Does Medicare Cover The Shingles Vaccine
En español | Unlike some common vaccines, like those for the flu, hepatitis B and pneumonia, shingles shots are not covered under Medicare Part B, the component of original Medicare that includes doctor visits and outpatient services. Part A, which deals with hospital costs, doesnt cover shingles shots either.
Medicare coverage for Shingrix and Zostavax, the two commercially available shingles vaccines, is provided only if you are enrolled in a stand-alone Part D drug plan or a Medicare Advantage plan that includes Part D drug coverage.
Medicare requires Part D plans to cover the shingles vaccine, so if youre enrolled in Part D, you shouldnt have difficulty obtaining the shot. Most require a copayment, which can vary widely from plan to plan.
And if you havent yet met your plans deductible for the year, youll likely pay the full price. For Shingrix, the newer vaccine, that averages around $190, according to GoodRx, a website and app that tracks prescription prices.
When Should I Get The Second Dose
The CDC recommends that adults ages 50 and older get a second dose of Shingrix two to six months after their first dose. If youve waited longer than six months since your first dose of Shingrix, its safe to get a second dose right away. Most people dont need to repeat the first dose.
Some immunocompromised adults may need a second dose within one to two months. If you have a disease or are taking medication that affects your immune system, talk to your healthcare provider about the best timeline for your two doses of the shingles vaccine.
Skipping The Second Dose Of The Shingles Vaccine Might Mean You Have Less Protection Against This Painful Rash
Medically reviewed in March 2021
Shingles is a painful condition, and the effects of it can last for months or even years in some cases. Although there is no cure for shingles once you have it, there is a vaccine that prevents shingles in the first place.
The Centers for Disease Control and Prevention recommends that healthy adults over the age of 50 get the shingles vaccine. This is true even if youve had shingles in the past, or if you were previously vaccinated with the older shingles vaccine.
The shingles vaccine is administered in two separate dosesonce you receive the first dose, the second should be given 2 to 6 months later. After the second dose, the vaccine is more than 90 percent effective at preventing shingles, according to the CDC.
Why the second dose matters The shingles vaccine is designed to be given as two doses, not as one. Despite the effectiveness of the vaccine, some people skip their second dose. Some simply forget to follow up and lose track of the appointment date. Others may skip the second dose due to costdepending on your insurance plan, you may be responsible for a co-pay or deductible fee, or you may need to pay for the second dose out of pocket.
Getting the second dose gives you the full protection the vaccine offers. Below are some ways to make sure you get your second dose.
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Who Should Not Get The Shingles Vaccine
Some people shouldnt get the shingles vaccine. These people include those:
- Who currently have shingles.
- Who have had a severe allergic reaction to the shingles vaccine in the past.
- Who have tested negative for immunity to the varicella-zoster virus, meaning youve never had chickenpox. If youve never had chickenpox, you should get the chickenpox vaccine.
- Who are ill. You should wait until your illness has passed before receiving the shingles vaccine.
- Who are pregnant or breastfeeding.
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Do I Need To Pay For Shingles Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
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How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
Who Should Not Have The Shingles Vaccine
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
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When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix
Shingrix causes a strong response in your immune system, so it may produce short-term side effects. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days. You may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen. Contact your healthcare provider if the symptoms are not improving or if they are getting worse.
In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people might have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.
Know Your Risk Of Getting Shingles And Complications
About 1 out of every 3 people in the United States will develop shingles during their lifetime.
If youve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they dont remember it.
Your risk of getting shingles and having serious complications increases as you get older.
About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.
Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.
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When To See A Healthcare Provider
For most people, the effects of Shingrix are mild and short-term. In very rare cases, Shingrix can cause more serious side effects.
Seek urgent medical care if you experience signs of a severe allergic reaction a few minutes or hours after your second dose of Shingrix, such as:
- Rapid heartbeat
- Facial swelling
- Swelling in the throat or mouth
You should also let your healthcare provider know if your Shingrix side effects are severe or arent going away on their own.
Go Over Your Allergies
If you are allergic to any of the vaccines ingredientslike soap bark, neomycin, or polysorbateor had an allergic reaction to a previous dose of Shingrix, you should not get the vaccine, Dr. Friedland says. You should also talk to your doctor if you have a weakened immune system due to HIV/AIDS or another disease that affects the immune system or are on immune system-suppressing drugs or treatments like adalimumab , infliximab , or etanercept .
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Swelling Around The Injection Site
Swelling around the injection site is another common side effect of Shingrix. Like pain and redness, minor swelling can usually result from a localized immune system response, which isnt necessarily dangerous.
You can apply hydrocortisone cream on or around the injection site to reduce redness and swelling. However, if you experience severe swelling that doesnt go away, or the swelling accompanies other symptoms of an allergic reaction, seek medical attention right away.
What Else To Know About The Shingles Vaccine
Ready to get vaccinated? This is the essential info on how the shots are given, what to expect with side effects, and more.
You need two doses of Shingrix to get full protection from shingles. You should get your second dose 2 to 6 months after the first. Your doctor or pharmacist will inject the vaccine into the muscle of your upper arm, so wear clothes that give easy access to that area.
If it has been more than 6 months since you got your first dose, go ahead and get your second dose. You donât need to start over, Dooling says.
Because Shingrix is so new, experts arenât sure whether youâll eventually need another shot, or a booster, years down the road.
âThe CDC is actively following how protected people remain after the two-dose series,â she says. We know that after 4 years, protection remains above 85%. Only time will tell how durable that protection is.â
You do not have to wait between Shingrix and COVID-19 vaccination. The CDC has determined its safe to get the COVID-19 vaccine at the same time as Shingrex, but recommends they be given in different arms. You should not get eithe vaccine if you have COVID.
Side effects are fairly common. You may have heard that people sometimes have unpleasant side effects soon after they get the shingles vaccine.
âShingrix tends to have has more side effects than some vaccines, like those for the seasonal flu,â says Kistler. The shingles vaccine may cause:
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Shingles Vaccine And Insurance
Private health insurance plans often cover vaccination costs. Still, a patient might have a charge depending on the specific insurance plan.
Medicaid may or may not cover the vaccine cost.Medicare Part D plans cover the shingles vaccine, but there may be a cost to the patient depending on the plan. Usually, the fees are less than $50 per dose.
Medicare Part B does not cover the shingles vaccine.
Can You Get Them All At The Same Time Yes
If you are coming in for your third or fourth dose of the Covid-19 vaccine and haven’t had your flu or pneumonia shots yet, you can get them all at the same time.
“Get the more reactive one in one arm and the flu and pneumonia vaccines spaced an inch on the other arm,” Dr. Tan says. “Yes, both arms may hurt, but this is a small price to pay for protection against three deadly diseases,” he notes.
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On Mixing And Matching Covid
This is different from getting multiple vaccines in the same sitting.
“If you are in a location and can get your third shot or Covid-19 booster, and the type you received for your first two shots in the series is not available, it’s reasonable to receive the other type as a booster,” Dr. Sobhanie says.
This only applies to the Pfizer and Moderna mRNA Covid-19 vaccines.
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How Do You Catch Shingles
You do not “catch” shingles it comes on when there’s a reactivation of chickenpox virus that’s already in your body.
After you’ve recovered from chickenpox, the varicella-zoster virus lies dormant in your nerve cells and can reactivate at a later stage when your immune system is weakened.
Anyone who has had chickenpox can get shingles.
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Personal Stories About Considering A Shingles Vaccine
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I talked to my doctor about the shingles vaccine and I think I’m going to get it. My wife had shingles 2 years ago, and she was really in a lot of pain. If I can avoid that by getting a vaccine, it will really be worth it to me.
Abel, 65
I’m not going to get a vaccine, at least not right now. I don’t like to take medicines of any kind if I don’t have to.
Hattie, 50
Who Is At Risk For Shingles Infection
Although it can occur at any age, shingles is more common in older adults and in people with compromised immune systems. In fact, those who are immunocompromised are 1-6 times more prone to infection and have a significantly higher risk of recurrence.
Even people with normal immune systems are at greater risk as they age. Because our immune systems tend to weaken as we get older, by age 50 many people previously infected with chickenpox will have lost the specific immunity they developed after the original infection. When this happens, the virus can wake up and trigger shingles. Some experts believe that chronic stress, some medications and certain health conditions may also trigger the virus to reactivate.
In addition, people who have had COVID-19 are at increased risk. In a recent study, researchers have found that patients over 50 with a history of COVID-19 infection have a 15 percent higher risk of getting shingles, says Dr. Kumar.
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What Are The Possible Side Effects Of Shingles Immunisation
All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.
For most people, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.
Talk to your doctor about possible side effects of shingles vaccines, or if you have possible side effects that worry you.
Common side effects of shingles vaccines include:
- pain, redness, swelling or itching where the needle went in
Serious reactions to immunisation are rare. With Zostavax® vaccination, very rarely a generalised chickenpox-like rash may occur around 24 weeks after vaccination. This may be associated with fever and feeling unwell. This rash may be a sign of a serious reaction to the virus in the vaccine. Seek medical attention and inform of recent Zostavax vaccination if you experience this reaction.
The Consumer Medicine Information links in How do you get immunised against shingles? list the side effects of each vaccine.
Why Is It Important To Receive A Vaccination Against Shingles
About 33% of adults in the U.S. will develop shingles at some point in their lives. Shingles can cause painful blisters, a rash, chills, and fever, among other symptoms. Many people who have shingles later develop PHN, which can cause long-lasting pain that is difficult to treat.
Getting the Shingrix vaccine can help individuals avoid shingles and PHN and help prevent shingles from spreading to vulnerable people.
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Even In 2022 La Covid Death Rate Is Worse Than Car Crashes Heres Why
An analysis of death certificates from January to April showed COVID-19 deaths were nine times those caused by motor vehicles and more than five times the rate for flu and pneumonia.
Most people age 50 and older who got their second booster shot did so fairly quickly after federal at the end of March. According to data the CDC recently presented, many got the additional shot in April and May.
And for most individuals age 5 to 49, it has been six months or more since their last COVID-19 vaccine or booster, the CDC said in a slide presentation earlier this month.
The updated booster from Pfizer and BioNTech is available for those 12 and older, while the offering from Moderna is an option only for adults 18 and older. Children age 5 to 11 are eligible for a conventional booster shot.
Walgreens, CVS, Rite Aid and the Los Angeles County Department of Public Health have said they are administering the new Omicron booster.
But itll take some time before other providers are running at full capacity. In recent days, Kaisers Northern California system was offering limited COVID-19 booster shot appointments for late September, but many locations had no appointments available. Kaisers Southern California system said it expects the updated booster will be available at some level by next week, but that supply may be limited to start.
Weighing The Risks Vs Benefits
The vaccine to prevent shingles will help you to avoid shingles symptoms, which in most cases are quite mild but may cause intense pain in some people.
Shingles symptoms come in two stages: the prodromal stage and the eruptive stage. In the first stage, your symptoms may include:
About three to five days later, you develop a prickly and painful pimple-like rash. These pimples turn into blisters during this eruptive stage, and your skin may be red and swollen. Shingles sores also can affect your mouth, which is another symptom the vaccine can prevent.
Shingles isnt generally life-threatening. It can be, though, if your immune system is compromised. During an outbreak and after the rash clears up, some people may experience complications that require immediate medical attention.
Common ones include:
- Postherpetic neuralgia : Damaged nerves cause lingering pain for three months or more.
- Bacterial skin infections: When shingles blisters pop, bacteria can get in.
- Eye damage: One branch of the trigeminal nerve goes to the eye. Damage there can lead to eye damage, which can be severe.
While you may experience side effects with the vaccine, the benefits outweigh the risks of shingles symptoms and complications in most people.
If you were vaccinated with Zostavaxa shingles vaccine that is no longer being givenask your healthcare provider about getting the Shingrix vaccine.
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