January/February 2009

CDC updates Zostavax recommendations

The Centers for Disease Control and Prevention (CDC) recommends adults 60 years old or older receive the Zostavax vaccine to prevent herpes zoster (shingles). A one-time vaccine, Zostavax does not treat shingles or post-herpetic neuralgia once it develops. Zostavax prevented shingles in about half (51 percent) and post-herpetic neuralgia in 67 percent of the participants in a clinical trial, the CDC reports.

In October 2008, the CDC updated its recommendation as follows:

  • Anyone 60 years of age or older should get the shingles vaccine, regardless of whether they recall having had chickenpox or not.

  • People who have had shingles can receive the shingles vaccine to help prevent future occurrences of the disease no matter when they first had shingles.

  • There is no specific time after having shingles that a person must wait before receiving the vaccine. The decision to be vaccinated should be made with the doctor and be based on an individual’s specific circumstances. Generally, a person should wait until the shingles rash has disappeared before getting vaccinated.

  • A person who has received the vaccine cannot infect others with this virus. It is safe for them to be around infants and young children, pregnant women, or people with weakened immune systems after receiving the shingles vaccine. Transmission of the chickenpox virus from a person who has received the shingles vaccine has never been documented. Some people who get the shingles vaccine develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.

Coverage

Coverage of Zostavax for members of Blue Cross and Blue Shield of Florida (BCBSF)/Health Options commercial plans (non-Medicare) varies. Check eligibility and benefits through the Availity®1 Health Information Network.

For Medicare beneficiaries, the shingles vaccine is covered under Medicare Part D, not Medicare Part B. The amount of member cost-sharing varies by plan. Medicare beneficiaries can get a prescription for Zostavax from their physicians and have the vaccine administered by a certified pharmacist.

Physicians who administer the vaccine can bill BCBSF/Health Options online for the administration of Zostavax to BlueMedicareSM Rx, BlueMedicareSM HMO, BlueMedicareSM PPO and BlueMedicareSM PFFS members electronically through the eDispenseTM Part D Vaccine Manager. A product of Dispensing Solutions, Inc., eDispense is a web portal that provides physicians with real-time claims processing for in-office administered vaccines. When using eDispense Part D Vaccine Manager to file a Medicare Part D vaccine claim, physicians must accept BCBSF’s reimbursement amount (including member’s copayment) as payment in full for the vaccine.

To enroll, go to http://enroll.edispense.com.

1 Availity, L.L.C., is a multi-payer, joint-venture company. For more information or to register, visit Availity's website at www.availity.com.