The Shingles Vaccine
What is shingles?
Shingles is a viral infection caused by the varicella-zoster virus. When first infected with varicella-zoster, individuals will first experience chickenpox. Afterwards, the virus will lay dormant in nerve tissue near the spinal cord and brain. Your immune system is able to keep the virus dormant, but as you age, your immune system becomes less effective.
While shingles is not life threatening it can be very painful, causing an itchy rash and even fluid-filled blisters on the skin. These blisters can lead to infections if not properly treated. Other symptoms as noted by the Mayo Clinic include burning, numbness, tingling, sensitivity to touch, fever, headache, sensitivity to light, and fatigue. The virus can also lead to vision loss if near the eye as well as an array of neurological problems. Another item to note is that shingles can be passed to someone who is not immune to chickenpox. So, children who have not had the vaccine and individuals who are immunocompromised are especially at risk.
How is the shingles vaccine covered?
Most common vaccinations such as the flu shot, pneumococcal, or Tdap are covered under Part B. However, shingles shots are covered under Part D. This means that your copay for the shot will vary based on your plan. The two most popular shingles shots are Zostavax* and the newer Shingrix, which average around $190 per shot at retail price. For individuals over the age of 50, it is recommended by the CDC to receive 2 doses of the vaccine separated by 2 to 6 months. So, speak with your provider to determine your dose schedule and copay prior to receiving your shot!
*Note that new batches of Zostavax will no longer be sold as of July 1, 2020 and current batches will expire November 18, 2020.
Where can I get the shingles vaccine?
At the pharmacy. Note that a prescription by a doctor is still required to receive the vaccination. Just make sure that the pharmacy you use is a “preferred pharmacy” in your Part D plan’s network so you get the best pricing.
At the doctor’s office. Before you get the vaccination, check if your doctor is able to bill for Part D plan directly. If they are able to, you will only need to worry about your copay. If your doctor is not able to bill your Part D plan directly, you will need to pay for the vaccine in full and file a reimbursement claim later. Also note that your doctor may charge an additional fee for administering the vaccine.