Published: November 09, 2008 12:08 am      

Veterans clinic dealing with shortage of shingles vaccine

Martinsburg, Allegany health facilities run out of Zostavax

CUMBERLAND — Due to an increase in demand and a few other factors, there is a nationwide shortage of Zostavax, the shingles vaccine.

The Martinsburg Veterans Affair Medical Center does not have any vaccine but has put in an order to get more.

“Right now we have around 150 to 200 vials on order,” said Michael Evanko, chief of pharmacy services. “We will eventually get it all in and, as it comes in, we will notify the outpatient clinics so they can schedule appointments so veterans can receive it.”

In order to get the vaccine, veterans must make appointments with the local clinics, which then consult with Martinsburg. If the vaccine is available, veterans can make appointments to go to Martinsburg to receive it.

“They have to come to Martinsburg for two reasons,” Evanko said. “One, because the manufacturer doesn’t recommend transportation between the clinics, and two, due to the narrow storage requirements, having it stored here allows us to verify the vaccine is stored correctly.”

Evanko said he is sure veterans can go elsewhere to receive the vaccine, but does not know where or what the cost or availability would be.

One option is the Allegany County Health Department, but at this time it is also experiencing a back order.

“We are actually out of all the vaccine right now,” said Dr. Sue Raver, Allegany County health officer, “and we don’t expect to get any in until the end of the year.”

Raver said the vaccine is expensive with an up-front cost of $173. She adds that insurance companies are just getting on board for paying for the vaccination so patients need to check with them before getting it.

With the orders placed for both Allegany County Health Department and Martinsburg VA Medical Center, all that’s left to do is wait until a supply comes in. But this delay isn’t new or shocking for Evanko.

“There seems to have been a shortage from at least May or June of this year,” he said. “We’ve been having difficulties before now, but this time we got a letter from the manufacturer telling us about the problem.”

Deb Wambold, manager for global communications of Merck & Co. Inc., international developer, manufacturer and distributor of pharmaceuticals, confirmed the shortage and said the delays have been going on for a few months.

“Over the last few months we have had an increase in demand for the vaccine,” Wambold said. “We also have had some temporary limitations for the main ingredient, varicella bulk, used to make this vaccine.”

Wambold said varicella bulk is used to make three vaccines, Verivax for chicken pox, Zostavax for shingles and a combination of Verivax and MMR. She adds that Merck also had to prioritize the chicken pox vaccine.

“The CDC (Centers for Disease Control and Prevention) Advisory Committee on Immunization Practices puts forth recommendations for use of all vaccines,” Wambold said. “They just put forth a recommendation that there be a second dose of Verivax.”

She said this has greatly increased the demand for Verivax and, consequently, the need to cut down on the other two vaccines to make more of that particular one.

However, Wambold said Merck is still taking orders, they are just being put into a queue and shipped when available.

“We are continually making Zostavax, but it’s just taking time for our supply to catch up to the demand,” Wambold said. “We ship supply as it becomes available, but at this time we’re still expecting our customers to experience delays for the next couple months.”

Shingles is caused by the same virus that causes chicken pox. It stays in the body and can reappear years later to cause a case of shingles. Shingles usually starts out with a little pain or itching sensation even before the rash appears. The rash lasts a couple of weeks and can vary in pain. In some cases, the pain can continue even after the rash goes away. This is known as post-herpetic neuralgia, a long-lasting pain in the nerves.

The vaccine, licensed in 2006, is used to help prevent shingles and PHN. It is recommended for people 60 years old or older and is a one-time vaccination. Only people who have had chicken pox can get the vaccine.

For more information, log on to www.shinglesinfo.com, www.cdc.gov/nip or contact the U.S. Centers for Disease Control and Prevention at (800) 232-4636.

Tess Hill can be reached at thill@times-news.com.