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Shingles vaccine to cost unless you are 70

Shingles vaccine to cost unless you are 70 - Featured Image

A vaccine to prevent the painful and potential deadly shingles infection will be available to 70-year-olds free of charge from November this year.

But those in their 50s, 60s, and 80s will continue to have to fork out $200 or more for a dose of the Zostavax vaccine if they want to be protected from the viral infection.

The Federal Government has allocated $100 million over four years to provide the vaccine free through the National Immunisation Program (NIP), and expects around 240,000 people to be immunised each year.

It is also funding as five-year catch up program during which Australians aged between 71 and 79 years are eligible to receive Zostavax through the NIP. Altogether, the Government expects around 1.4 million will be administered the vaccine through this initiative.

But other vulnerable groups, particularly those in their 60s, will have to make their own arrangements if they want to be protected from the infection, the risk and severity of which increases markedly with age.

Shingles is caused by the reactivation of the varicella-zoster virus that causes chicken pox in children. Following initial infection, the virus lies dormant in nerve roots near the spinal cord, and can reactivate at any time.

The infection often appears as a painful rash or blisters on the skin, and the associated pain can be excruciating.

In addition to the rash, in 50 per cent of cases shingles can lead to post-herpetic neuralgia, a chronic and debilitating form of neuropathic pain that can persist months or even years after the rash has healed.

Drug company bioCSL said that more than 97 per cent of Australians had developed antibodies to the varicella-zoster virus by the time they were 30 years of age, indicating almost universal potential to develop shingles among the adult population – though medical experts warn there is no way to predict who might develop shingles, or when.

Zostavax is approved for the prevention of shingles in those aged 50 years or older, and for the over 60s is also indicated as a protection against post-herpetic neuralgia and as a treatment to reduce acute and chronic zoster-associated pain.

But even though shingles is recognised as a risk for those 50 years and older, the medicines watchdog has resisted calls for Zostavax to be subsidised for those aged 50 to 69 years because of the vaccine’s limited longevity and doubts about the cost effectiveness of the measure.

Research indicates the vaccine is only effective for around 10 to 12 years, meaning that a typical 50-year-old receiving it would need at least two, and possibly three or more boosters to maintain protection.

Even though prevalence increases with age, from around 2 infection per 1000-person years in the under 50s to 5 per 100 person-years among those in their 50s, to 7 per 1000 among those in their 60s, and 10 per 1000 in 70-year-olds, an evaluation by the US Centers for Disease Control and Prevention found that Zostavax was not cost effective for those in their 50s.

It calculated that for every 1000 people receiving the vaccine at age 50, only 25 shingles cases and one case of shingles-related pain would be prevented.

Australia’s Therapeutic Goods Administration has done significant work evaluating the veracity of drug company claims about the longevity and effectiveness of the vaccine, and in 2014 advised against subsidising Zostavax for 60-year-olds because of “unacceptable assumptions” in the economic case for the proposal.

Adrian Rollins