Is the Shingles Vaccine now available in Thailand?

[wilcopops]

the vaccination you had for Chicken pox will fade over time...the new vaccine appears to work for about 3 years or so.

[bubba]

I asked my doctor (Bumrungrad, 6 month check-up) yesterday about the shingles vaccine and he told me that it remains unapproved and unavailable here, but that there is a lot of interest in it here. He was not aware of any near-term plans for it to be approved or made available in Thailand.

I was wrong in my previous post on pricing in the U.S., I had said $80 - $100 based on info, from my brother-in-law who is a physician, but I misunderstood. The manufacturer's price is $150, while many retail pharmacies charge $180 - $200. He confirmed the minimum age of 60 for this vaccine, but I have no clue how stringent various clinics, doctors and pharmacies might be.

Again, Aciclovir, if taken at the first sign, can greatly reduce the impacts of a shingles episode. My doctor recommended keeping some on hand, which I do. It is available here over the counter as Virogon.

Interestingly, as I posted earlier, I asked my doc at Bumrungrad (Dr. Vattana) the same question a couple of months back and after making a call while I was in his office, he came back and told me that Zostavax was coming and would likely be available April or May.

According to the Thai FDA website, Zostavax was approved by them three years ago:

http://drug.fda.moph.go.th/zone_search/files/sea007o.asp

[Pushit]

I was unaware that there is a vaccine to stop you getting it. But I did suffer from it a few years ago now and had it on my face.

It will either go from your ear and down you face, or from your ear up your face.

The one that goes down your face will give you a lot of pain, but is the one that goes up your face that is most dangerous.

If you get the one that goes up your face, you have the chance of it getting into your eyes and the worst scenario is that you can get encephalitis and that is life threatening.

It took about a month or so of tablets to clear it up and have never suffered again. I have no idea of why I got it, but can tell you it was one of the most painful ilnesses I have had in my life.

THIS WAS NOT SHINGLES. TRY AGAIN.

The doctor at Bangkok Christian Hospital who diagnosed my facial Herpes Zoster was qualified with a degree from a Japan. Please let us all know where you qualified as a dermatologist?

[mizztraveller]

Shingles isn't a skin disease ie you don't see a dermatologist. It's a neuropathic disease.

Sent from my GT-I8552 using Thaivisa Connect Thailand mobile app

[wilcopops]

I was unaware that there is a vaccine to stop you getting it. But I did suffer from it a few years ago now and had it on my face.

It will either go from your ear and down you face, or from your ear up your face.

The one that goes down your face will give you a lot of pain, but is the one that goes up your face that is most dangerous.

If you get the one that goes up your face, you have the chance of it getting into your eyes and the worst scenario is that you can get encephalitis and that is life threatening.

It took about a month or so of tablets to clear it up and have never suffered again. I have no idea of why I got it, but can tell you it was one of the most painful ilnesses I have had in my life.

THIS WAS NOT SHINGLES. TRY AGAIN.

The doctor at Bangkok Christian Hospital who diagnosed my facial Herpes Zoster was qualified with a degree from a Japan. Please let us all know where you qualified as a dermatologist?

Never worship qualifications, judge by how effective they are.......and a dermatologist for Shingles, yes fine.....on the face it can damage your eyes. One would expect a GP to pick this up though.

Edited April 11, 2014 by wilcopops

[Tywais]

Shingles isn't a skin disease ie you don't see a dermatologist. It's a neuropathic disease.

Sent from my GT-I8552 using Thaivisa Connect Thailand mobile app

I was sent to a dermatologist to make the evaluation and she knew exactly what it was and what treatment to prescribe. WebMD shows Dermatologist as one qualified for diagnosis. American Academy of Dermatology shows it in their purview. But just a primary care physician or worse case situations a neurologist are also appropriate.

[dhream]

I read this because my current Thai female partner has shingles. No big deal? Think again.

We had only recently started seeing each other, (early March 2014) i suggested a series of routine blood tests for STI's just to avoid any tears and recriminations if either one of us was carrying something nasty, but not life-threatening.

She came back HIV + (I was negative, but now I still have to wait and do a series of negative confirmation tests at 90 and 180 days.) It was a tremendous shock I can tell you! Our first thought was a false positive, it was not to be.

She is in her thirties and I don't want to scare anyone, but if you are not over 55 and you have suddenly got shingles, then you had better get an HIV test done pronto, as it is a classic symptom of the immune system breaking down in non-elderly people. You'd have to have some serious other non-HIV immune issues (that you'd certainly know about) to get shingles otherwise.

Your best bet for a quick result (within 20 minutes) is the Red Cross center near the US Embassy in Chiang Mai. The other clinics take weeks, and my girlfriend was told the bombshell-dropping news over the phone, and near clinic closing time, I don't know if that was deliberately heartless, or if they are just overloaded with cases!

HIV is about the only known vector for shingles 'out of the blue' in an otherwise healthy, under 55 year old, who has already had chickenpox. Shingles you see, is kept locked up in the spine after the pox, and only comes out to wreak havoc when the immune system, for one reason or another, is compromised, and can't keep Shingles safely locked away.

Bizarrely, it seems that in Chiang Mai, they don't even suggest an HIV test here when you diagnose with shingles under a certain age. CM is an up and coming HIV hotspot in Thailand (after an initial reduction in cases earlier in the 21st century) a fact everybody blithely ignores -until you actually do some casual Googling.

BTW the test was triple checked and her CD4 counts and viral load have since confirmed this unfortunate news.

She is not a working girl, never has been, and in fact is pretty conservative by any standard, she has had only three (western) partners in the last 6 years, including me, although HIV can be 'dormant' for up to nine years before 'warning flags' like shingles appear, it is one of the first symptoms -apart form the sero-conversion symptoms, which sometimes never manifest, and quickly subside anyway.

Again, i'm not trying to spread alarm, but you'd be mad not to get checked out for HIV if you have had shingles (or recurring thrush, or recurring and massive amounts of internal mouth ulcers, or your partner has these).

As for me, my only other scare was that I got adult chickenpox about ten years ago (in BKK).

Testing HIV + will NOT necessarily lead to AIDS or kill you... if you get onto anti-retrovirals early enough, so denial, and delay, is not advisable... if you think shingles is bad, from what I've learned, you're going to hate full-blown AIDS complications.

Finally, you won't get thrown out of Thailand if you are already here on a visa, and test positive.

Hope this helps someone bite the bullet -and maybe save a couple of dozen other people from contracting HIV from that someone...

As for me, well, in a somewhat silly and self-defeating way, we had lots of unprotected sex with each other (but no one else) for almost a month between the time we tested and the results, it is simply too early to test me again, and it could go either way for me, but I took the gamble (as I suspect most here do) and now I have to man up to the consequences come what may.

Edited April 17, 2014 by dhream

[Sheryl]

HIV is about the only known vector for shingles 'out of the blue' in an otherwise healthy, under 55 year old, who has already had chickenpox.

Not exactly true.

What is true is that shingles will tend to occur when the immune system is weakened, either by disease (such as HIV, but also by any other recent illness), medication (immunosupressant drugs or cancer chemotherapy ), lack of sleep/emotional stress or age. Indeed its occurrence in an otherwise healthy young person should spark consideration of HIV but usually not in a person in their early 50's.

Incidence of shingles in people without HIV or other immuno-compromsing condition, in the US is:

2 per 1000 person-years among adults younger than 50

5 per 1000 person-years among adults 50 - 59

7 " " 60 - 69

10 " " 70 - 79

12 " " 80 - 89

So the big increase comes right at age 50, but it is by no means unknown before that - 1 in 500 persons per year.

2 per 1000 person-years among adults younger than 50, and increased to 5, 7, 10, and 12 cases per 1000 person-years among adults in their 50s, 60s, 70s, and 80s, respectively. - See more at: http://www.jwatch.org/jw200711150000001/2007/11/15/what-incidence-shingles#sthash.97vW51pr.dpuf

2 per 1000 person-years among adults younger than 50, and increased to 5, 7, 10, and 12 cases per 1000 person-years among adults in their 50s, 60s, 70s, and 80s, respectively. - See more at: http://www.jwatch.org/jw200711150000001/2007/11/15/what-incidence-shingles#sthash.97vW51pr.dpuf

[dhream]

Sheryl,

The Devil is in the detail, note my wording, 'the only known vector... in an otherwise healthy under 55 year old' all of your scenarios (including lack of sleep) describe 'health-compromised individual' scenarios. QED, the 2 in 1000 individuals who are healthy and get it 'out of the blue' are as yet unknown vector scenarios, thus the science behind my comment is sound. I also go on to explain the shingles trigger factors, as you have done here.

Nevertheless, your post is helpful and insightful, and if I were a sexually active individual in Thailand, or the US for that matter, the 2-1000 statistic alone would give me pause for thought that HIV must be considered given the impact of the disease on the individual and others, regardless of whether non-HIV 'explanations' may also be apparent, remember that, whilst unusual in safe-sex scenarios or non-injecting drug users, there are other ways HIV can be transmitted, here is one of them:

I was going to leave this out, but I'll say it.... My GF was given a HBV (Hepatitis B vaccine) at Chiang Mai Klaimor hospital yesterday, after her CD4 test results were in, the nurse did not use gloves, nor apply a band aid, and my GF was bleeding openly from the needle wound, as she emerged with her (unwashed) hand covering the wound, she then went to the payment counter with a HIV + bloodstained hand and paid the clerk! (Now lets say the clerk handles the contaminated paperwork with a paper cut on their finger...)

I was horrified when I found out and sent her to get a dressing, and then to wash her hands, because yes, they did not even swab her hands after I sent her back to the nurse, nor did she apparently think to ask for one! It beggars belief.

There is so much HIV/AIDS stigma here, and yet so much basic hygiene ignorance, it is staggering!

As Jim Rohn once said, 'Casualness creates casualties'... So get tested folks!

Edited April 18, 2014 by dhream

[Sheryl]

HIV is not a vector. It is a risk factor.

And as I tried to point out, age becomes a major risk factor starting at 50, not 55. Perfectly common for an otherwise healthy 50-54 years old to get shingles, no other risk factor than their age.

[dhream]

HIV is not a vector. It is a risk factor.

And as I tried to point out, age becomes a major risk factor starting at 50, not 55. Perfectly common for an otherwise healthy 50-54 years old to get shingles, no other risk factor than their age.

My mistake, it is a risk factor. Misused the word 'vector'. Apologies.

[Pikiss]

My husband got unfortunately ill with herpes zoster. His doctor in Bangkok Pattaya Hospital told today that the vaccine should be approved and available in Thailand next January.

[BigC]

Yes they have in Bangkok hosptial

[Sheryl]

It is now newly registered in Thailand so indeed, some hospitals may have it and rest should soon.

The distributor is Zuellig so those looking for it could give them a call and ask which hospitals in your area they have supplied it to.

Contact Information: Tel: (+66) 2656 9800 Email: [email protected]

[PMNL]

Zostavax is now available in chiangmai.

[Sheryl]

Where exactly?

[CaptHaddock]

Current data on US price of Zostavax: I just got the injection yesterday at a Walgreen's in Massachusetts. My cost as an uninsured person was $224.99. Walgreen's in New York City refused to administer the vaccine without a doctor's prescription per NY State regs! I have never heard of a doctor's prescription being required for a vaccine since no specific condition is required for a vaccine, just the presence of risk factors.

[Tywais]

Where exactly?

I just found one place and it is a private clinic well known by Chiang Mai expats for 4990 Baht/shot. Run by Dr. Morgan. - Health Care Medical Clinic. If it is available there I would guess at the major hospitals also.

Guess I may go over to have it done as I just came off shingles last year and don't want it again.

[Thanyaburi Mac]

FYI, this just in. That's a good price, I paid $207 in the U.S. four years ago, about baht 6,600.

Mac

Good morning.We would like to inform you that we already have Zostazax(Shingles) vaccine in Vibhavadi hospital.

The cost is Baht 6,820(medicine only)&Doctor fee and service charge (about Baht 700-800).

Best regards,

International Service Department

Vibhavadi Hospital

Bangkok, Thailand.

Tel + 66 2 9412800 ext 1242

Fax +66 2 9412169

[lopburi3]

I checked during flu shot yesterday at Vejthani Hospital and Zostavax is not yet available there - check with pharmacy by doctor found they hope to have next month.

[bubba]

I was just in California last week and enquired at a Walgreens. The pharmacist told me their price was $230, and only available without a physician's prescription to those under 60 yo. Younger than 60, they need a prescription.

She also went on to explain that this is a very delicate vaccine. It comes on two components - one is a powder that must be kept frozen at all times, and then carefully mixed with a diluent just before injection. This all sort of makes me wonder whether the bargain price vaccination clinics in Thailand are handling the vaccine properly. Or worse yet, that they are genuine.

[Mango Bob]

I just checked with every international hospital in Bangkok and no one has it including Bumrungard.

[Thanyaburi Mac]

Mango

You've missed a few, check Post #83 and a couple of others.

Or, perhaps you just asked the wrong question or person....

Mac

[lopburi3]

But has anyone actually received a shot/anywhere in Thailand? Have not seen any confirmed reports. And I know for fact Vejthani did not have it a week ago.

[PMNL]

Yes, I too got it for around $50 (give or take) at a pharmacy in the US, no doctor visit required (this may vary by state though). Penumococcal and I think flu vaccines can be gotten the same way.

Pneumococcal should be given at least 4 weeks apart from the Zostavax.

The Flu is safe to do so.

[PMNL]

I was just in California last week and enquired at a Walgreens. The pharmacist told me their price was $230, and only available without a physician's prescription to those under 60 yo. Younger than 60, they need a prescription.

She also went on to explain that this is a very delicate vaccine. It comes on two components - one is a powder that must be kept frozen at all times, and then carefully mixed with a diluent just before injection. This all sort of makes me wonder whether the bargain price vaccination clinics in Thailand are handling the vaccine properly. Or worse yet, that they are genuine.

There are two components on the vaccine and both should be kept at 4-8 degree Celsius. No freezer required. Surely you can check out http://www.merck.ca/assets/en/pdf/products/ci/ZOSTAVAX_II-CI_E.pdf

I don't know where the pharmacist get the wrong information from.

[bubba]

I was just in California last week and enquired at a Walgreens. The pharmacist told me their price was $230, and only available without a physician's prescription to those under 60 yo. Younger than 60, they need a prescription.

She also went on to explain that this is a very delicate vaccine. It comes on two components - one is a powder that must be kept frozen at all times, and then carefully mixed with a diluent just before injection. This all sort of makes me wonder whether the bargain price vaccination clinics in Thailand are handling the vaccine properly. Or worse yet, that they are genuine.

There are two components on the vaccine and both should be kept at 4-8 degree Celsius. No freezer required. Surely you can check out http://www.merck.ca/assets/en/pdf/products/ci/ZOSTAVAX_II-CI_E.pdf

I don't know where the pharmacist get the wrong information from.

Well, she was a qualified pharmacist and was the person giving the Zostavax vaccines, so I took what she said as accurate. I dunno, maybe she got her information here, where it says:

To maintain potency, ZOSTAVAX must be stored frozen between -58°F and +5°F (-50°C and -15°C).

Or maybe here, where it says:

Lyophilized zoster vaccine must be kept frozen at -50 to -15°C.¹ (See Storage under Stability.) Reconstitute immediately following removal from the freezer.¹

Surely you can check those as well, and then reply with your own professional judgement.

Edited November 7, 2014 by bubba

[mesquite]

I went through this last year and was told that the Zoster Herpes vaccine was not in Thailand. I ended up getting it in Singapore. Cost was 400 SGD

[mesquite]

But has anyone actually received a shot/anywhere in Thailand? Have not seen any confirmed reports. And I know for fact Vejthani did not have it a week ago.

It does show up on Dr Morgan's website, so maybe it is here.

http://www.healthcaremedicalclinic.com/

Edited November 7, 2014 by mesquite

[lopburi3]

From what I gather it has recently been approved for Thailand but am yet to see any report of actual availability beyond price lists. I do know there were very severe shortages in US several years ago so it is not something that is easily produced for expanded markets I suspect - so there may be a delay, as there seems to be, between approval for sale and actual availability.