Who can provide a shingles vaccination?
May 23, 2014 7:06 AM Subscribe
I want a shingles vaccination. My doc says no.
I asked my doc about getting a shingles vaccination the last two times I saw him. He said no, they don't do this until age 60. I'm 55, not on steroids, not immunocompromised, not on chemo. I don't know if I ever had chicken pox. By my research the "60 years old" limit seems rather arbitrary, some places say 55 or 50.
I'm just rather concerned about getting shingles after hearing the horror stories. They don't even have the vaccination in the office, all I need is a prescription from him, I'll find a place to get the actual shot.
I've asked some of my other doctors, cardiologist and urologist. Both said no, the script should come from my primary care. Am I breaking some sort of "doctors code" asking around for this?
Mainly, I need to know what type of doc do I need to see to get this medication, and is my primary going to be pissed off because I'm going behind his back?
I asked my doc about getting a shingles vaccination the last two times I saw him. He said no, they don't do this until age 60. I'm 55, not on steroids, not immunocompromised, not on chemo. I don't know if I ever had chicken pox. By my research the "60 years old" limit seems rather arbitrary, some places say 55 or 50.
I'm just rather concerned about getting shingles after hearing the horror stories. They don't even have the vaccination in the office, all I need is a prescription from him, I'll find a place to get the actual shot.
I've asked some of my other doctors, cardiologist and urologist. Both said no, the script should come from my primary care. Am I breaking some sort of "doctors code" asking around for this?
Mainly, I need to know what type of doc do I need to see to get this medication, and is my primary going to be pissed off because I'm going behind his back?
There is a lot of scare-mongering that has been on the tv lately about shingles. IMO it looks like big pharma looking for cash. (FWIW it's only on American tv; not on Canadian tv. We have some magic shingles-b-gone stuff up here I guess.) But that's not your question.
There are some key terms that perk up doctor's ears.
Very long story short, when trying to get additional assessments for what I knew was an issue, I learned that doctors learn certain key phrases that make them perk up and take you seriously. They are looking for risk categories. So... you need to find out what key indicators make you (or your family history) more at risk for shingles. You've covered the basics (which makes me wonder why you're worried) but look up other stats (where you live? shingles in your area? did your brothers or sisters have chicken pox? classmates?) that increase your chances of being in a higher risk category. Bring that back to your doctor (or try a walk in clinic?) and see if that takes.
Last ditch: call up the makers of that vaccine and find out where & how to get a script.
Yes there's an informal system among doctors but you're within your right to advocate for yourself if you truly think this is an issue.
posted by St. Peepsburg at 7:30 AM on May 23, 2014 [1 favorite]
There are some key terms that perk up doctor's ears.
Very long story short, when trying to get additional assessments for what I knew was an issue, I learned that doctors learn certain key phrases that make them perk up and take you seriously. They are looking for risk categories. So... you need to find out what key indicators make you (or your family history) more at risk for shingles. You've covered the basics (which makes me wonder why you're worried) but look up other stats (where you live? shingles in your area? did your brothers or sisters have chicken pox? classmates?) that increase your chances of being in a higher risk category. Bring that back to your doctor (or try a walk in clinic?) and see if that takes.
Last ditch: call up the makers of that vaccine and find out where & how to get a script.
Yes there's an informal system among doctors but you're within your right to advocate for yourself if you truly think this is an issue.
posted by St. Peepsburg at 7:30 AM on May 23, 2014 [1 favorite]
I think they only give you the shingles vaccine if you are at higher risk for it or have had it before. I got shinles 2 years ago and last year my pcp offered it to me and I did take it. For what it's worth, I got shingles when I was 28. I don't know if the doctor will be willing to write a script for it if it's just based on a concern.
posted by zw98105 at 7:33 AM on May 23, 2014 [1 favorite]
posted by zw98105 at 7:33 AM on May 23, 2014 [1 favorite]
Mr. BlahLaLa got shingles at 55, so maybe find another doctor and ask again.
posted by BlahLaLa at 7:37 AM on May 23, 2014
posted by BlahLaLa at 7:37 AM on May 23, 2014
Definitely keep in mind your insurance might not cover it if you don't get it from a doctor, so be prepared to pay the full cost out of pocket.
posted by ThePinkSuperhero at 7:48 AM on May 23, 2014 [1 favorite]
posted by ThePinkSuperhero at 7:48 AM on May 23, 2014 [1 favorite]
My uncle died of shingles, I discussed with my doc and he's also a pharmacist, he suggested waiting. I'll wait, if he believes that's the way to go.
If you're still convicted about it, go to the Doc-in-a-Box at the pharmacy, have them write you the scrip and then walk back and have the pharmacist give it to you.
Are you sure you'll need a prescription? They may dispense it directly, my Publix does and the cost is $225.
posted by Ruthless Bunny at 7:54 AM on May 23, 2014
If you're still convicted about it, go to the Doc-in-a-Box at the pharmacy, have them write you the scrip and then walk back and have the pharmacist give it to you.
Are you sure you'll need a prescription? They may dispense it directly, my Publix does and the cost is $225.
posted by Ruthless Bunny at 7:54 AM on May 23, 2014
Some doctors provide you with the full benefit of their education and experience. Other doctors are walking prescription pads. You have the former, and you want the latter. Look for the type of doctor who would also write out Vicodin prescriptions to anyone doctor-shopping for their addiction. I'd try walk-in clinics in run-down strip shopping centers in the shadier parts of town. If your city is Houston, I can point you to some very likely candidates.
posted by Houstonian at 7:55 AM on May 23, 2014
posted by Houstonian at 7:55 AM on May 23, 2014
My doctor also refused me the shingles vaccine because I'm way too young for it to be a good idea she said. So two things: First, she said that shingles is not a big deal at all if treated immediately. She said if I get a rash in a line on my torso, I should go to the ER immediately. They'd treat it and it would be all good in a couple of days. Also, she said the other reason not to do it too young is that they don't actually know yet how long it lasts and if you get it too young, it can wear off. Booster-need on that vaccine isn't understood yet (As of a couple of years ago).
Second, if you really do want the vaccine, just go to a walk-in clinic. Those people will do whatever you ask them to with little concern for best practice. You're really more of a customer than a patient at many of those places. I do not suggest you do this. I did not do this.
posted by If only I had a penguin... at 7:55 AM on May 23, 2014 [4 favorites]
Second, if you really do want the vaccine, just go to a walk-in clinic. Those people will do whatever you ask them to with little concern for best practice. You're really more of a customer than a patient at many of those places. I do not suggest you do this. I did not do this.
posted by If only I had a penguin... at 7:55 AM on May 23, 2014 [4 favorites]
While at a Walgreens at 2am last night waiting for my Rx's to be filled, I was surrounded by signs of every possible font and size- all of which loudly proclaimed that if you're 50 or older you should talk to them RIGHT NOW about getting your shingles vaccine.
Me? I wouldn't do it. You doctor - who you presumably trust with Important Medical Decisions- has recommended that you don't have the vaccine. Perhaps if you heard his reasoning you would better accept the opinion?
posted by PorcineWithMe at 8:28 AM on May 23, 2014 [1 favorite]
Me? I wouldn't do it. You doctor - who you presumably trust with Important Medical Decisions- has recommended that you don't have the vaccine. Perhaps if you heard his reasoning you would better accept the opinion?
posted by PorcineWithMe at 8:28 AM on May 23, 2014 [1 favorite]
In 2008, the U.S. federal Advisory Committee on Immunization Practices (ACIP) issued its guidance on Zoster (Shingles) vaccination. It recommended vaccination for those 60 and older. That was consistent with the Food and Drug Administration 's 2006 licensure, which was limited to those 60 and older.
In March 2011, FDA expanded the licensure, approving the use of Zostavax in adults aged 50 through 59 years as well. As explained in this November 2011 update from the ACIP Zoster Working Group, ACIP decided not to amend its 2008 age recommendations, but that decision was influenced in part by supply issues. The Wall Street Journal reported in April 2012 that Merck has "restored supply of Zostavax."
In short, it does not seem unreasonable for someone aged 55 who's worried about shingles to get the vaccine, even without any unusual risk factors. You should see if your doctor will give you a prescription if you make clear that you're willing to pay for it out of pocket. He might be thinking that to get insurance coverage, he'd have to make up nonexistent risk factors, which he of course should not do.
If he just says, "No, rule is 60" and refuses to discuss why he thinks it's a bad idea, you might want to consider getting a new doctor.
posted by Mr.Know-it-some at 8:53 AM on May 23, 2014 [2 favorites]
In March 2011, FDA expanded the licensure, approving the use of Zostavax in adults aged 50 through 59 years as well. As explained in this November 2011 update from the ACIP Zoster Working Group, ACIP decided not to amend its 2008 age recommendations, but that decision was influenced in part by supply issues. The Wall Street Journal reported in April 2012 that Merck has "restored supply of Zostavax."
In short, it does not seem unreasonable for someone aged 55 who's worried about shingles to get the vaccine, even without any unusual risk factors. You should see if your doctor will give you a prescription if you make clear that you're willing to pay for it out of pocket. He might be thinking that to get insurance coverage, he'd have to make up nonexistent risk factors, which he of course should not do.
If he just says, "No, rule is 60" and refuses to discuss why he thinks it's a bad idea, you might want to consider getting a new doctor.
posted by Mr.Know-it-some at 8:53 AM on May 23, 2014 [2 favorites]
If your doctor didn't give you a reasonable explanation for refusing, you need a new doctor.
posted by Violet Hour at 9:01 AM on May 23, 2014
posted by Violet Hour at 9:01 AM on May 23, 2014
It depends on the state that you live in too. I live in Massachusetts. My PCP gave me an rx for the vaccine but since I'm not 60 the pharmacies in my state can't give it to me under MA state law. However, I was able to go into Connecticut and get it because they don't have an age restriction law there.
Also, I'm pretty sure that none of these pharmacies will give you the shot without a prescription. Good luck!
posted by Hanuman1960 at 9:01 AM on May 23, 2014
Also, I'm pretty sure that none of these pharmacies will give you the shot without a prescription. Good luck!
posted by Hanuman1960 at 9:01 AM on May 23, 2014
Keep in mind that the vaccine only reduces your risk of getting shingles by 51%. It is not 100% effective. (And it t reduces the risk of post-herpetic neuralgia, which occurs in about 20% of shingles cases, by 67%, but that leaves a 33% chance of developing it. Stats per CDC.) The overall lifetime odds of getting shingles are around 50%.
So basically, you're looking at a vaccine that reduces your odds of getting it, ever, from 50% to 25%, and your odds of getting the neuralgia complication from 10% to 3.3%. But those odds cover the rest of your life, to age 85, let's say. And the odds increase as you get older. So the odds during the next five years are more like 5% without the vaccine, 2 or 3% with the vaccine, and of neuralgia 2 percent without, and a smidgen with.
On top of that, if you are unlucky and do get it in the five year window, but get to the doctor early, the treatment is quick and effective.
posted by beagle at 9:12 AM on May 23, 2014 [1 favorite]
So basically, you're looking at a vaccine that reduces your odds of getting it, ever, from 50% to 25%, and your odds of getting the neuralgia complication from 10% to 3.3%. But those odds cover the rest of your life, to age 85, let's say. And the odds increase as you get older. So the odds during the next five years are more like 5% without the vaccine, 2 or 3% with the vaccine, and of neuralgia 2 percent without, and a smidgen with.
On top of that, if you are unlucky and do get it in the five year window, but get to the doctor early, the treatment is quick and effective.
posted by beagle at 9:12 AM on May 23, 2014 [1 favorite]
I just had shingles this year (ugh) and while it was uncomfortable, once I got medicated, it wasn't that huge a deal. Not that people don't have horrible experiences and your mileage may certainly vary, but mine was more annoying/itchy than painful.
posted by emjaybee at 9:37 AM on May 23, 2014
posted by emjaybee at 9:37 AM on May 23, 2014
The vaccine is FDA-approved for people over 50 so if you go to a pharmacy or walk-in clinic that provides them, you probably won't need a prescription. Your insurance may or may not cover it.
posted by The Elusive Architeuthis at 9:42 AM on May 23, 2014
posted by The Elusive Architeuthis at 9:42 AM on May 23, 2014
Pretty sure you can just walk in to a Walgreens, pay a couple hundred and be done with it. I have their shingles ad pretty much memorized from sitting in there.
posted by misanthropicsarah at 10:23 AM on May 23, 2014
posted by misanthropicsarah at 10:23 AM on May 23, 2014
Is it meant for those who never had chicken pox or for those who did?
posted by brujita at 11:38 AM on May 23, 2014
posted by brujita at 11:38 AM on May 23, 2014
I had shingles in grad school - I think I was 24. It was misery. I completely and wholehearted understand your desire to avoid it. It sucks.
That said I'm not trying to get the vac since my doctor said it wasn't indicated for me. You're trading risk of Shingles versus risk of the vaccine.
You aren't breaking any doctor code asking other doctors to prescribe it, but they are unlikely to do so. You have insurance and a primary care physician. You're asking for a vaccination which is outside the norm and outside their area of expertise. They aren't going to take the risk there. They'll refer you back to primary care.
posted by 26.2 at 11:46 AM on May 23, 2014
That said I'm not trying to get the vac since my doctor said it wasn't indicated for me. You're trading risk of Shingles versus risk of the vaccine.
You aren't breaking any doctor code asking other doctors to prescribe it, but they are unlikely to do so. You have insurance and a primary care physician. You're asking for a vaccination which is outside the norm and outside their area of expertise. They aren't going to take the risk there. They'll refer you back to primary care.
posted by 26.2 at 11:46 AM on May 23, 2014
My wife was in the same situation and sought out an infectious disease doc who gave her the shot. She knew that this particular doc is very pro-vaccine, so it might be a special case.
posted by SemiSalt at 1:05 PM on May 23, 2014
posted by SemiSalt at 1:05 PM on May 23, 2014
brujita: It is only possible to get shingles if you've already had chicken pox - it's caused by a flare-up of the chicken pox virus which lies dormant in your body for, basically the rest of your life once you've had it.
posted by augustimagination at 1:06 PM on May 23, 2014
posted by augustimagination at 1:06 PM on May 23, 2014
I'm over 60. My aunt had painful shingles that I definitely do not want. I asked my doctor for the shingles vaccine and he advised against it but gave it to me anyway. I had a reaction to the vaccine that caused an itchy rash that lasted several days and made me very sorry I made him give it to me.
posted by Joleta at 9:08 PM on May 23, 2014
posted by Joleta at 9:08 PM on May 23, 2014
Costco pharmacies give the vaccination without a prescription. In Hawthorne, California the cost is $195 without Medicare, $95 with Medicare. They may require the patient to be at least 60 years old. Call ahead.
posted by conrad53 at 2:12 AM on May 24, 2014
posted by conrad53 at 2:12 AM on May 24, 2014
I asked my doctor, a very responsible practitioner who was not operating a prescription factory at the mall, for the vaccine when I was in my early 30s and she had no problem giving it to me despite my lack of risk factors (immunosuppression, e.g.). If you don't feel like you are working well with your doctor and he/she is not listening to your concerns, find another one.
posted by foxy_hedgehog at 7:53 AM on May 24, 2014
posted by foxy_hedgehog at 7:53 AM on May 24, 2014
« Older Looking for quotes about chess. | I don't respect you, but I can't break up with you Newer »
This thread is closed to new comments.
posted by PhoBWanKenobi at 7:11 AM on May 23, 2014 [2 favorites]