In June the CDC's Advisory Committee on Immunization Practices updated their recommendations about who should receive the shingles vaccine, Zostavax. They now recommend that if you are 60 years or older, and your doctor has recommended medications that will suppress your immune system, you should speak with him or her about receiving Zostavax at least two weeks prior to starting the immuno-supressant medication. This comes at a time when Zostavax is in short supply and is on back-order from the manufacturer.
Immune-Suppressing Medications
People who have a suppressed immune system are at much higher risk of developing shingles, a very painful rash caused by a reactivation of the chicken pox virus. Types of medications that can cause immune suppression include newer therapies for psoriasis and rheumatoid arthritis, to name a few.
Why a Shortage?
Merck, the maker of Zostavax, believes that the increased awareness in the general population about the vaccine has caused an increased demand for it, according to Reuter's Health. In addition, the new guidelines cause patients and doctors to be more aware of the need for the vaccine.
How Long to Wait
According to Merck, orders that were placed before 6/17/08 have been filled. Orders placed afterward will be filled by the date they were ordered whenever a new supply becomes available. The earliest anticipated ship date for orders placed immediately after the supply ran out is 12-16 weeks.
Dr. Brannon's Recommendations
If you are considering taking medication that may suppress your immune system, and are older than 60, I would recommend calling your doctor's office to confirm that they have Zostavax in stock.
If the office is low on vaccine and they treat a large number of people with immune suppressing medication, I think it's better to save the remaining vaccine for these higher risk patients. You can always ask your doctor or the staff if there is an alternate place you can get the vaccine.
Sources:
CDC. "Prevention of Herpes Zoster - Recommendations of the Advisory Committee on Immunization Practices (ACIP)." Morbidity and Mortality Weekly Report. 57(2008): 19-20.
