By Howard Cohen

Miami Herald

Finding a place to get your first shot of the shingles vaccine, or second required dose, is getting as difficult as scoring “Hamilton” tickets.

In South Florida alone, many pharmacy outlets at chains like Publix and Walgreens have reported problems obtaining vaccines and waiting lists are growing.

The vaccine’s manufacturer, GlaxoSmithKline, acknowledged in November that “demand has exceeded supply” but that “there have been no manufacturing issues.”

The shortage problem for the Shingrix vaccine is nationwide, reports Healthline. “The shortage of Shingrix appears to be due largely to an unprecedented demand for the drug,” the health website said.

The vaccine is a two-step process: the first shot, then a second shot two to six months later. Shingrix is recommended for adults 50 and over to prevent shingles (aka herpes zoster), according to the Centers for Disease Control and Prevention.

Shingrix is more than 90 percent effective in preventing shingles, the CDC said.

Shingrix is the preferred drug to help prevent shingles, which is characterized by a painful rash and is caused by a reactivation of the varicella zoster virus _ the same virus that causes chickenpox. People who are most susceptible are those who have had chickenpox, and it’s more common in people over 50, but children can develop shingles, too.

According to the CDC, almost 1 out of 3 people in the United States will develop shingles at some point. There are an estimated 1 million cases of shingles every year in the U.S. Though there has been some difficulty obtaining Shingrix, there is no significant upshot or epidemic in cases.

Still, many people want the vaccine _ especially those who got the first dose in the summer of 2018 and are now overdue.

“Due to high levels of demand for the GSK’s Shingrix vaccine, GSK has implemented order limits and providers have experienced shipping delays,” said Kristen Nordlund, spokeswoman for the CDC.

The forecast isn’t especially glowing, either.

“It is anticipated order limits and shipping delays will continue throughout 2019,” Nordlund said.

In response, GSK increased the U.S. supply for 2018 and plans to make even more doses available in the U.S. in 2019, the CDC added. “Additionally, GSK will continue to release doses to all customer types on a consistent and predictable schedule during 2019.”

GSK spokesman Sean Clements told Healthline that the pharmaceutical company plans to ship “large volumes” of the vaccine twice monthly to providers and is “planning on bringing significantly more doses to the United States for 2019 compared to” 2018.

GSK said about 7 million doses of Shingrix were administered globally since 2017, and nearly two-thirds, or 70 percent, of the recipients completed both recommended dosages.

“Shingrix has been met by unprecedented demand by healthcare providers and patients,” Clements told Healthline. “Providers are immunizing patients at a rate several times what was previously seen for shingles. Because of this demand, patients may find their provider or pharmacy is temporarily out of stock. They should check back often or ask the pharmacy to contact them when they are restocked.”

That bit of news is welcomed by Publix. The Lakeland-based grocery store chain is a major provider of medications, including the elusive Shingrix.

Signs at many Publix pharmacies, right by the cash registers, beckon, “Beware, shingles. Beware. ... Recommended for all adults over 50. Let’s make life easy.”

But it’s not been that easy.

“Publix Pharmacy operations is distributing the vaccine to stores as soon as it’s received from the manufacturer and our pharmacy managers are calling customers on the waiting lists as the vaccine supply is received at the store,” said Nicole Krauss, Publix Super Markets’ community relations manager for the Miami division.

So what do you do while you wait?

Try to chill, health officials say. And keep tapping that Shingrix Vaccine Finder site on the internet to see when your provider received a shipment.

“You should make every effort to get the second dose of Shingrix between two and six months after you got the first dose,” the CDC’s Nordlund said.. “If your doctor or pharmacist is out of Shingrix, you can use the Vaccine Finder to help find other providers who have Shingrix. You can also contact pharmacies in your area and request to be put on a waiting list for Shingrix if they do not have the vaccine in stock.”

Though that second dose is necessary to make that first shot fully effective, don’t despair _ and don’t give up, the CDC said.

“If it’s been more than six months since you got the first dose, you should get the second dose as soon as possible,” Nordlund said. “You don’t need to restart the vaccine series.”

Publix plans to remain diligent, Krauss said.

“We continue to look to the CDC for the latest regarding dosage guidelines and encourage customers/patients to follow their recommendation,” she said. “ ... We are committed to getting the vaccine out to customers as readily as it becomes available.”

Who should get the shingles vaccine

• The Centers for Disease Control and Prevention recommends that people age 50 and older receive two doses of the Shingrix shingles vaccine. The CDC recommends the administration of two doses of Shingrix within a two- to six-month period or a single dose of Zostavax, another vaccine for shingles that has been promoted for people 60 and older. The CDC and health experts say Shingrix is preferred over Zostavax.

• People who have had an adverse reaction to a previous dose of Shingrix are advised not to get the vaccine or can consider the Zostavax vaccine, which has been approved since 2006. Shingrix was not studied on pregnant or nursing women so some healthcare providers may not recommend they get the vaccine.

Effectiveness

• According to the CDC, in adults 50 to 69 years old who received two doses, Shingrix was 97 percent effective in preventing shingles; among adults 70 years and older, Shingrix was 91 percent effective.

Shingles symptoms

• People usually have tingling, itching and pain in the area where the rash will develop one to five days before a shingles rash develops, the CDC says.

• The rash most often forms in a single vertical stripe on the right or left side of the body.

• Sometimes the rash forms on the face and can affect the eye and cause vision loss.

• Symptoms can also present themselves through an upset stomach, headache, fever and chills.

Transmission

• The shingles rash consists of blisters that typically scab over in seven to 10 days and clears up within two to four weeks, according to the CDC.

• Shingles, which some have described as “a burning sensation,” can’t be spread from one person to another, the CDC says. “However, the virus that causes shingles, the varicella zoster virus, can be spread from a person with active shingles to another person who has never had chickenpox.”

In such a case, the person “exposed to the virus might develop chickenpox, but they would not develop shingles,” the CDC says.

• The virus is spread through direct contact with fluid from the blisters but is only spread when the rash is in the blister phase. Shingles is not contagious before the blisters appear, or once the rash crusts or scabs over.

• Shingles is less contagious than chickenpox and covering the rash minimizes the risk of transmission.

Side effects of the vaccine

• Shingrix side effects can include pain, redness, and swelling at the injection site. Also, muscle pain, tiredness, headache, shivering, fever and upset stomach. Tell your healthcare provider if you are pregnant, plan to become pregnant, or are breastfeeding.

If you have shingles

• Keep the rash covered.

• Avoid touching or scratching the rash, even if tempted.

• Avoid contact with pregnant women who have never had chickenpox or the chickenpox vaccine or premature or low birth weight infants or people with weakened immune systems.

Shingrix vaccine locator

• You can type in your location and this Shingrix.Com site will advise you about the availability of the Shingrix vaccine in your area.

• Visit the Vaccine Locator: https://www.shingrix.com/shingles-vaccine-locator.html?q=33173.

But there is no guarantee that the site, updated weekly, will be accurate. Some of the listed locations may still be out of stock, so you ought to call before driving over.

• For frequently asked questions about Shingrix, visit the CDC.

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