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by tptacek 20 days ago
Wait, you can just pay for the shingles vaccine, before you're 50? Where do I do that?

I had shingles in my 30s. It was the sickest I've ever been.

7 comments

You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.

We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card.

So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.

> You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.

Is that not usually true in other countries?

I doubt you need a prescription for most vaccines. Typically there's some sort of guidelines that might say normally given to over 55 years old, but there will be some wiggle room due to other hard to prove preconditions such as family history of xxx or sensitivity to yyy. You say you have one of those things and Costco or the public health dept. will give you the vaccine no questions asked. For example when the COVID-19 vaccine was rolled out it was supposed to be for older people, but also people with various other (not easy to test for) preconditions such as asthma. So everyone who wasn't an anti-vaxxer developed asthma.

Medications are different. Need prescription for that, although $$ and a zoom call can solve that problem.

There is a large industry in the US that specializes in catering to people that want medications, vaccines, diagnostics, and treatments that are outside the recommended standard of care that medical insurance or public health systems cover. You have to pay for these services directly but the market is competitive so the cost is quite reasonable.

A doctor must sign off on these but that step is mostly performative outside of some narrow exceptions. My impression is that this type of medical care is much more accessible in the US than most other developed countries.

That's it.

Some countries are even more open. You can walk up to pharmacies in some countries and ask for most medications without a prescription. Up until 10-20 years ago you could walk into pharmacies in some countries and get abusable drugs, too, but that became enough of a problem that they cracked down on it.

The unique thing about the US is that we have access to almost everything first, and you can find a doctor willing to prescribe it to you if you look hard enough. In many other countries doctors don't want to stray far from the government prescribing guidelines. You may also not be allowed certain treatments unless your doctor can prove you meet the government requirements.

In the US, the enforcement is on the backend, if at all. There have been many cases of doctors getting the bright idea of turning their prescription pad into a money printer and writing prescriptions for scheduled medications to anyone willing to pay cash. Some of them make millions before the DEA catches up and goes after them. The smarter ones have moved into spaces where the enforcement brings less attention. Prescribing opioids is out, but I can't even turn on the radio without getting ads for doctors who will write me a prescription for testosterone to "get an edge in the gym".

Yes, it is. In my experience, in most cases, your regular doctor will prescribe things if they are not dangerous even if they aren't recommended.
In some countries, getting that prescription is much harder (unless you have the medical condition the medicine is intended/licensed for)
Not exactly. My doctor wanted to start me on a medicine that would make me more likely to develop shingles so he asked me to get the vaccine series before he'd prescribe the medicine. I guess there's no such thing as a prescription for a vaccine, so I just went to my local pharmacy. I made the mistake of writing on the form that I had no health issues. The pharmacist came out and said because I wasn't 50 and had no health issues they weren't allowed to administer the vaccine. Even after I explained my condition and the doctor's request they still refused. They wouldn't even let me fill out a new form. I had to go to a different pharmacy which conveniently didn't ask about my current health status.

It's stupid too, because the question I answered "wrong" wasn't clear. It basically sounded like they were asking me if I currently had a cold or covid.

I'm in my 40s and asked my GP for it since I similar had a bad experience with it a few years ago. After warning me 3 times that it might not get covered by insurance, they gave it to me. I tried to get the second dose at a pharmacy, and they would not do it since I'm under 50. I got the second dose at my GP again a few months later.
You can just ask for vaccines at the pharmacy. I got a potentially missed childhood vaccination as an adult and they asked a few questions about why I wanted it, but were happy to give it to me. If it’s something odd you might need to go to a travel clinic.
Not this one you can't.
I told my local Walgreens I am immunocompromised and they did not ask for proof (early 40s).

https://www.cdc.gov/shingles/hcp/vaccine-considerations/inde...

See this is the information I'm looking for. :)
Happy to help!
Safeway pharmacy staff dgaf about anything from my personal experience.
I got mine at a tiny off-chain pharmacy. I just lied about my age. They didn't even check my ID. I did it in my early 30s, definitely did not look 50. Very happy I did so, have seen a few younger friends go through shingles and it _sucks_.
Sorry Tom, but you definitely look older than your age!8-))
If you just want to pay out of pocket or with an HSA, etc. you can get many vaccines at a pharmacy. Might need to check if there are limited hours for that service or appointments needed. Not sure if Shingrix is one of them.
I've tried to get the shingles vaccine at Walgreens before and been turned down because I wasn't old enough.
Huh. Well maybe not then. Did you make it clear you'd pay out of pocket and not insurance?
Yes. I really want this vaccine.
Have you tried asking your PCP?
I'm pretty confident I could talk my PCP into it! I'm just wondering if there is some easier retail way to do it.
Most age recommendations do not prevent you from access, but determine whether the insurance will pay. I got both the shingles and HPV vaccines despite being outside the age bracket.
If you have already had shingles as an adult, aren’t you fairly well protected for the next ten years or so, at least? I’d wager that you are one of the people least at risk since your immune system is already primed and readying suppress the virus that’s latently infecting you.
You are more likely to have a recurrence of shingles after once having it before. At any rate, I had mine more than 10 years ago.
Yep! You rarely kill off all of the bugs.

Usually just most, except some in your organs where your immune response is different, out of necessity.

Then, if your immune functionality drops below a certain threshold that they can replicate inhibited, and leave the fort, you’re dealing with a systemic infection again.