Federal advisory panel recommends routine shingles vaccines for adults 60 and over

Wednesday, October 25th 2006, 10:15 am
By: News On 6

ATLANTA (AP) _ An influential government advisory panel voted Wednesday to recommend routine vaccines to protect older adults against shingles.

The Advisory Committee on Immunization Practices voted to recommend the vaccine for adults 60 and over. The committee's recommendations usually are accepted by federal health officials, and they influence insurance coverage for vaccinations.

Shingles is a painful, blistering skin rash that is most common in people 60 and older. It usually goes away after four weeks, but one in five shingles sufferers develops excruciating long-term nerve pain known as postherpetic neuralgia. Complications also can include scarring and loss of vision or hearing.

Antiviral medications are only of limited help, and some doctors say they do not prevent shingles from progressing into postherpetic neuralgia.

No vaccine was available until May, when the U.S. Food and Drug Administration licensed Zostavax, made by Merck & Co.

Shingles is caused by the varicella zoster virus, which also causes chickenpox. An estimated 15 percent to 30 percent of people infected with the virus develop shingles later in life.

The virus essentially hibernates for decades in nerve cells around the spine. It reactivates in some patients, probably because the body's immune system weakens with age, doctors say.

The vaccine is a souped-up version of Merck's chickenpox vaccine for children, with a live virus that is 14 times more potent.

The FDA approval was based largely on a study involving more than 38,000 people, with 19,000 getting the actual vaccine and others who got placebo. People who got the shot developed shingles at only half the rate of those who got the fake vaccine, researchers found.

Zostavax is not recommended for pregnant women, people with compromised immune systems or those with allergies to gelatin or other vaccine components.

Merck has sold about $11 million worth of the vaccine since it came on the market, company officials said.

The single-dose vaccine costs about $160 per shot. Some health insurers now cover it; the committee's recommendation is likely to increase the number that do.

If the vaccine is covered, patients are less likely to decline the shot because of the large out-of-pocket cost, said Dr. Sandra Fryhofer, an Atlanta internist who has been an advocate for the shingles vaccine.

``That's why the ACIP recommendation is so important,'' she said.

Lorraine Bailey, one of Fryhofer's patients, shared the doctor's position.

Bailey, 78, had chickenpox as a child and developed a painful, red, welty rash on the right side of her face last fall.

``It's like your face is on fire, even with the pain medication,'' Bailey said. ``I would have the vaccine, yes.''