Don’t get shingles, get the vaccine now

by Madeleine Kolb

Two days ago standing at the prescription counter at CVS, I nearly lost it. I got very  frustrated and was taking it out on the young pharmacist at the counter.

The more he tried to explain that CVS no longer carries the shingles vaccine, the more irate I became. Finally, I got a grip. I stopped in mid-tirade and said

I know it’s not your fault. I’m just so frustrated because I’m doing what I was told to do, and now I need to go home and start over. I apologize.

What on earth is shingles and how do you get it?

What provoked this incident was my attempt to get a shingles shot. There are four different vaccinations indicated for a person with my risk factors, and Shingles is one of them.

Shingles is a skin rash caused by the Varicella Zoster virus—the same virus which causes chicken pox. And only people who’ve had chickenpox can get shingles. In addition to the rash, the main symptom is pain—intense, protracted pain. 

Viruses are diabolical. They invade your body and wreak havoc. If you get better, some viruses go dormant. You may think they’re gone, but they’re still lurking there. After years or even decades, they may become activated and wreak more damage. Think Herpes or AIDS.

Treatment for shingles involves taking antiviral drugs and drugs for the pain. The best course, though, is to prevent it by getting vaccinated for shingles.

How do you get the vaccine?

Normally, getting a vaccine—a shot—is no big deal. But for me getting the shingles shot turned into an obstacle course. One reason is that many doctors, including mine, do not store supplies of the shingles vaccine.

So they write a prescription for a patient (let’s call him Larry) who takes it to a drug-store which gives him a packet of the vaccine to take to his doctor’s office where a doctor or nurse gives him the shot. The technical term for this is “brown-bagging.”

But it’s more complicated than that. The vaccine needs to be kept cold, so Larry needs to bring a small cooler with real ice or frozen Blue-ice packs to the drug-store to bring the vaccine to his doctor’s office. This was the procedure described by Susie (not her real name) at my doctor’s office who also mentioned a specific pharmacy to go to.

Searching for a simple shingles shot

On Monday this week, I checked my health insurance company’s web site and found out that the pharmacy Susie mentioned was not a service provider in its network, but CVS was. On Tuesday morning I set out.

*** I drove to CVS—armed with my prescription, my medical insurance card, and my small cooler holding several frozen packs of Blue-ice. It was there that I had the interaction described above with the perfectly nice young pharmacist at the prescription counter.

*** I drove back home and called my doctor’s office. This time I spoke to Estelle (not her real name) who promised to get back to me.

*** I checked my health insurance company’s website again and found that RiteAid Pharmacy was also on the list of service providers.

*** I called RiteAid and found out that the pharmacy did carry shingles vaccine.

*** I called my doctor’s office and spoke to Estelle (who had not called me back). She  said that she thought RiteAid also administered the shots at the pharmacy. At this point, I had a feeling of elation: this was the big breakthrough I was waiting for.

*** I called RiteAid back and asked whether the company administered the shots at the pharmacy. The pharmacist said that it did!

*** I drove to RiteAid (which is very near the CVS I had gone to earlier), filled out some forms, waited a bit, and got my shingles shot.

*** When I got home, I called my doctor’s office and spoke to Estelle again. I told her that RiteAid had the vaccine and was able to administer it right then and there. No ice chest, no trip back to the doctor.

The good part

Although the vaccine is not 100% effective in preventing shingles, I’m as immune from this horrible disease as I can be. And for the rest of my life. Also my health insurance covered the cost of the vaccine as part of its preventive care program.

The not-so-good part

*** The process is way too complicated. Some doctors’ offices store shingles vaccine on-site; some send patients to a pharmacy. Some pharmacies store the vaccine on-site; some don’t. Of those which do store the vaccine, some pharmacies administer the shot; some don’t. This last group provides the vaccine, and the patient needs to bring it to his doctor’s office in a cooler to get the shot.

*** The cost aspect has its own complications. If health insurance doesn’t cover the cost of the vaccine, Medicare will. But Medicare won’t cover the cost up front; it will reimburse the cost which is a hefty $200. So you need to get specific information about coverage for shingles vaccination under your own health care insurance and/or Medicare.

*** The worst part though, is that at least one million people a year in the U.S. get this terrible disease which is largely preventable by vaccination. However, the cost of the vaccine, the potential hassle, or both mean that some people at risk may not be able to prevent a long, painful, debilitating bout with shingles.

I hope that my experience will help you avoid some of the problems I encountered and keep you from ranting at a nice young pharmacist who is just trying to help. I welcome your comments

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{ 20 comments… read them below or add one }

1 Angela Artemis January 7, 2011 at 7:06 pm

Madeleine,
That was fascinating. I didn’t know there was a vaccine for shingles. I wonder if Vitamin D can prevent shingles too? If your immune system is weak Vitamin D can help –
Have you ever heard of that?

Happy New Year to you!
Angela Artemis recently posted..A Simple Guide for Living In The LightMy Profile

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2 Madeleine Kolb January 8, 2011 at 2:23 pm

Angela,
I didn’t know about the vaccine either. I found out about it when I took the online questionnaire at the CDC website which I refer to in Part 1 of this project, and I’m so glad I did. If you Google “shingles” and look at some of the images of people who have it, especially near their eyes, you’ll want to ask your doctor about the vaccine right away.

I don’t know whether Vitamin D would help prevent shingles. I haven’t come across any information about that.

Happy New Year, my friend!

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3 Virgie Hines September 7, 2011 at 11:00 am

I believe half the unhappiness in life comes from people being afraid to go straight at things.

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4 Richard March 10, 2012 at 11:06 pm

Got mine from my physician the minute it was available. But I’ve learned you have to be proactive with innoculations. I keep track of my Tdap and ask for a renewal when it gets close to a decade for tetanus. Going to India I got a whole bunch of shots that the WHO or CDC “suggested” but only had them after I specifically asked. You can’t expect physicians and nurses to always be the ones to keep track of such things, or know what you may need.

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5 Madeleine Kolb March 11, 2012 at 11:55 am

The key word here is “proactive.” In an earlier post, I linked to a CDC online questionnaire which asks about individual risk factors for certain diseases and comes up with a list of recommended vaccinations. You’re absolutely right about doctors and nurses not always being able to keep track of what vaccinations each patient has had and when.

I’m glad to hear that you’ve had your Shingles vaccine. What a terrible disease that is.

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6 Brenda McGuire April 20, 2012 at 1:34 pm

Do I haft to have a percription from a Doctor to get the shot?

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7 Madeleine Kolb April 20, 2012 at 3:08 pm

Yes, you need a doctor’s prescription.

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8 John Civis June 4, 2012 at 5:14 pm

Do I need a prescription? It depends on which state you live in. In Massachusetts, as of about a month ago, you just need to be 60 or more years old. Walmart and Rite-Aid are mostly doing the \”get your shot in the store\” approach, but call in advance to the store you want to go to, they might be out or only do certain days and hours, etc.

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9 Carol Cherman June 22, 2012 at 5:32 pm

Wow! You described my frustrating experience to a T. My doctor’s office didn’t keep the vaccine on hand. The doctor wrote a prescription for me. My insurance company told me they cover the shot, but when my doctor tried to order the vaccine, she was told that the company she usually dealt with wasn’t covered by my insurance. She was referred to another company, but that wasn’t covered either. I called my insurance company back and they gave me a referral to a pharmacy that administers the shot. When I called them, they said they don’t deal with my insurance company. Grrrr. Ultimately I was told to pick up the vaccine from a pharmacy that carries it, transport it to my doctor in a cooler, and have the doctor administer it. The cost would be a $20 co-pay to the doctor for administering the shot, and I would need to pay the pharmacy in full (approx. $200), then file paperwork with the insurance company, including a copy of the prescription, in order to be reimbursed for the cost of the vaccine. I found out that the pharmacy that was located downstairs in my doctor’s building carried the vaccine all the time. All I had to do was buy it and run upstairs to have the doctor administer the shot. No cooler. Neat! The night before I was to receive the shot, I was doing my grocery shopping. Inside the store is a pharmacy. Outside the store was a sign saying “Get your shingles shot here.” Knowing there was no chance this would be covered, I went to the pharmacy anyway just to ask about it. They ran my insurance card and, to my utter shock, they told me my insurance would pay them – I wouldn’t have to file any paperwork – and the pharmacist could administer the shot for $20. I must have asked the guy 5 times if he was sure that was right. Bingo! However, not expecting to get a shot at the grocery store, I didn’t have my prescription with me. I was told that since I was over 60 something, I didn’t need a prescription. I went ahead and got the shot, AND they gave me a coupon for 10% off my groceries!!! So the shot cost less than $20 and saved me a trip to my doctor’s office across town. Good luck getting this shot if you aren’t persistent and determined.

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10 Madeleine Kolb June 22, 2012 at 8:33 pm

Carol, Our separate experiences getting a Shingles shot do sound quite similar. And equally frustrating.

A big problem is that the system is so complicated that even people in your doctor’s office may not know how it works. Or worse yet, they think they know, so they give you incorrect information which causes you to spend way too much time going here and there to get an essential vaccine.

As you say, it takes a lot of persistence and determination. The good news is that the vaccine is apparently good for the rest of your life.

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11 ray September 3, 2012 at 9:19 pm

I called Medicare and Blue Cross/Blue Shield and both denied any coverage whatsoever for the shingles vaccine. The manufacturer agreed to cover all costs if the doctor ould agree…try to find such a doctor…kind of a joke.

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12 Madeleine Kolb September 4, 2012 at 2:24 pm

Ray, It’s a very frustrating experience to find where and how to get a Shingles shot and how much it will cost. I was quite fortunate that my shot was covered by insurance, but I still did a lot of running around to find a pharmacy which stocked the vaccine and gave the shots on-site.

Medicare actually does cover it but not under Parts A or B, as you might expect. It’s covered under Part D, the Medicare Prescription Drug Plan. However, the cost is high and is not the same under all Part D plans.

So here’s my suggestion: Speak to your doctor and ask for a prescription for a Shingles shot. Call around to large pharmacies, such as Rite-Aid, or megastores, such as WalMart, to ask whether they gives shingles shots and what the cost would be.

It’s a shame that it’s such an obstacle course to get protection against this horrible disease. (Please let us know how it works out.)

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13 FLORD MARTIN January 24, 2013 at 6:59 pm

Well the shot is not cheap $220 bucks at Walgreens!
Medicare will not cover it if you don’t have prescription drug coverage?
I have Tri Care but not all pharmacies accept it!
They all recommend it but as usual Red Tape up the Ying Yang!
And then later you find out when you get the bill this is not covered or that
is not covered?

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14 Madeleine Kolb January 24, 2013 at 8:48 pm

Flord, It’s often frustrating, and it can be expensive to get a shingles shot. I’ve heard that it’s getting easier, but it doesn’t sound as if that was your experience.

And this is for a vaccine to prevent a serious and incredibly painful condition. Not to mention the costs for treatment if a person does get shingles. As I said above, I was fortunate that my insurance covered the cost.

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15 Susan February 3, 2013 at 11:51 am

According to the government website, HealthCare.Gov, the shingles vaccine is a covered preventive service. My husband on Medicare, has the Massachusetts Medex Blue Cross supplement and they don’t cover it. He paid $260. I’m not on Medicare yet. My Blue Cross policy will only cover the vaccine, if it’s administered in the doctor’s office. She doesn’t carry it in her office. She recommended getting it from a pharmacy and bringing it to her office. I called several pharmacies within a coupe of miles. They either don’t carry it or refuse to have it taken out of the pharmacy. Ironically, my husband’s doctor carries it in his office, so I’m going to see if I can get it there.

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16 Madeleine Kolb February 9, 2013 at 5:35 pm

The shingles vaccine is covered under Medicare Part D but not under Part B. Some private insurance covers it, some doesn’t. Therefore, your husband would not be covered unless he has Medicare Part D.

I’m surprised that your Blue Cross insurance covers the vaccine only if it’s administered in a doctor’s office. Many doctors don’t have the facilities to stock the vaccine wheras some of the large pharmacy chains (or pharmacies within large supermarkets) do have the vaccine and can administer it without an appointment.

I hope you can get the shingles shot at your husband’s doctor’s office. You really don’t want to take a chance on getting this horrible disease.

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17 Richard Walker March 13, 2013 at 4:44 pm

My experience today mirrored yours. I stood in line, filled out the forms, handed in my Medicare and medical insurance cards … and was told … “Oh this isn’t covered.” Back to square one.
I think everybody knows there is a lot of POLITICS behind this issue and our representatives ARE NOT working for their constituents (OLD DEFINITION BEFORE CITIZENS UNITED).

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18 Madeleine Kolb March 13, 2013 at 8:25 pm

Richard, I appreciate your comment, but it’s disheartening to hear that people are still having problems getting this essential vaccination.

It’s hard to understand the rationale for such a cumbersome procedure. Especially when shingles is an extremely painful but largely avoidable disease. By “largely avoidable,” I mean that the vaccine is not 100% effective, but it’s the best protection we have.

This is definitely something for you to pursue. The vaccine is covered under Medicare Part D but not under Part B. My shot was covered under my insurance. I’d suggest making some calls to pharmacies (such as CVS or Rite-Aid) near where you live or pharmacies within huge supermarkets (such as WaMart).

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19 Jason Bush March 16, 2013 at 7:50 am

I made an appointment online to get the shingles vaccine at a local CVS. I got there and was told that they didn’t have the shingles vaccine. How is it possible that a company has a website where you can schedule an appointment for the shingles vaccine at a specific time at a specific CVS and then not have the vaccine? What a poorly run organization!

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20 Madeleine Kolb March 16, 2013 at 11:02 am

Jason, That is just absurd. Clearly there’s no communication between the IT people at CVS headquarters and the people who give the vaccine (when it’s available) in the individual pharmacies. At the very least, the website should advise people to call their local pharmacy and speak to a human being to schedule an appointment.

Of course, as indicated by your experience and mine and that of many other people, the system is fragmented and puts people at risk of a horrendous disease. Maybe it’s time for me to do further investigation.

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