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Kaiser Permanente Shingles Vaccine Cost

Help Your Child Handle Immunizations

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Many immunizations are given as shots . Your child may experience brief pain as the needle penetrates the skin or muscle. Some vaccines cause more discomfort than others. In general, you can help by making sure that he or she is physically comfortable and well rested before getting immunized. You can use home treatment measures to help relieve some of the common minor reactions to immunizations.

Study Population And Data

This is a prospective cohort study with continuous accrual of people as they become age eligible for zoster vaccination. The study began on January 1, 2007, and continues through 2023. Eligibility is based on US dates of approval of the vaccine for people aged 60 years and older and for people 5059 years old . To ensure accurate ascertainment of vaccination status and baseline covariates, we restrict study entry to KPNC members with continuous membership since becoming age eligible for the zoster vaccine and at least 12 months of continuous membership before study entry. We exclude individuals who had an HZ diagnosis in the year before study entry. The cohort is updated annually to include newly age-eligible KPNC members.

All members of the cohort start follow-up unvaccinated but are age eligible for vaccination. They contribute unvaccinated person-time while they remain unvaccinated if they receive the zoster vaccine, they then contribute vaccinated person-time. They contribute unvaccinated or vaccinated person-time until HZ diagnosis or follow-up is censored by disenrollment from KPNC, receipt of a second dose of zoster vaccine , death, or the end of available data .

What Matters Most To You

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to get a shingles vaccine

Reasons not to get a vaccine

I want to lower my chances of getting shingles.

I would rather take my chances without getting a vaccine.

I’m afraid of the pain that shingles can cause.

I’m not afraid of shingles pain.

Getting shots doesn’t bother me.

I don’t like getting shots.

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Should I Get The Shingles Vaccine

The CDC recommends shingles immunization for adults aged 50 and up, as well as those aged 19 and up, who have compromised immune systems as a result of disease or pharmaceutical therapy. It also recommends having the shingles vaccination if you’ve had shingles and/or chickenpox in the past, as well as if you’ve had another shingles vaccine called Zostavax, which is no longer available in the United States.

What Are Some Reasons To Get Immunized

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  • Immunizations protect you or your child from dangerous diseases.
  • They help reduce the spread of disease to others.
  • They are often needed for entrance into school or day care. And they may be needed for employment or for travel to another country.
  • Getting immunized costs less than getting treated for the diseases that the shots protect you from.
  • The risk of getting a disease is much greater than the risk of having a serious reaction to the vaccine.
  • When immunization rates drop below a certain level, preventable diseases show up again. Often, these diseases are hard to treat. For example, measles outbreaks still occur in the U.S.

If you are a woman who is planning to get pregnant, talk to your doctor about what immunizations you have had and what you may need to protect your baby. And if you live with a pregnant woman, make sure your vaccines are up-to-date.

Traveling to other countries may be another reason to get immunized. Talk with your doctor months before you leave, to see if you need any shots.

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What Are Your Chances Of Getting Shingles

Only people who have had chickenpox can get shingles.

Out of 100 people, about 30 may get shingles sometime in their lives.footnote 2 And the risk is higher for people age 50 and older. Older people are also more likely to have severe pain with shingles.

Most people who get shingles will not get it again. But some people get shingles more than once.

How Should You Treat Shingles

Antiviral medicines like acyclovir, valacyclovir, and famciclovir have been developed to reduce the length and severity of the illness. They are most effective when started soon after the shingles rash appears. Consequently, you should call your health care provider to explore treatment options as soon as you contract or believe you have contracted shingles.

Topical or oral pain medicines may help reduce the pain caused by shingles. Wet compresses, calamine lotion, and colloidal oatmeal baths may also help relieve itching.

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What Are The Symptoms Of Shingles

Shingles is a painful rash that develops on one side of the face or body. The rash forms blisters that typically scab over in 7-10 days. Shingles typically takes 2-4 weeks to clear up.

People often feel pain, itching, or tingling in the area 1-5 days before the rash appears.

Most commonly, shingles forms a single stripe of rash on either the left or right hemisphere of the body. Occasionally, the rash occurs on one side of the face. Less commonly, the rash looks similar to chickenpox and is spread more liberally . Shingles can sometimes affect the eyes and cause loss of vision.

Other symptoms of shingles can include fever, headache, chills and upset stomach.

What Are The Side Effects Of Vaccines

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Most side effects from vaccines are minor, if they occur at all. Ask your doctor or pharmacist about the reactions that could occur. They may include:

  • Redness, mild swelling, or soreness where the shot was given.
  • A slight fever.
  • Drowsiness, crankiness, and poor appetite.
  • A mild rash 7 to 14 days after chickenpox or measles-mumps-rubella shots.
  • Temporary joint pain after a measles-mumps-rubella shot.

Serious reactions, such as trouble breathing or a high fever are rare. If you or your child has an unusual reaction, call your doctor.

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What Kinds Of Vaccines Does Cvs Offer

CVS Pharmacy offers a full list of vaccines. Among the most commonly requested ones are:

  • Influenza : The flu vaccine is offered on a seasonal basis. Two different kinds are available. Four-strain flu vaccine protects against four strains of the virus for children and adults. The high-dose or senior-dose flu vaccine is for people age 65 and older.

  • Shingles: The shingles vaccine is recommended for people age 50 and older. It is given in two doses spaced 2 to 6 months apart.

  • COVID-19: The long-awaited coronavirus vaccine is finally available to all adults age 16 and older starting April 19 and earlier in many places. A vaccine for younger teens and children is expected later this year.

  • Tdap: The CDC recommends the combination tetanus, diphtheria, and pertussis vaccine for adolescents and adults every 10 years to protect against all three infections.

Each state has its own age requirements and other vaccine restrictions, so be sure to check your local stores rules before heading to CVS.

Are There Any Side Effects From The Vaccine

Common side effects from the shingles vaccine include pain, redness, soreness, or swelling at the site of the injection, or other symptoms such as headache, muscle aches, fever, shivering, fatigue. People who have one of these reactions after the first dose of vaccine can still get the second dose. Serious side effects from the shingles vaccine are rare.

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You Can Get A Shingles Vaccine Two Ways:

At the pharmacy. Youll still need a doctors prescription, but once thats been transmitted, you can get the shot at a retail pharmacy.

Most major chains and some independent pharmacies can administer the vaccine. Just make sure to use a store in your drug plans network so that it can bill your plan directly and youll owe just the copayment.

At the doctors office. If youre vaccinated in a doctors office, check whether it can bill your drug plan directly or works with a pharmacy that can do so. If so, it will work as mentioned above, with you owing a copayment. If not, you may need to pay the full cost up front and then file a claim for reimbursement from your plan.

Remember that the doctors fee for administering the vaccine may exceed your plans allowable charge, in which you case youre on the hook for the difference. It pays to check beforehand.

Editor’s note: This article was originally published on Jan. 1, 2014. It has been updated with the latest information regarding Medicare coverage in 2020.

Is The Cost Of The Vaccine Covered By Insurance

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Coverage may vary by plan. To find out if your benefit plan covers the cost of the Shingrix vaccine, refer to your coverage agreement.

Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii ⢠Kaiser Foundation Health Plan of Colorado ⢠Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 ⢠Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 ⢠Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 ⢠Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc., 1300 SW 27th St., Renton, WA 98057

Selecting these links external site icon will take you away from KP.org. Kaiser Permanente is not responsible for the content or policies of external websites. Details

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© } Kaiser Foundation Health Plan, Inc.

Importante

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Is The Shingles Vaccine Covered By Medicare And Can I Get It At Cvs

Because the shingles vaccine requires two doses, if you have to pay full price around $400 total it may approach the $445 maximum Part D deductible that Medicare allows for 2021.

If thats the case, you may want to consider getting your vaccine early in the year. This way you dont have to worry about your deductible resetting in a new plan year soon after meeting it. You should discuss the risks and benefits of this strategy with your healthcare provider.

As far as going to CVS Pharmacy or CVS in Target to get your shingles vaccine, this is definitely an option. You can always call ahead or go online to schedule same-day appointments, or go in on a walk-in basis at many locations.

Risks Of A Vaccine Reaction

  • A sore arm with mild or moderate pain is very common after recombinant shingles vaccine. Redness and swelling can also happen at the site of the injection.
  • Tiredness, muscle pain, headache, shivering, fever, stomach pain, and nausea are common after recombinant shingles vaccine.

These side effects may temporarily prevent a vaccinated person from doing regular activities. Symptoms usually go away on their own in 2 to 3 days. You should still get the second dose of recombinant shingles vaccine even if you had one of these reactions after the first dose.

Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after recombinant zoster vaccine.

People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.

As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

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How Safe Are Vaccines

False claims in the news have made some parents concerned about a link between autism and the shot for measles, mumps, and rubella. But studies have found no link between vaccines and autism.

Some parents question whether mercury-containing thimerosal might cause autism. Studies have not found a link between thimerosal-containing vaccines and autism. Today, all routine childhood vaccines made for the U.S. contain either no thimerosal or only trace amounts.

Two major government agencies, along with vaccine makers and other groups, watch for, study, and keep track of adverse events that occur after vaccines are given.

What Immunizations Are Recommended For Children And Adolescents

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Ask your doctor what shots your child should get. The immunization schedule includes vaccines for:

  • Bacterial meningitis.

Immunizations start right after birth, and many are given throughout a baby’s first 23 months. Booster shots occur throughout life.

Fewer immunizations are needed after age 6. But older children and teens need shots too . Some shots are also given during adulthood .

It is important to keep a good record, including a list of any reactions to the vaccines. When you enroll your child in day care or school, you may need to show proof of immunizations. Your child may also need the record later in life for college, employment, or travel.

Talk to your doctor if you or your child plans to be in a group living situation, like a college dormitory or summer camp. You may want certain shots, like those for meningitis.

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How To Contract The Shingles

The varicella-zoster virus reactivates in your body after you’ve had chickenpox, resulting in shingles. According to the CDC, you cannot receive shingles from someone else who has it. Chickenpox can, however, be contracted from someone who has shingles, increasing your chances of developing shingles later.

According to the National Library of Medicine, no one knows why the varicella-zoster virus suddenly becomes active again years later. According to the findings, many people who had mild cases of chickenpox are unaware they even had the virus in the first place.

How Does Your Medicare Deductible Affect Your Vaccine Costs

The deductible amount of your Medicare plan affects how much you pay out of pocket before your insurer starts contributing to the cost of your prescription drugs. Depending on how many medications you take, the deductible could affect how much you spend on the vaccine.

Below, we’ll compare how much you’d pay for the shingles vaccine on two plans with different deductibles. In this situation, the person with the MedicareRx Walgreens plan pays less overall, even though they’re paying full price for the shingles vaccine.

Scenario: Shingrix is the only medication needed during the policy

AARP MedicareRx Walgreens
Cost of two doses of Shingrix vaccine $160 each, for a total of $320, because the deductible hasn’t been met $45 copay each, for a total of $90
Total annual cost of premiums and shingles vaccine $788 $1,122

In the example above, the AARP MedicareRx Walgreens prescription drug plan has a $455 deductible for Tier 3 drugs like the shingles vaccine. That means if you haven’t already met your deductible, you would pay full price for the vaccine, which would be $320 for two doses. The plan costs $38.60 per month for someone living in Charlotte, N.C. If the shingles vaccine is the only Tier 3, 4, or 5 drug needed during the policy year, your total annual spending would be $788.

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What Are The Side Effects

The shingles vaccine, according to the CDC, can induce temporary side effects that make it difficult to accomplish ordinary tasks for two to three days.

The following are some of the possible shingles vaccine side effects:

  • Sore arm with mild to moderate pain
  • Redness and swelling at the injection site

According to the CDC, side effects are more common in younger people, and you may have a reaction to the shingles injection after both doses. It is recommended that you take over-the-counter pain medicines such as ibuprofen or acetaminophen if you experience side effects after getting the shingles vaccine.

According to the CDC, another possible side effect of the shingles vaccine is Guillain-Barré syndrome . GBS is a rare but dangerous illness in which your immune system targets the peripheral neurological system, which controls the nerves in your brain and spinal cord, according to the National Library of Medicine.

What Kind Of Insurance Does Cvs Accept For Vaccines

CVS accepts more than 5,000 health insurance plans for vaccinations. Many routine vaccinations are considered preventive care under the Affordable Care Act and must be covered with no charge to you for visits to an in-network provider.

As a result, people with private insurance often find they have zero copays for routine vaccinations at retail pharmacies. But youll want to check with your plan or ask the pharmacist to run your insurance card before you receive the vaccine to be sure.

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About The Shingles Vaccine

The Centers for Disease Control and Prevention recommends that healthy adults over the age of 50 get the shingles vaccine because it’s the only way to protect against the disease and its associated side effects. The risk of getting shingles increases as you age or if you have a weakened immune system. Always consult your doctor to find out if the shingles vaccine is right for you.

The CDC-recommended vaccine, Shingrix, is a recombinant zoster vaccine that has two doses administered within six months of each other. It’s classified as a Tier 3 drug by most insurance companies, which means it’s a brand-name pharmaceutical with a higher copayment than a Tier 1 or 2 drug.

Use the Shingrix vaccine locator to find where the shingles vaccine is being offered, and check with your Medicare Part D or Medicare Advantage provider to see which locations give you the lowest price.

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