Nationwide, about 35% of people 60 and older were vaccinated against herpes zoster (shingles) in 2018, compared to 7% in 2008, according to a report by the Centers for Disease Control and Prevention ( CDC) released on July 9.
However, the report also shows that low-income adults and those who are black or Hispanic (of all races) are much less likely to be vaccinated than non-Hispanic whites.
About 39% of non-Hispanic white adults received the herpes zoster vaccine in 2018, compared to only about 19% of Hispanic and black adults, according to the report.
These findings are consistent with the disparities that exist with other adult vaccines.
Adults with incomes below the federal poverty level ($ 12,760 annually for an individual) are only half as likely to be vaccinated as those with annual incomes of more than $ 25,000, according to the report.
Cara James, CEO of the nonprofit Grantmakers in Health and former director of the Office of Minority Health at the Centers for Medicare and Medicaid Services (CMS), said that blacks and Hispanics are more likely than non-Hispanic whites to be without health insurance or a regular healthcare provider, which may explain their lower vaccination rates.
They also probably don’t have the money to pay for the injection.
These lower vaccination rates may have a new negative impact if a vaccine for COVID-19 is developed, James said. Although they are more likely to have the coronavirus and experience more severe cases of COVID-19, these communities may not be first in line to get vaccinated due to cost and other factors.
Nearly 1 in 3 people in the United States will develop shingles at some point in their lives. An estimated one million cases are diagnosed annually. Anyone who has recovered from chickenpox can get shingles, even children can develop it. However, the risk of developing shingles increases as you get older, the CDC says.
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For about a third of adults, the virus reactivates as shingles and often presents as a painful rash anywhere on the body. Some may have mild forms but in other cases, the pain may last for a long time, after the rash disappears.
The drug maker Merck offered the first shingles vaccine, called Zostavax, in the United States in 2006. In late 2017, the Food and Drug Administration (FDA) approved a newer, more effective vaccine, Shingrix, and this month Merck stopped selling his.
Shingrix, produced by GlaxoSmithKline, is 97% effective in preventing the disease in adults ages 50-69, compared to approximately 51% for Zostavax. The CDC recommends that all people over the age of 50, including those who were vaccinated with Zostavax, receive Shingrix. No prescription is required.
The Affordable Care Act (ACA) required that preventive health services, including vaccines, be offered to people with health insurance at no out-of-pocket costs. But Medicare beneficiaries were excluded in this rule.
Although Medicare beneficiaries receive free flu and pneumonia vaccinations, they often have to pay out-of-pocket for other vaccinations, including shingles. Payments are set by your drug plan.
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Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Nashville, said he recommends that his patients receive the Shingrix vaccine before they turn 65 and enroll in Medicare. Schaffner blames Congress for adding vaccine costs for people with Medicare.
“We have seen that a substantial part of the population receives the vaccine, but it is far from the 100% goal,” added Schaffner.
GlaxoSmithKline said the average Medicare member pays $ 50 for each of the two doses of the vaccine, which are usually given a few months apart.
For people without insurance, Shingrix costs around $ 300 for both doses.
In addition to cost, another factor that can influence the low vaccination rate is access. The Shingrix lawsuit caused a shortage of the vaccine shortly after its launch, but GlaxoSmithKline executives say they now have a fair amount of doses to distribute.
About 17 million people have received at least one dose of Shingrix, although the vaccine is recommended for more than 100 million people, said Sean Clements, a spokesman for the laboratory. In comparison, he said, 20-25 million people received Zostavax after 14 years on the market.
Dr. Anjali Mahoney, a family physician in Los Angeles and vice president for clinical affairs at the Keck School of Medicine at the University of Southern California, said she was pleased to hear of the huge increase in people receiving the vaccine.
“About 1 in 3 people get herpes zoster in their lives, and that’s not something they want to have,” he said. The complications and pain caused by shingles, he added, can last for years, long after the rash is gone.
He also said that cost barriers for Medicare beneficiaries keep the numbers lower than they should be.
KHN (Kaiser Health News) is a non-profit news service covering health topics. It is an editorially independent program of KFF (Kaiser Family Foundation) that has no relationship with Kaiser Permanente.