"The Medicare Part D partnership is with pharmacies, not physicians, so if people get the vaccine at a pharmacy, it's relatively seamless," Harpaz explains. "But if they want to do it at their physician's office, they either have to pay full cost and then file to get reimbursed, or the physician sends them to the pharmacy to get the vaccine and bring it back, to which the CDC is very opposed" because the vaccine must remain frozen.
Finally, not many older adults and their doctors even know about the vaccine. Unlike the publicity surrounding the flu vaccine, the shingles vaccine has had a much lower public profile.
"The fact that it's not been marketed is directly tied to the supply shortage. They don't want to overpromise and get people angry," says Harpaz.
A person's lifetime risk of getting shingles is about 30 percent, and those odds increase with age, say researchers. "The risk of getting shingles by age 85 can be 50 percent," says the study's lead author, Hung-Fu Tseng, a research scientist with Kaiser Permanente.
A 2005 shingles study found the vaccine to be less effective in those 79 and older, but the new study found that it lowered the risk of shingles in patients of all ages including the oldest population, Tseng wrote. Because shingles tends to be more debilitating for those in their 80s, it makes plenty of sense to give the vaccine to the oldest seniors, adds Harpaz.
There's also another reason for seniors to get the vaccine, he says. Older adults who got shingles even after getting the vaccine experienced milder symptoms and a shorter period of pain. The vaccine also reduced the risk of hospitalization and more severe complications.
The benefits are clear, he says. Now, if only the vaccine were actually available.
Update: Rite Aid has announced that nearly 1,900 of its pharmacies have the shingles vaccine in stock. To find a Rite Aid location near you, go to www.riteaid.com/shingles and enter your zip code. Patients should call first to see if appointments are necessary and for the cost, which varies with insurance coverage. Rite Aid pharmacists can administer the vaccine in 27 of the 31 states where the pharmacies are located; in Massachusetts, New Hampshire, New York and West Virginia, state regulations require the pharmacy to hold scheduled clinics.
Candy Sagon writes about nutrition and health for the AARP Bulletin.