Latest news with #Zostavax
Gulf Today
a day ago
- Health
- Gulf Today
Many older people are really eager to be vaccinated
Paula Span, Tribune News Service Kim Beckham, an insurance agent in Victoria, Texas, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out-of-pocket. Her doctor and several pharmacies turned her down because she was below the recommended age at the time, which was 60. So, in 2016, she celebrated her 60th birthday at her local CVS. 'I was there when they opened,' Beckham recalled. After getting her Zostavax shot, she said, 'I felt really relieved.' She has since received the newer, more effective shingles vaccine, as well as a pneumonia shot, an RSV vaccine to guard against respiratory syncytial virus, annual flu shots and all recommended COVID-19 vaccinations. Some older people are really eager to be vaccinated. Robin Wolaner, 71, a retired publisher in Sausalito, California, has been known to badger friends who delay getting recommended shots, sending them relevant medical studies. 'I'm sort of hectoring,' she acknowledged. Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, sought an additional MMR shot, though she was vaccinated against measles, mumps, and rubella as a child, in case her immunity to measles had waned. For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody foresaw. The new studies are coming at a fraught political moment. The nation's health secretary, Robert F. Kennedy Jr., has long disparaged certain vaccines, calling them unsafe and saying that the government officials who regulate them are compromised and corrupt. On June 9, Kennedy fired a panel of scientific advisers to the Centers for Disease Control and Prevention, and later replaced them with some who have been skeptical of vaccines. But so far, Kennedy has not tried to curb access to the shots for older Americans. The evidence that vaccines are beneficial remains overwhelming. The phrase 'Vaccines are not just for kids anymore' has become a favorite for William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center. 'The population over 65, which often suffers the worst impact of respiratory viruses and others, now has the benefit of vaccines that can prevent much of that serious illness,' he said. Take influenza, which annually sends from 140,000 to 710,000 people to hospitals, most of them seniors, and is fatal to 10% of hospitalized older adults. For about 15 years, the CDC has approved several enhanced flu vaccines for people 65 and older. More effective than the standard formulation, they either contain higher levels of the antigen that builds protection against the virus or incorporate an adjuvant that creates a stronger immune response. Or they're recombinant vaccines, developed through a different method, with higher antigen levels. In a meta-analysis in the Journal of the American Geriatrics Society, 'all the enhanced vaccine products were superior to the standard dose for preventing hospitalisations,' said Rebecca Morgan, a health research methodologist at Case Western Reserve University and an author of the study. Compared with the standard flu shot, the enhanced vaccines reduced the risk of hospitalization from the flu in older adults, by at least 11% and up to 18%. The CDC advises adults 65 and older to receive the enhanced vaccines, as many already do. More good news: Vaccines to prevent respiratory syncytial virus in people 60 and older are performing admirably. RSV is the most common cause of hospitalization for infants, and it also poses significant risks to older people. 'Season in and season out,' Schaffner said, 'it produces outbreaks of serious respiratory illness that rivals influenza.' Because the FDA first approved an RSV vaccine in 2023, the 2023-24 season provided 'the first opportunity to see it in a real-world context,' said Pauline Terebuh, an epidemiologist at Case Western Reserve School of Medicine and an author of a recent study in the journal JAMA Network Open. In analysing electronic health records for almost 800,000 patients, the researchers found the vaccines to be 75% effective against acute infection, meaning illness that was serious enough to send a patient to a health care provider. The vaccines were 75% effective in preventing emergency room or urgent care visits, and 75% effective against hospitalisation, both among those ages 60 to 74 and those older. Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it, Terebuh said. As for adverse effects, the study found a very low risk for Guillain-Barré syndrome, a rare condition that causes muscle weakness and that typically follows an infection, in about 11 cases per 1 million doses of vaccine. That, she said, 'shouldn't dissuade people.' The CDC now recommends RSV vaccination for people 75 and older, and for those 60 to 74 if they're at higher risk of severe illness (from, say, heart disease). As data from the 2024-25 season becomes available, researchers hope to determine whether the vaccine will remain a one-and-done, or whether immunity will require repeated vaccination. People 65 and up express the greatest confidence in vaccine safety of any adult group, a KFF survey found in April. More than 80% said they were 'very 'or 'somewhat confident' about MMR, shingles, pneumonia, and flu shots. Although the COVID vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety. Even skeptics might become excited about one possible benefit of the shingles vaccine: This spring, Stanford researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20%, a finding that made headlines. Biases often undermine observational studies that compare vaccinated with unvaccinated groups. 'People who are healthier and more health-motivated are the ones who get vaccinated,' said Pascal Geldsetzer, an epidemiologist at the Knight Initiative for Brain Resilience at Stanford and lead author of the study. 'It's hard to know whether this is cause and effect,' he said, 'or whether they're less likely to develop dementia anyway.' So the Stanford team took advantage of a 'natural experiment' when the first shingles vaccine, Zostavax, was introduced in Wales. Health officials set a strict age cutoff: People who turned 80 on or before Sept. 1, 2013, weren't eligible for vaccination, but those even slightly younger were eligible. In the sample of nearly 300,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did. 'Just as in a randomized trial, these comparison groups should be similar in every way,' Geldsetzer explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes 'more powerful and convincing evidence,' he said. The team also found reduced rates of dementia after shingles vaccines were introduced in Australia and other countries. 'We keep seeing this in one dataset after another,' Geldsetzer said. In the United States, where a more potent vaccine, Shingrix, became available in 2017 and supplanted Zostavax, Oxford investigators found an even stronger effect.
Daily Maverick
30-05-2025
- Health
- Daily Maverick
Understanding shingles: Risks, vaccination gaps, and the quest for better health solutions
The only shingles vaccine on the market in South Africa was discontinued in 2024. A newer and better vaccine is being used in some other countries, but has not yet been registered in South Africa, though it can be obtained by those with money who are willing to jump through some hoops. Shingles is a common and painful condition that mostly affects the elderly and people with weakened immune systems. It generally appears with a telltale red rash and cluster of red blisters on one side of the body, often in a band-like pattern. 'Shingles is pretty awful to get – it's extremely painful, and some people can get strokes, vision loss, deafness and other horrible manifestations as complications,' said infectious disease specialist, Professor Jeremy Nel. 'Shingles really is something to avoid, if at all possible.' One way to prevent the viral infection is to get vaccinated. But while two vaccines against shingles have been developed and broadly used in the developed world, neither is available in South Africa. Two vaccines Zostavax, from the pharmaceutical company MSD, was the first vaccine introduced to prevent shingles. It was approved for use in the US in 2006 and in South Africa in 2011. It is 51% effective against shingles in adults over 60. A more effective vaccine, Shingrix, which is more than 90% effective in preventing shingles, was introduced by GlaxoSmithKline (GSK) in the US in 2016. It is not yet authorised for use in South Africa, but GSK has submitted paperwork for approval with the South African Health Products Regulatory Authority (Sahpra), said company spokesperson Kamil Saytkulov. The superior protection offered by Shingrix compared with Zostavax quickly made it the dominant shingles vaccine on the market. As a result, MSD discontinued the production and marketing of Zostavax. MSD spokesperson Cheryl Reddy said Zostavax was discontinued globally in March 2024. Before then, the vaccine was sold in South Africa's private healthcare system for about R2,300, but it was never widely available in government clinics or hospitals. No registered and available vaccine Since Zostavax has been discontinued and Shingrix remains unregistered, the only way to access a vaccine against shingles in South Africa is by going through the onerous process of applying to Sahpra for a Section 21 authorisation – a legal mechanism that allows the importation of unregistered medicines when there is an unmet medical need. 'Access will only be available to those who are able to get Section 21 approval' and 'this is a costly and time-consuming process, requiring motivation by a doctor,' said Dr Leon Geffen, director of the Samson Institute for Ageing Research. The cost of the two-dose Shingrix vaccine imported through Section 21 authorisations is currently about R15,600, said Dr Albie de Frey, CEO of the Travel Doctor Corporate. People who seek Section 21 authorisation typically have to pay for this out of their own pockets. 'Shingrix is not covered [by Discovery Health] as it is unregistered in South Africa and is therefore considered to be a General Scheme Exclusion,' Dr Noluthando Nematswerani, chief clinical officer at Discovery Health, told Spotlight. The Department of Health did not respond to queries about whether Section 21 processes are being pursued for priority patients in the public sector or whether there has been any engagement with GSK on the price of this product. People who receive organ transplants, for example, should be prioritised to receive the shingles vaccine since the medications they are given to suppress their immune system puts them at high risk of developing shingles. Why is the price of Shingrix so high? Unlike South Africa, where companies must sell pharmaceutical products at a single, transparent price in the private sector, the US has no such requirement. Even so, the US Centers for Disease Control and Prevention (CDC) pays $250 (R4,600) for the two-dose Shingrix vaccine through CDC contracts. This is less than a third of the charge when Shingrix is imported to South Africa. Equity Pharmaceuticals, based in Centurion, Gauteng, is importing GSK's Shingrix for patients who receive Section 21 authorisations to use the unregistered vaccine. It is unclear what price Equity Pharmaceuticals is paying GSK for Shingrix to be imported under Section 21 approvals, or what its mark-up on the medicine is. Asked about the price of Shingrix in South Africa, Saytkulov told Spotlight: 'Equity Pharmaceuticals is not affiliated with GSK, nor is it a business partner or agent of GSK. Therefore we cannot provide any comments with regards to pricing of a non-licensed product, which has been authorised for importation through Section 21.' Equity Pharmaceuticals also said it was difficult to comment on the price. 'The price of a Section 21 product depends on a number of fair considerations, including the forex rate, the quantity, transportation requirements, and the country of importation. Once the price and lead time are defined for an order, the information is shared with the healthcare provider to discuss with their patient and the medical aid,' the company's spokesperson, Carel Bouwer, said. Nematswerani pointed out that 'Section 21 pricing is not regulated' and that the price can change due to many factors including supplier costs, product availability and inflation. What causes shingles? Shingles is caused by the same highly infectious virus that causes chickenpox. Most people are infected with the varicella-zoster virus (VZV) during childhood. Chickenpox occurs when a person is first infected by VZV. When a person recovers from chickenpox, the VZV virus remains dormant in their body but can reactivate later in life as the immune system weakens. This secondary infection that occurs, typically in old age when the dormant virus reactivates, is called shingles. People who were naturally infected with chickenpox, as well as those vaccinated against chickenpox with a vaccine containing a weakened form of the VZV virus, can get shingles later in life. But, people who were vaccinated against chickenpox have a significantly lower risk of developing shingles later in life compared with those who naturally contracted chickenpox, according to the World Health Organization (WHO). The chickenpox vaccine is available in South Africa's private sector but is not provided in the public sector as part of the government's expanded programme on immunisation. Chickenpox is usually mild in most children, but those with weakened immune systems at risk of severe or complicated chickenpox should be vaccinated against it, said Professor James Nuttall, a paediatric infectious diseases sub-specialist at the Red Cross War Memorial Children's Hospital and the University of Cape Town. Who should be vaccinated against shingles? South Africa does not have guidelines for who should receive the shingles vaccine and when. The US CDC recommends that all adults older than 50 receive the two-dose Shingrix vaccine. It also recommends that people whose immune systems can't defend their body as effectively as they should, like those living with HIV, should get the vaccine starting from age 19. While Shingrix works better than Zostavax at preventing shingles, it has other advantages that make it a safer and better option for people with weak immune systems. The Zostavax vaccine contains a weakened live form of the VZV virus and thus poses a risk of complications in people with severely weakened immune systems. 'In the profoundly immunosuppressed, the immune system might not control the replication of this weakened virus,' explained Nel. The Shingrix vaccine does not contain any live virus and therefore does not present this risk. In March 2025, the WHO recommended that countries where shingles is an important public health problem consider the two-dose shingles vaccine for older adults and people with chronic conditions. '[T]he vaccine is highly effective and licensed for adults aged 50 and older, even if they've had shingles before,' according to the WHO. It advised countries to weigh up how much the vaccine costs with the benefits before deciding to use it. The cost of not vaccinating against shingles The cost of not vaccinating against shingles is high for people who develop the condition, as well as the health system. '[T]he risk of getting shingles in your lifetime is about 20 to 30%… by the age of 80 years, the prevalence is almost 50%,' said Geffen. 'Shingles is often a painful, debilitating condition, with significant morbidity. It can result in chronic debilitating pain which affects sleep, mood and overall function,' he added. Beyond preventing shingles and its complications, new evidence suggests that getting the vaccine may also reduce the risk of developing dementia and heart disease. In April, a large Welsh study published in Nature reported that people who received the Zostavax vaccine against shingles were 20% less likely to develop dementia seven years after receiving it compared with those who were not vaccinated. In May, a South Korean study published in the European Heart Journal reported that people vaccinated against shingles had a 23% lower risk of cardiovascular events, such as stroke or heart disease, for up to eight years after vaccination. DM
TimesLIVE
27-05-2025
- Health
- TimesLIVE
Why most people in SA can't get the shingles vaccine
The only shingles vaccine on the market in SA was discontinued last year. A newer and better vaccine is being used in some countries, but has not yet been registered in SA, though it can be obtained by those with money who are willing to jump through hoops. Shingles is a common and painful condition that mostly affects the elderly and people with weakened immune systems. It generally appears with a telltale red rash and cluster of red blisters on one side of the body, often in a band-like pattern. 'Shingles is pretty awful to get. It's extremely painful, and some people can suffer strokes, vision loss, deafness and other horrible manifestations as complications,' said infectious disease specialist Prof Jeremy Nel. 'Shingles is something to avoid, if at all possible,' he said. One way to prevent the viral infection is by getting vaccinated against it. However, while two vaccines against shingles have been developed and broadly used in the developed world, neither of these are available in SA. Zostavax, from the pharmaceutical company MSD, was the first vaccine introduced to prevent shingles. It was approved for use in the US in 2006 and in SA in 2011. It is 51% effective against shingles in adults over 60. Shingrix is not covered [by Discovery Health] as it is unregistered in SA and is therefore considered to be a general scheme exclusion Dr Noluthando Nematswerani, chief clinical officer at Discovery Health A more effective vaccine, Shingrix, which is more than 90% effective in preventing shingles, was introduced by GlaxoSmithKline (GSK) in the US in 2016. It is not yet authorised for use in SA, but GSK has submitted paperwork for approval with the SA Health Products Regulatory Authority (Sahpra), said company spokesperson Kamil Saytkulov. The superior protection offered by Shingrix compared to Zostavax quickly made it the dominant shingles vaccine on the market. As a result, MSD discontinued the production and marketing of Zostavax. MSD spokesperson Cheryl Reddy said Zostavax was discontinued globally in March 2024. Before then, the vaccine was sold in the private healthcare system for about R2,300, but it was never widely available in government clinics and hospitals. No registered and available vaccine Since Zostavax has been discontinued and Shingrix remains unregistered, the only way to access a vaccine against shingles is by going through the onerous process of applying to Sahpra for a section 21 authorisation, a legal mechanism that allows the importation of unregistered medicines when there is an unmet medical need. 'Access will only be available to those who are able to get section 21 approval' and 'this is a costly and time-consuming process requiring motivation by a doctor,' said Dr Leon Geffen, director of the Samson Institute For Ageing Research. The cost of the two-dose Shingrix vaccine imported through section 21 authorisation is about R15,600, said Dr Albie de Frey, CEO of the Travel Doctor Corporation. People who do go through the effort of getting section 21 authorisation typically have to pay the price themselves. 'Shingrix is not covered [by Discovery Health] as it is unregistered in SA and is therefore considered to be a general scheme exclusion,' Dr Noluthando Nematswerani, chief clinical officer at Discovery Health, told Spotlight. The department of health did not respond to queries regarding whether section 21 processes are being pursued for priority patients in the public sector or whether there has been any engagement with GSK regarding the price of the product. People who receive organ transplants, for example, should be prioritised to receive the shingles vaccine as the medications they are given to suppress their immune systems puts them at high risk of developing shingles. Unlike SA, where companies must sell pharmaceutical products at a single, transparent price in the private sector, the US has no such requirement. Even so, the US Centers for Disease Control and Prevention (CDC) pays $250 (R4,473) for the two-dose Shingrix vaccine through CDC contracts. This is less than a third of the price charged when Shingrix is imported into SA. Equity Pharmaceuticals, based in Centurion in Gauteng, is importing GSK's Shingrix for patients who receive section 21 authorisations to use the unregistered vaccine. It is unclear what price Equity Pharmaceuticals is paying GSK for Shingrix to be imported under section 21 approvals, or what is Equity Pharmaceuticals' mark up on the medicine. When asked about the price of Shingrix, Saytkulov said: 'Equity Pharmaceuticals is not affiliated with GSK nor is it a business partner or agent of GSK. Therefore, we cannot provide any comments with regards to pricing of a non-licensed product which has been authorised for importation through section 21.' Equity Pharmaceuticals also said it was difficult to comment on the price. 'The price of a section 21 product depends on a number of fair considerations, including the forex rate, the quantity, transportation requirements and country of importation. Once the price and lead time are defined for an order, the information is shared with the healthcare provider to discuss with their patient and the medical aid,' the company's spokesperson Carel Bouwer told Spotlight. Nematswerani said 'section 21 pricing is not regulated' and prices can change due to many factors including supplier costs, product availability and inflation. Shingles is caused by the same highly infectious virus that causes chickenpox. Most people are infected with the varicella-zoster virus (VZV) during childhood. Chickenpox occurs when a person is first infected by VZV. When a person recovers from chickenpox, the VZV virus remains dormant in their body but can reactivate later in life as one's immune system weakens. The secondary infection that occurs, typically in old age when the dormant virus reactivates, is called shingles. People who were naturally infected with chickenpox, and those vaccinated against chickenpox with a vaccine containing a weakened form of the VZV virus, can get shingles later in life. However, people who were vaccinated against chickenpox have a significantly lower risk of developing shingles later in life compared to those who naturally contracted chickenpox, according to the World Health Organization (WHO). The chickenpox vaccine is available in the private sector but is not provided in the public sector as part of government's expanded programme on immunisation. Chickenpox is usually mild in most children, but those with weakened immune systems at risk of severe or complicated chickenpox should be vaccinated against it, said Prof James Nuttall, a paediatric infectious diseases sub-specialist at the Red Cross War Memorial Children's Hospital and the University of Cape Town. Who should be vaccinated against shingles? SA does not have guidelines regarding who should receive the shingles vaccine and when they should receive it. The US CDC recommends all adults older than 50 receive the two-dose Shingrix vaccine. They also recommend people whose immune systems can't defend their body as effectively as it should, such as those living with HIV, should get the vaccine starting from age 19. While Shingrix works better than Zostavax to prevent shingles, it has other advantages that make it a safer and better option for people with weak immune systems. The Zostavax vaccine contains a weakened live form of the VZV virus and thus poses a risk of complications in people with severely weakened immune systems. 'In the profoundly immunosuppressed, the immune system might not control the replication of the weakened virus,' explained Nel. The Shingrix vaccine does not contain any live virus and therefore does not present the risk. In March this year, the WHO recommended countries where shingles is an important public health problem consider the two-dose shingles vaccine for older adults and people with chronic conditions. 'The vaccine is highly effective and licensed for adults age 50 years and older, even if they've had shingles before,' according to the WHO. It advised countries to look at how much the vaccine costs compared to the benefits before deciding to use it. The cost of not vaccinating against shingles is high for people who develop the condition, and the health system. 'The risk of getting shingles in your lifetime is about 20 to 30%. By the age of 80 years the prevalence is almost 50%,' said Geffen. 'Shingles is often a painful debilitating condition, with significant morbidity. It can result in chronic debilitating pain which affects sleep, mood and overall function,' he said. Beyond preventing shingles and its complications, new evidence suggests getting the shingles vaccine may also reduce one's risk of developing dementia and heart disease. In April, a large Welsh study published in Nature reported people who got the Zostavax vaccine against shingles were 20% less likely to develop dementia seven years after receiving the vaccine compared to those who were not vaccinated. In May, a South Korean study published in the European Heart Journal reported people vaccinated against shingles had a 23% lower risk of cardiovascular events, such as strokes and heart disease, for up to eight years after vaccination.
Eyewitness News
27-05-2025
- Health
- Eyewitness News
Why most people in South Africa can't get the shingles vaccine
The only shingles vaccine on the market in South Africa was discontinued last year. A newer and better vaccine is being used in some other countries, but has not yet been registered in South Africa, though it can be obtained by those with money who are willing to jump through some hoops. Shingles is a common and painful condition that mostly affects the elderly and people with weakened immune systems. It generally appears with a telltale red rash and cluster of red blisters on one side of one's body, often in a band-like pattern. 'Shingles is pretty awful to get – it's extremely painful, and some people can get strokes, vision loss, deafness and other horrible manifestations as complications,' said infectious disease specialist Professor Jeremy Nel. 'Shingles really is something to avoid, if at all possible,' he added. One way to prevent the viral infection, is by getting vaccinated against it. But while two vaccines against shingles have been developed and broadly used in the developed world, neither of these are currently available in South Africa. TWO VACCINES Zostavax, from the pharmaceutical company MSD, was the first vaccine introduced to prevent shingles. It was approved for use in the United States in 2006 and in South Africa in 2011. It is 51% effective against shingles in adults over 60. A more effective vaccine, Shingrix, that is over 90% effective in preventing shingles was introduced by GlaxoSmithKline (GSK) in the United States in 2016. It is not yet authorised for use in South Africa, but GSK has submitted paperwork for approval with the South African Health Products Regulatory Authority (SAHPRA), said the company spokesperson, Kamil Saytkulov. The superior protection offered by Shingrix compared to Zostavax quickly made it the dominant shingles vaccine on the market. As a result, MSD discontinued the production and marketing of Zostavax. MSD spokesperson Cheryl Reddy said Zostavax was discontinued globally in March 2024. Before then, the vaccine was sold in South Africa's private healthcare system for about R2,300, but it was never widely available in government clinics or hospitals. NO REGISTERED AND AVAILABLE VACCINE Since Zostavax has been discontinued and Shingrix remains unregistered, the only way to access a vaccine against shingles in South Africa is by going through the onerous process of applying to SAHPRA for a Section 21 authorisation – a legal mechanism that allows the importation of unregistered medicines when there is an unmet medical need. The cost of the two-dose Shingrix vaccine imported through Section 21 authorisations is currently around R15,600, said Dr Albie de Frey, CEO of the Travel Doctor Corporation. People who do go through the effort of getting Section 21 authorisation typically have to pay this price out of their own pockets. 'Shingrix is not covered [by Discovery Health] as it is unregistered in South Africa and is therefore considered to be a General Scheme Exclusion,' Dr Noluthando Nematswerani, Chief Clinical Officer at Discovery Health, told Spotlight. The Department of Health did not respond to queries regarding whether Section 21 processes are being pursued for priority patients in the public sector or whether there has been any engagement with GSK regarding the price of this product. People who receive organ transplants, for example, should be prioritised to receive the shingles vaccine, as the medications they are given to suppress their immune system put them at a high risk of developing shingles. WHY IS THE PRICE OF SHINGRIX SO HIGH? Unlike South Africa, where companies must sell pharmaceutical products at a single, transparent price in the private sector, the United States has no such requirement. Even so, the US Centers for Disease Control and Prevention (CDC) pays $250 or R4,600 for the two-dose Shingrix vaccine through CDC contracts. This is less than a third of the price charged when Shingrix is imported into South Africa. Equity Pharmaceuticals, based in Centurion in Gauteng, is importing GSK's Shingrix for patients that receive Section 21 authorisations to use the unregistered vaccine. It is unclear what price Equity Pharmaceuticals is paying GSK for Shingrix to be imported into South Africa under Section 21 approvals, or what Equity Pharmaceuticals' mark up on the medicine is. When asked about the price of Shingrix in South Africa, Saytkulov told Spotlight: 'Equity Pharmaceuticals is not affiliated with GSK nor is it a business partner or agent of GSK. Therefore, we cannot provide any comments with regards to pricing of a non-licensed product, which has been authorised for importation through Section 21.' Equity Pharmaceuticals also said it was difficult to comment on the price. 'The price of a Section 21 product depends on several fair considerations, including the forex rate, the quantity, transportation requirements, and the country of importation. Once the price and lead time are defined for an order, the information is shared with the healthcare provider to discuss with their patient and the medical aid,' the company's spokesperson, Carel Bouwer, told Spotlight . Nematswerani pointed out that 'Section 21 pricing is not regulated' and that price can change due to many factors, including supplier costs, product availability, and inflation. WHAT CAUSES SHINGLES? Shingles is caused by the same highly infectious virus that causes chickenpox. Most people are infected with the varicella-zoster virus (VZV) during childhood. Chickenpox occurs when a person is first infected by VZV. When a person recovers from chickenpox, the VZV virus remains dormant in their body but can reactivate later in life as one's immune system weakens. This secondary infection that occurs, typically in old age when the dormant virus reactivates, is called shingles. People who were naturally infected with chickenpox, as well as those vaccinated against chickenpox with a vaccine containing a weakened form of the VZV virus, can get shingles later in life. But, people who were vaccinated against chickenpox have a significantly lower risk of developing shingles later in life compared to those who naturally contracted chickenpox, according to the World Health Organization (WHO). The chickenpox vaccine is available in South Africa's private sector but is not provided in the public sector as part of government's expanded programme on immunisation. Chickenpox is usually mild in most children, but those with weakened immune systems at risk of severe or complicated chickenpox should be vaccinated against it, said Professor James Nuttall, a paediatric infectious diseases sub-specialist at the Red Cross War Memorial Children's Hospital and the University of Cape Town. WHO SHOULD BE VACCINATED AGAINST SHINGLES? South Africa does not have guidelines regarding who should receive the shingles vaccine and when they should receive it. The US CDC recommends that all adults over 50 receive the two-dose Shingrix vaccine. They also recommend that people whose immune systems can't defend their body as effectively as it should, like those living with HIV, should get the vaccine starting from age 19. While Shingrix works better than Zostavax at preventing shingles, it has other advantages that make it a safer and better option for people with weak immune systems. The Zostavax vaccine contains a weakened live form of the VZV virus and thus poses a risk of complications in people with severely weakened immune systems. 'In the profoundly immunosuppressed, the immune system might not control the replication of this weakened virus,' explained Nel. The Shingrix vaccine does not contain any live virus and therefore does not present this risk. In March 2025, the WHO recommended that countries where shingles is an important public health problem consider the two-dose shingles vaccine for older adults and people with chronic conditions. '[T]he vaccine is highly effective and licensed for adults aged 50 years and older, even if they've had shingles before,' according to the WHO. It advised countries to look at how much the vaccine costs compared to the benefits before deciding to use it. THE COST OF NOT VACCINATING AGAINST SHINGLES The cost of not vaccinating against shingles is high for people who develop the condition, as well as the health system. Beyond preventing shingles and its complications, new evidence suggests that getting the shingles vaccine may also reduce one's risk of developing dementia and heart disease. In April, a large Welsh study published in Nature reported that people who got the Zostavax vaccine against shingles were 20% less likely to develop dementia seven years after receiving the vaccine compared to those who were not vaccinated. In May, a South Korean study published in the European Heart Journal reported that people vaccinated against shingles had a 23% lower risk of cardiovascular events, such as stroke or heart disease, for up to eight years after vaccination.
New York Post
06-05-2025
- Health
- New York Post
This vaccine lowers risk of heart attack and stroke by 26% — so why was it discontinued in the US?
The nerve! A type of herpes virus — the varicella-zoster virus — causes chickenpox in childhood and shingles later in life. Shingles travels along nerves, triggering a distinctive blistering rash and what some have described as the worst pain they have ever experienced. Advertisement 3 Shingles infections trigger a distinctive blistering rash and intense pain. ryanking999 – A shingles infection can cause blood vessel damage, inflammation and clot formation, raising the risk of heart attack and stroke. Older adults, people with weakened immune systems and those who've had chickenpox are at higher risk of shingles. Experts say vaccination is the most effective way to reduce this risk. Advertisement Now, a new study out of South Korea reports that a certain type of vaccine can offer benefits beyond lowering the risk of shingles — but it's no longer available in the US. The live zoster vaccine, which contains a weakened version of the shingles virus, can lower the risk of heart failure, a stroke, a heart attack or death from heart disease by 26% for up to eight years, according to research published Monday in the European Heart Journal. 'Our study suggests that the shingles vaccine may help lower the risk of heart disease, even in people without known risk factors,' said Dong Keon Yon from the Kyung Hee University College of Medicine in Seoul. 'This means that vaccination could offer health benefits beyond preventing shingles.' Advertisement 3 Experts say vaccination is the most effective way to reduce the risk of developing shingles. Getty Images South Korea offers two live zoster vaccines — SkyZoster was approved in 2017 and Zostavax in 2009. The US allowed Zostavax until 2020. Advertisement Researchers found that its effectiveness waned over time and it didn't protect everyone, such as people over 80 and those with weakened immune systems. Studies suggested that Zostavax was 67% effective in the first year but only 50% effective in year 2. It was replaced by Shingrix, a recombinant vaccine that uses a protein from the varicella-zoster virus to activate the body's immune system to recognize and fight the virus. Shingrix has been found to be over 90% effective in preventing shingles. 3 Shingles is most common in older adults, people with weakened immune systems and those who've had chickenpox. Suriyawut – The Centers for Disease Control and Prevention recommends that healthy adults 50 and older and immunocompromised adults 19 and older get two doses of Shingrix. Yon's team said more research on the recombinant vaccine is needed to see if it can provide similar cardio benefits as the live zoster vaccine. South Korea also offers Shingrix. Yon's study included data from over 1.2 million adults 50 and over in South Korea. Advertisement The protective effect was strongest in the two to three years after vaccination and especially pronounced in men, people younger than 60 and those who smoke, drink alcohol or avoid exercise. 'This is one of the largest and most comprehensive studies following a healthy general population over a period of up to 12 years,' Yon said. 'For the first time, this has allowed us to examine the association between shingles vaccination and 18 different types of cardiovascular disease,' he added. 'We were able to account for various other health conditions, lifestyle factors and socioeconomic status, making our findings more robust.' Yon noted that the study does not establish a direct causal relationship between the vaccine and the lower risk of heart problems, so underlying factors should be considered.
