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Should you get the shingles vaccine?

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Should you get the shingles vaccine?

If you're 60 or older, the official recommendations say yes. But pluses and minuses make for a complicated equation.

Vaccinations aren't just kid stuff anymore, and now there's another one that older Americans are being urged to get in addition to their annual flu shot, the pneumococcal pneumonia vaccine at age 65, and a tetanus booster every 10 years. The Advisory Committee on Immunization Practices, the group that sets vaccine policy for Americans, made its official recommendation for the shingles vaccine in 2008. All Americans ages 60 or older should get the shot, the committee says, even if they've already had shingles.

The committee's recommendation of the need for the vaccine after shingles is a departure from the FDA-approved instructions for the vaccine (the package insert), which is silent on the subject. And it contradicts a question-and-answer sheet posted on the agency's Web site when the vaccine was approved, which suggests that it is unnecessary after you've had shingles because "it's unlikely that people who have had shingles will suffer from them again."

It's difficult to gauge the practical effects of the recommendations. Doctors may be more inclined to urge their patients to get the vaccine. But insurance coverage is spotty. For example, Medicare Part B, which covers flu shots and pneumococcal vaccine, doesn't cover the shingles vaccine. Pricing varies, but the total bill, including the doctor's fee, can come to several hundred dollars. And the vaccine is no guarantee: results from the Shingles Prevention Study, the 39,000-person trial that laid the groundwork for FDA approval, showed that about half the time the vaccine did not protect people against shingles, although...

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