RENEE MONTAGNE, host:
Now, we turn to a disease that can strike anybody who had chickenpox as a child, and that's almost all adults. It's called shingles, and it's caused by the chickenpox virus, which hides out in nerve cells for a lifetime. Sometimes, for reasons no one understands, it wakes up and causes a painful rash, a rash that can be bad enough to be debilitating.
There is a way to prevent shingles, though as NPR's Richard Knox reports, relatively few people have taken advantage of it.
RICHARD KNOX: When Julie Fair first got shingles, she and her doctor thought it was a pulled muscle in her back. Then three days later, an angry, red rash began to spread.
Ms. JULIE FAIR: It started in one specific spot on my back, and then wrapped around, as if a large hand were wrapping around my side.
KNOX: Soon, she was gripped by incredible pain.
Ms. FAIR: If the bedding at night moved over me, I would just scream. I mean, it was excruciating. Taking a shower was painful. Really, really the most extreme pain I've ever had.
KNOX: More than childbirth.
Ms. FAIR: Yes. More than childbirth, because it just was constant.
KNOX: It didn't go away for six months. And even today, five years later, she feels a ghost of that pain on most days.
The good news is there's a vaccine against shingles. It's been available for four years.
Dr. RAFAEL HARPAZ (Centers for Disease Control and Prevention): This vaccine can prevent life-shattering disease.
KNOX: That's Dr. Rafael Harpaz of the Centers for Disease Control and Prevention. He and other researchers looked at how well the vaccine worked in a huge number of people: 76,000 patients in the Kaiser Permanente Health Plan, versus a quarter-million who didn't get vaccinated. Their report is in the current Journal of the American Medical Association.
Bottom line: The vaccine prevents shingles 55 percent of the time. It's even better at preventing the most severe cases.
Dr. HARPAZ: If you look at preventing something like six months worth of severe pain, it's over 70 percent effective.
KNOX: So here's a vaccine that can prevent severe and lasting pain in hundreds of thousands of people. But the fact is, very few people get the shot, only about 10 percent of those who should.
To figure out why, I went to see Dr. Richard Dupee. He's a geriatrics specialist at the Tufts Medical Center in Boston.
Dr. RICHARD DUPEE (Geriatrics Specialist, Tufts Medical Center, Boston): The recommendation is for everybody over the age of 60 to get a shot.
KNOX: Have you had one?
Dr. DUPEE: No.
(Soundbite of laughter)
KNOX: And to tell the truth, neither have I, even though my doctor has urged me to. I just haven't gotten around to it.
Dupee says patients are slowly becoming aware there is a vaccine against shingles, but there are obstacles.
First, there have been repeated shortages. Merck, the vaccine's maker, says it can't make enough.
Dr. DUPEE: So we have not given a shingles vaccination here for about a week.
KNOX: Hmm. You just can't get it.
Dr. DUPEE: Can't get it.
KNOX: And the vaccine is expensive: $160 a shot. For people over 65, Medicare covers it, but�payment can be complicated. Most private plans cover it, but not all of them, so some patients may have to put up the money and hope to get paid back.
Another problem is the vaccine, called Zostavax, needs to be kept frozen. Most doctors don't have freezers in their offices, so they send patients to drug stores.
Dr. DUPEE: Most pharmacies don't have enough freezer space to handle the volume of Zostavax that we would need. So they order it, freeze it, the patient picks it up, comes in here, and we give them the shot.
KNOX: But the shot has to be given within 30 minutes after the vaccine leaves the freezer, and that's hard to manage.
Perhaps the biggest roadblock is that people just don't take shingles very seriously until they've had it.
Dr. DUPEE: We're not aggressive enough, and the patients are not aggressive enough. But if you've seen a case, one case, you become a believer.
KNOX: I'll get my shot.
Dr. DUPEE: Yeah. Me, too.
(Soundbite of laughter)
KNOX: You promise?
Dr. DUPEE: I will.
KNOX: One more thing: Julie Fair, who suffered so much five years ago, wants to know if she should get the vaccine, even those she's already had shingles.
Ms. FAIR: I want to be sure, because I really don't want to go through an episode like this.
KNOX: The CDC says yes. People who have shingles need to be vaccinated, because it can recur. So, Fair's going to ask her doctor for the vaccine and hope she can get it.
Richard Knox, NPR News.
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