Shingles causes painful blistering, and can result in serious complications. It is very common in older people, but the vaccine can cost up to $900. Photo: 123RF
Doctors and patients are calling for more funding to broaden the eligibility criteria for the free shingles vaccine to stop people suffering from extraordinarily painful and debilitating symptoms.
Shingrix was funded for people aged 65 but if they missed getting vaccinated in the 12 months after their birthday they would need to pay anywhere from $400 to $900 for the two shots required.
University of Auckland associate professor Helen Petousis-Harris said the situation was absurd.
"Shingles doesn't care about birthdays and the risk only increases with age. You don't just flick a switch on at 65. A 64-year-old is just as vulnerable as someone a few months older, and a 66-year-old is at even greater risk," she said.
"It makes absolutely no sense, it's not like the virus checks your ID."
Petousis-Harris said broader access to the vaccine, which provided about 10 years of protection and was highly effective even for the elderly, would save the health system money.
"I think it would be a cost-saving, not just in terms of medical attention and cases with hospitalisation, but also for people who are still working and still earning, it's a massive loss of income while they're sick," she said.
Vaccinologist and University of Auckland associate professor Helen Petousis-Harris. Photo: RNZ / Dan Cook
She said shingles could spell the end of independence for some elderly people, which was a huge cost that should be factored into funding decisions.
"As you get older, your risk of getting shingles goes up and up and up, but it does occur in much younger people," she said.
There has been an uptick in shingles cases - including among younger people - since the Covid-19 pandemic.
Shingles was caused by the reactivation of the same virus that caused chickenpox, varicella zoster. It caused a painful blistering rash on one side of the face or body that lasted for 10 to 15 days.
One in five people with shingles developed severe nerve pain that could last months or years, or even permanently. Others could develop hearing loss or blindness and neurological complications including encephalitis, meningitis and Guillain-Barré syndrome.
One in every three people could expect to suffer at least one attack of shingles in their lifetime, a risk that increased to one in two people over the age of 85, according to Te Whatu Ora.
Auckland deputy mayor Desley Simpson recently suffered from a painful shingles infection she likened to having "a hedgehog strapped to my face".
"It was terribly, terribly painful and I have a high pain tolerance. I had it in my hair, and it felt like I couldn't go outside in the wind without it feeling like someone was pulling my hair out," she said.
Auckland Council finance and performance Committee Chair Desley Simpson. Photo: RNZ / Dan Cook
Simpson thought her usual good health, fitness and healthy diet would protect her, but the stress of her job meant she was susceptible.
She said it was a "crying shame" the vaccine was only free for a year for most people, especially as many were working until later in life and often had a lot of stress in their lives.
Simpson urged people to call around pharmacies and medical centres because the cost could vary widely.
Grey Power spokesperson Jo Millar said the cost ranged from at least $400 to up to $900 for both doses.
She said the cost of the vaccination was out of reach for many superannuitants but the cost to the country was far greater when people were hospitalised with the illness.
"If we broke it down to an hourly rate, which I always do for pensioners, a single person gets about $9 an hour and a married couple gets about $7 an hour each - so how many hours do we need to add up to $900?" she said.
"Every time a person spends three or four days in hospital, that's an immense cost to the health system. It's also debilitating for the person and it's a stress and a strain for the families of those people."
Millar said she could not understand why New Zealand did not fund the vaccine more widely, especially when compared to other countries such as Australia, the United Kingdom and Canada.
The Australian government boasted of having one of the world's "most comprehensive and widely available vaccination programs", including everyone aged 65 years old and over, First Nations people 50 years and over and immunocompromised people over 18.
In July 2024, Pharmac widened access to the vaccine for some immunocompromised people over 18 years old, such as those with organ transplants, poorly controlled HIV or end-stage kidney disease.
Pharmac director advice and assessment Dr David Hughes said the change was expected to benefit 15,000 people in the first two years.
There were five funding proposals to widen access for Shingrix on Pharmac's options for investment list which had positive recommendations from funding advisors; a catch-up programme for people who missed a vaccination during the pandemic, an application to expand the funded group to those aged 50 to 64 years old, another for those over 65 who needed a catch-up dose after receiving the previous vaccine, Zostavax, and an application covering Māori and Pacific people over 60.
The proposals dated back several years and most were re-ranked multiple times.
Hughes said the medicines and vaccines on the options for investment list were ranked every quarter and changed over time.
The rankings depended on health benefits, funding, supplier negotiations and other applications under consideration, so proposals could stay on lists for a while, he said.
Pharmac was continuing to look at ways to expand eligibility for free shingles vaccines but it had a fixed budget and had to make choices about what to fund, Hughes said.
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