cleared up. Since then about once a year I have felt like the shingles wanted to come back (had the initial sensation, but it stopped there). But this year they came back but with a much reduced pain. I attribute the lesser symptoms to the vaccine. But the trend isn't good, as if the vaccine is wearing off?

If your Dr. practices evidence-based medicine, and you don't have a contraindication for the new vaccine, then I would be curious why you think your Dr. would not recommended it.

-gauss

 

[timo2]

If your Dr. practices evidence-based medicine, and you don't have a contraindication for the new vaccine, then I would be curious why you think your Dr. would not recommended it.

-gauss

I had that thought because when I received the originally one, I was given the impression that it would last quite a while. I now see that was wrong. it also is possibly just my personality as to how I interpreted the information. And possibly I expect them to say "you've had enough shingle shots already!

 

[gindie]

Visited my Rhumey last week and he suggested that I should get the Shingrix vaccine.

Anyway, went to our local grocery store and the pharmacy provided the shot for $175 (free for my insurance plan.). Anyway, I received the injection...

Unfortunately, I've been recuperating from the side effects which were a little more severe than I expected. I've had a sore arm (from the injection,) and a terrible headache with some grogginess throughout the day. I'm really not looking forward to doing this again.

Remember, it's a 2-shot sequence

 

[gauss]

I had that thought because when I received the originally one, I was given the impression that it would last quite a while. I now see that was wrong. it also is possibly just my personality as to how I interpreted the information. And possibly I expect them to say "you've had enough shingle shots already!

Don't be shy about asking for it. The science supports it as investigated and documented by the AICP. The recommendations on this currently being published by the CDC are below.

You might want to print out a couple of copies and take it with you to your Dr.'s office to facilitate the discussion if the Dr. is not up to speed on this yet.

Zoster vaccines

• Administer 2 doses of recombinant zoster vaccine (RZV) (Shingrix) 2–6 months apart to adults aged 50 years or older regardless of past episode of herpes zoster or receipt of zoster vaccine live (ZVL) (Zostavax).
• Administer 2 doses of RZV 2–6 months apart to adults who previously received ZVL at least 2 months after ZVL.
• For adults aged 60 years or older, administer either RZV or ZVL (RZV is preferred). “ZVL” has replaced the term “
• “ZVL” has replaced the term “HZV” (herpes zoster vaccine) that was used in past adult immunization schedules to refer to the live zoster vaccine. A row for RZV was added above the row for ZVL and a dashed line was used to separate RZV and ZVL rows to denote that the 2 zoster vaccines are recommended for the same purpose.

Note the recommendations assume that you have no contraindications present (ie Immunocompromised, Pregnancy, HIV Infection).

Good Luck and let us know how the discussion goes.

-gauss
"Hoping to stay shingles-free"

 

[testing321]

My wife got her first Shingrix shot last week at Walgreens. She has a Cigna plan and paid $0 copay even though she hasn't yet met the deductible. So Cigna is covering it as a preventive.

 

[ExitLeft]

CVS told me 50-59 yo requires a prescription, while >60 doesn’t. I don’t understand this requirement. It wasn’t related to insurance, as she didn’t even ask about my coverage. I want the shot, but the inconvenience stinks. (DW and DBIL both got shingles in their 50’s.)

 

[CaptTom]

Interesting. My local CVS assured me I don't need a prescription, but my insurance has given me two different answers as to whether or not it's covered. The last one said the formulary is updated monthly, and to wait a month and check again.

Now that I think about it, I'm not even sure if this is supposed to go under medial, or Rx.

 

[Done]

I got the Shringrix vaccination at Costco Pharmacy. It appeared that my HDHP insurance plan did not cover it at all, although I had seen literature online indicating that it was a covered vaccine. I called insurance CS and they determined that it was 100% covered at age 50+, but it is a medical benefit, not a pharmacy benefit.

I'm happy to report that I finally did receive reimbursement for the vaccine, but not as I was expecting. The insurance rep was incorrect in stating that it was a medical benefit. It is a pharmacy benefit like other vaccines, with no prescription needed, so customer service spent an hour on the phone with the pharmacy manager to correct the billing. I then needed to go into Costco to receive a full refund. Hopefully it is now fixed for the next patient.

 

[gauss]

CVS told me 50-59 yo requires a prescription, while >60 doesn’t. I don’t understand this requirement. It wasn’t related to insurance, as she didn’t even ask about my coverage. I want the shot, but the inconvenience stinks. (DW and DBIL both got shingles in their 50’s.)

That sounds like they were quoting the older (Zostavax) vaccine which was only recommend for those ages 60 and older. I had the same problem several years ago.

I would expect the Shingrix (new vaccine) to be offered to those 50 and over without needing a prescription.

-gauss

 

[jonat]

DW and I got our first of the two Shingrix shots at Costco a week ago; both of us had previously gotten Zostavax. Cigna insurance paid 100%. My doctor's office doesn't have it yet (and my doctor was grousing that their electronic medical records system had no way to record that we had received Shingrix, though they are switching to a new one next year that should.)

 

[tb001]

I think one is indicated for younger population but has more side effects. Maybe that's why it requires an Rx? All I'll say is I'm under 50 and have shingles right now and I'll be getting the vaccine as soon as I can. It's horrible.