Shingrix Shortages Only the Latest Vaccine Supply Issue in US: Public Health Watch

Apparently, the nationwide supply of the shingles vaccine needs a shot in the arm.

According to reports in the mainstream media, demand for the new, potentially more effective product called Shingrix has outpaced inventory at manufacturer GlaxoSmithKline (GSK). In some regions of the country, pharmacies have been forced to set up waiting lists for patients interested in getting the shot.

“Since I am in my late 40s, I haven’t had to worry about shingles yet; hence, I was only vaguely aware of the shortage issue,” said Frederick Chen, PhD, an associate professor in economics at Wake Forest University who has an interest in bioeconomics and has published articles on earlier vaccine shortages. “My wife, who is in her early 50s, recently had her annual physical, and she asked her doctor about getting the new shingles vaccine. Her doctor apparently told her, ‘Good luck finding it.’ From what I have been reading, this is definitely a national problem and not a regional issue.”

Of course, the Shingrix supply problem is hardly the first such shortage in the recent history of the United States. A review published in November 2017 in the American Journal of Health-System Pharmacy described several vaccine supply issues since 2001, with products designed for hepatitis A, hepatitis B, rabies, and varicella prophylaxis experiencing multiple shortages. These supply issues were typically caused by manufacturing problems (51%), and they lasted a median duration of 21.7 months.

Notably, the US Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices (ACIP) has recommended Shingrix for adults 50 years of age and older since it was introduced to the market in 2017. In a statement on its website, manufacturer GSK attributed the Shingrix shortfall its “accelerated adoption” as a first-line vaccine against shingles. The company has been ramping up production since December.

Although Dr. Chen emphasized that he is not an expert on the shingles vaccine market in the US, he noted that the supply problems associated with Shingrix are likely attributable to multiple factors, including the fact that it “is much more effective—it has an efficacy of more than 90%—than the older shingles vaccine.” The CDC still recommends said older product—Zostavax (Merck Vaccines)—for adults 60 years of age and older.

“The CDC also recommends that anyone who was previously vaccinated with Zostavax still get vaccinated with Shingrix,” said Dr. Chen. “Unlike Zostavax, which is administered in one dose, to get full protection with Shingrix requires two doses of the vaccine, spaced a few months apart). All of these factors can serve to drive up demand for Shingrix.”

He added that most insurance plans cover Shingrix, which may also be driving up demand.

“Shingrix is made by one company, so right now pharmacies and clinics are totally at the mercy of the company in terms of how many doses of the vaccines they carry or can provide,” Dr. Chen continued. “From what I have read, it takes several months to produce the Shingrix vaccine, so it does not sound like the shortage issue will be resolved anytime soon.”

GSK has offered assurances to the contrary, emphasizing that “there have been no manufacturing issues” associated with Shingrix and that the company’s efforts to essentially double production and delivery of the product in 2019 should address the shortages.

Stay tuned…