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High demand delays shingles vaccine

BY KAREN SHIDELER

The Wichita Eagle

Demand for the vaccine that prevents shingles has outstripped supply, and health care providers nationwide are telling patients they'll have to wait for the shot.

"They're not calling it a shortage," said Claudia Blackburn, director of the Sedgwick County Health Department. "There is a 'shipment delay.' "

The delays -- of three months or more -- have created patient waiting lists and frustration for area health care providers.

Shingles is a painful skin rash, most common in people 50 and older, that's caused by the same virus that causes chicken pox. Anyone who has had chicken pox is at risk because the virus stays in the body even after the person recovers. Usually it doesn't cause problems, but it can reappear years later.

"You don't want shingles," said Wichita physician Brenda Schewe, director of the internal medicine clinic at the University of Kansas School of Medicine-Wichita. "They hurt like the devil."

About 1 in 5 of those who get shingles also get post-herpetic neuralgia. It's severe pain that continues after the rash clears up.

The shingles vaccine, called Zostavax, won federal Food and Drug Administration approval for people 60 and older in May 2006. In trials, it reduced the overall incidence of shingles by 51 percent and the risk of post-herpetic neuralgia by 67 percent.

It's being tested now in people 50 to 59, according to Merck, which makes the vaccine.

Some, but not all, Medicare Part D and private health insurance plans cover the vaccine. It can cost more than $200 if insurance doesn't cover it, but demand still has been high.

"We probably have a list of almost 200 patients wanting to get it," said Paul Vossen, a pharmacist at Dandurand's Piccadilly Pharmacy. The pharmacy is one of several sites in Wichita that offer the vaccine when it's available. Because of the vaccine's cost and because it must be stored in a freezer, not every health provider offers it.

Dandurand's ordered 200 doses of the vaccine in August, Vossen said, and was told it should arrive in 12 to 15 weeks.

"They just keep moving the date back on us," he said. "The latest is, 'We're not sure.' "

A spokeswoman for Merck said demand has outstripped production.

The vaccine uses the same base as the chicken pox vaccine given to children, and Merck earlier had temporary limitations on the base ingredients, said Deb Wambold, spokeswoman for Merck.

In addition, demand grew as awareness of the shingles vaccine increased. That, coupled with the Centers for Disease Control and Prevention's recommendation that children get two doses of chicken pox vaccine rather than just one, ramped up demand even more, she said.

Merck is telling customers that delays will continue "over the coming months," Wambold said; she had no more specifics.

Blackburn said the Health Department is frustrated by the shortage because people are beginning to get flu shots now. Not being able to give both vaccines at the same time "is a missed opportunity for a high-risk population," she said.

Wichita Clinic pharmacy director Greg Rockers agreed.

He said the Wichita Clinic started having problems getting the vaccine about two months ago. He has been ordering more doses every month, to keep orders in the pipeline, but still was waiting on vaccine ordered in June.

The clinic has been keeping a list of patients who want the vaccine.

"I know about half of our first shipment is going to be taken up by back orders within our system," Rockers said.

Reach Karen Shideler at 316-268-6674 or kshideler@wichitaeagle.com.