Got an Rx for..

[ericn2k3]

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A customer came in with a Rx for Zostavax with MD note saying something like 'ok to immunize based on new guidelines'. I believe the patient age is 51. I check the CDC website and tried to search around for this new guideline but nothing. Anyone know anything about this?

 

[radio frequency]

“Shingles vaccine is approved by the Food and Drug Administration for people aged 50 years and older. However, CDC does not have a recommendation for routine use of shingles vaccine in people 50 through 59 years old.” i.e., you have a script, it’s approved and safe, you’re clear to vaccinate.

Shingles Vaccination | What You Should Know | CDC

 

[Dred Pirate]

“Shingles vaccine is approved by the Food and Drug Administration for people aged 50 years and older. However, CDC does not have a recommendation for routine use of shingles vaccine in people 50 through 59 years old.” i.e., you have a script, it’s approved and safe, you’re clear to vaccinate.

Shingles Vaccination | What You Should Know | CDC

that is what I thought - seemed too obvious of a question - but then again, I don't deal with that world

 

[ericn2k3]

“Shingles vaccine is approved by the Food and Drug Administration for people aged 50 years and older. However, CDC does not have a recommendation for routine use of shingles vaccine in people 50 through 59 years old.” i.e., you have a script, it’s approved and safe, you’re clear to vaccinate.

Shingles Vaccination | What You Should Know | CDC

I know this has always been the case but I've not seen any MD write a note about "new guideline". Our Rx system flagged it due to patient's age.

 

[Charcoales]

If it's not in your protocol not sure if you can give it... since the protocol would only be for what what was approved at signing between the doctor and the pharmacy. Unless some provision to future proof it?

 

[CetiAlphaFive]

A customer came in with a Rx for Zostavax with MD note saying something like 'ok to immunize based on new guidelines'. I believe the patient age is 51. I check the CDC website and tried to search around for this new guideline but nothing. Anyone know anything about this?

The MD probably had a Shingrix rep bring them pizza and didn't understand what was being said.

 

[CetiAlphaFive]

In all honesty, you should probably fax back,
"There are no new guidelines.
It's always been FDA approved for >50 years, ACIP just recommends against vaccinating under 60yo"

 

[radio frequency]

This would likely be state specific, but you don’t need to follow protocol for a standing order when you vaccinate based on a prescription.

 

[radio frequency]

In all honesty, you should probably fax back,
"There are no new guidelines.
It's always been FDA approved for >50 years, ACIP just recommends against vaccinating under 60yo"

My understanding is not that ACIP recommends against vaccinating those under 60 for Shingles, only that they do not have a recommendation of routine vaccination of those under 60.

 

[CetiAlphaFive]

My understanding is not that ACIP recommends against vaccinating those under 60 for Shingles, only that they do not have a recommendation of routine vaccination of those under 60.

Oh so they don't say don't do it they just don't say do it.

 

[owlegrad]

To be fair, he didn't say what new guidelines he was referring to. He might mean his own personal guidelines were updated. 😛

 

[Charcoales]

This would likely be state specific, but you don’t need to follow protocol for a standing order when you vaccinate based on a prescription.

I'm not sure if it's state specific but Walg prob can't vaccine even with Rx if selection tool denies the vaccine I think (haven't run into this situation too often to be fair). I know the protocol tends to deny the vaccine as far as I'm aware if we check the box that they have an rx

 

[soontobepharmd2017]

per cdc, can give shot if patient >50 but most insurances won't cover until pt is >60...

 

[CynicalIntern]

Per forums user Unchained, insurances will cover is if patient is >60 but ethically you shouldn't do it until after the patient dies. Ask Questions.

 

[Abby Atwood]

My old Walmart was told by the district manager that it’s okay to vaccinate a 50+ year old patient if we had a prescription, but we also had to have a epipen script on hand for the patient because they wouldn’t be covered by protocols.

 

[radio frequency]

My old Walmart was told by the district manager that it’s okay to vaccinate a 50+ year old patient if we had a prescription, but we also had to have a epipen script on hand for the patient because they wouldn’t be covered by protocols.

Wow, that is unfortunately really dumb. Are we healthcare providers or box checkers? Not every patient falls into the neat and tidy guidelines.

 

[rph3664]

My insurance pays for it at age 50, or before if certain conditions are met, so when I had my Girly Exam a couple months ago, I requested and got it. 🙂

 

[CetiAlphaFive]

My old Walmart was told by the district manager that it’s okay to vaccinate a 50+ year old patient if we had a prescription, but we also had to have a epipen script on hand for the patient because they wouldn’t be covered by protocols.

Lol.

Why is it that so many Pharm.D.s think that a bonus JD gets thrown in for free at graduation?

 

[grumpyRph]

i ran into this situation you'll like this:

i was covering overtime shift at a chain retail (the 'greens), and a doctor had sent in a e-rx with REFILLS for gardasil for a male in his 20's. i was there for the first refill or his second shot in the series. and we didn't do immunization selection tool. i gave him the shot and later got dinged because by the time he got his second shot/refill, he was outside the fda approved or guidlines age range. DANG IT! lol

 

[Sine Cura]

How do you get dinged? Did someone snitch on you?

 

[txpharmguy]

How do you get dinged? Did someone snitch on you?

It's an internal, computer generated audit for vaccines administered outside protocol parameters

 

[owlegrad]

I thought the guideline was for when to start the series, not completing it?

 

[Charcoales]

I thought the guideline was for when to start the series, not completing it?

Yeah seems very dumb to be denied the whole series in the middle of it

 

[grumpyRph]

It's an internal, computer generated audit for vaccines administered outside protocol parameters

yep which i didn't know until it happened! i suppose it's a pretty honest mistake. yeah it seemed very computer generated. i didn't get like a talking to by anyone but still it shows up on my record for the year and what not.

 

[grumpyRph]

yeah i guess the cdc guidelines and fda should come to more of an agreement on if there's a clear distinction of age when STARTING versus the age you are by the END OF FINISHING a series. ha.

 

[BidingMyTime]

My understanding was the CDC/FDA guidelines said the age for starting, that it's perfectly fine for finishing the series after the maximum age. I could be wrong, I've never actually given one of these things.

My other understanding was, there is nothing harmful about giving these vaccines after the age of 26, it's just it's probably unnecessary at that age because the person has probably already been exposed to HPV. The same reason we don't give Rotarix to adults. It only makes sense to finish the series if someone has started it, regardless of age, assuming they have they have the money/ins and desire to finish it.