July 12, 2014 at 1:00 am

To Your Health

Reaction to neomycin nixes shingles vaccine

Dear Dr. Roach: I am 61 years old, and was anxious to get a shingles vaccine shot. I was upset to learn that, because I am allergic to neomycin, an ingredient in the vaccine, I cannot get vaccinated. I have talked to my doctor and also to a pharmacist about other options, but they don’t know of any.

Do you know of other options I could use to protect myself against shingles?

B.G.P.

Dear B.G.P.: If it’s a severe (the Centers for Disease Control and Prevention says “life-threatening”) reaction to neomycin, then you cannot get the vaccine. There is no other way to reliably prevent getting shingles.

Keeping your immune system healthy (good diet, regular exercise, good sleep) may help. However, the most important thing for you and others who haven’t been vaccinated will be to recognize shingles early and get treated immediately. Being treated early, preferably within 24 hours of the rash, can reduce the duration of symptoms.

Shingles usually starts with pain, burning or itching on one side of the body in a particular location, called a dermatome. This might be a band around the torso, the top of the arm or part of the face.

The classic description of the rash is a clear, fluid-filled blister on reddened skin (“dewdrop on a rose petal”), but it does not always look so classic. See your doctor immediately after any painful rash shows up in a single area of the body.

Dear Dr. Roach: I had chickenpox as a child. I am 60 years old and was shocked to find out that the shingles vaccine costs $249 here.

My doctor offers it, but I cannot afford the cost, as my insurance does not cover it. Do you know of a place where I can get the vaccine at little or no cost?

M.B.

Dear M.B.: It is frustrating that a recommended and potentially cost-saving measure like a vaccine costs so much out of pocket.

However, the drug company (Merck) does have a rebate program that covers much of the cost for people with insurance that does not cover the shot. You can find out more at rebate4zostavax.com/ or at (888) ZOSTA-INFO. You have to pay for the vaccine, then get your rebate.

Email questions to ToYourGoodHealth@med.cornell.edu.