Courtesy of Minding Our Elders

Dear Carol: Why is there so little information about, and emphasis on, the shingles vaccine? When I asked my doctor about it, she said that it’s expensive, most insurance companies don’t pay for it, and Medicare doesn’t cover it. I then asked her if it cost more than $1,000. She said, "No, $200." I said, "I want the shot!" So I prepaid the $200 and received the immunization, then my insurance paid. If I had known about this vaccine, I would have had it given to my mother who is now suffering terribly from shingles. I’m at a loss to explain this doctor’s attitude, but to be fair to her I just don’t hear much about the vaccine. What gives? - Jeremy

Dear Jeremy: A friend of mine turned 60 just after the vaccine came out. Since age 60 is the recommended time to get the vaccine, she told the doctor she’d pay for the vaccine if necessary. In the end, her insurance company paid the full cost.

Shingles (herpes zoster) is a viral infection of the nerve roots. Shingles can affect elderly people, usually in their 50s and 60s and older. What happens is this: after we get over childhood chickenpox, the virus remains dormant in our nerve roots. In some people, it stays dormant forever. In others, the virus "wakes up" when disease, stress, or aging weakens the immune system. After the virus becomes active again, it can only cause shingles, not chickenpox.

Aside from the pain of active shingles, there are complications that can develop, and in some people, they last a long time. Called postherpetic neuralgia, complications can present as headaches and/or nerve pain that can persist from 30 days to many years, lowering the quality of life significantly.

Postherpetic neuralgia is difficult to treat; however, early treatment of shingles with antiviral medications may prevent development of postherpetic neuralgia. Once postherpetic neuralgia occurs, certain medications, such as anticonvulsants, antidepressants, and opioids, can relieve pain.

After you wrote to me, I checked the Medicare site about coverage of the vaccine. According to the information in Your Guide to Medicare Prescription Drug Coverage booklet , Medicare D covers the cost. I’d check with your individual policy to make sure.

Shingles can be very painful, as you see in your mother’s case. My friend didn’t hesitate to get the shot, and that was five years ago. I haven't read anything negative about the vaccine. I think your doctor needs to update her information. Unless there is another health issue that could be worsened by the vaccine, why shouldn’t we get it? - Carol