DEAR DR. GOTT:
This letter is to inquire about the availability of the shingles vaccine, Zostavax. The most recent ladies’ magazines (i.e., Good Housekeeping and Women’s day), The Saturday Evening Post and the September issue of Johns Hopkins Newsletter advised that women over the age of 60 receive the vaccine for shingles, especially if they had chickenpox as children.

My sister and I have spent weeks trying to locate someone to administer this vaccine. Johns Hopkins advised us to check with our family doctor. He advised us to check with a dermatologist who advised us to check with our local Health Department. They then referred us to the Passport Office.

Can you unravel this mystery?

DEAR READER:
And mysterious it is. Under normal circumstances, a family physician can order the vaccine and administer it. Your doctor appears to be passing the buck unnecessarily.

Zostavax is an injection that helps prevent shingles. It is recommended for individuals 60 and older. Those with compromised immune systems or are taking medications that affect the immune system and women who are of childbearing age or are pregnant or breastfeeding should not receive the vaccination.

According to the Physicians’ Desk Reference, the vaccine should be stored frozen and reconstituted immediately before administration. If not used within 30 minutes it must be thrown away. It comes in single dose vials so there is no extra vaccine that must be given in that short time frame or wasted cost. There is no statement that says it must be administered by a specific type of medical specialist, therefore I don’t understand why your physician cannot do the job. I see no reason he cannot give the injection other than simply not wanting to hassle with the specific administration instructions (which, frankly, is not a good enough reason).

If he is worried about losing money should you fail to show for your appointment, I suggest that he order the vaccine through your local pharmacy which you can then pick up and pay for on your way to the appointment. This ensures you get the vaccine in the appropriate time frame and the physician does not lose money buying a vaccine which can easily spoil.

I have found in my own practice, this method works very well and most patients are willing to spend the money for the vaccine. If it is covered under their insurance, they can then submit the bill and be reimbursed directly from the insurance company. Medicare may not cover this expense.

I suggest you discuss this option with your family physician. If he is still unwilling, perhaps you should seek a more understanding and compromising physician. The vaccine is a good health investment and can save you both money and time. Prescription medication to treat shingles can be very expensive, not to mention that shingles can last for weeks or even months. Some individuals have permanent, painful nerve damage. Find a physician who will work with you. Good luck.