Shingles vaccination levels fall short of expectations

Five years ago, Merck gained FDA approval for its shingles prevention vaccine Zostavax. The agency recently expanded that approval to adults 50 years and older. Yet vaccination rates remain low due to chronic vaccine shortages, difficulties with cold storage and the relatively high cost of the vaccine.

Just 10% of adults 60 years and older got the shot in 2009, according to a federal survey. Over the same period, about two-thirds of older adults received the flu shot. Part of the problem stems from Merck's struggle to provide enough of the vaccine to meet demand. "It really, really has been frustrating," said CDC epidemiologist Dr. Rafael Harpaz tells The New York Times. "There hasn't been a single year since the vaccine was licensed in 2006 that there's been no problem with supply."

Although the FDA recently expanded Zostavax's approval to adults 50 years and over, the CDC declined to recommend the shot for that age group, noting it might be best to keep the focus on adults 60 and above due to vaccine shortages. Merck is building a $1 billion vaccine facility in Durham, NC, to address this need, but it won't be operational until 2013.

Zostavax also has to be shipped and stored frozen, but many primary care physicians don't have freezers in their offices. So patients sometimes rely on pharmacies to provide the shots. Those who are able to get the injection in-office may have to pay out-of-pocket for the $160 vaccine--an expense older adults on a fixed income may not be able to afford. Zostavax's market penetration will remain low until Merck can address some of the barriers standing in the way of its success.

- read the New York Times piece

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