received a rx for shingrix for a 32 yo patient last week. Her doctor gave her all vaccines in the clinic before her treatment according to the pt. I don't know what happened but i gave her the shot. I feel horrible afterward... first time ever feeling that way after working in pharmacy for so long. I don't know why I did it. I feel pressured and not thinking clearly working fast paste environment. what do I do now to that pt. I feel responsible for her shot.
shingrix for <50 yo pt
- Thread starter jack_hen
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There are scenarios where it makes sense to vacinate < 50 against zoster. So you can relax, there is an absolute minimum age for every vaccine and for Shingrix it’s 18. If you had an Rx you should be fine.
https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/A/age-interval-table.pdf
https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/A/age-interval-table.pdf
you're fine...especially with shingrix vs zosta.....just remember to double check your state protocols next time even if CDC or ACIP says its okay or even if you have an Rx (this is to cover your butt). I know there have been scenarios where patients had given me rx's with the intention of getting it at the pharmacy and I had to tell them I could only dispense it for them to bring back to the doctor's office and not administer it there at the pharmacy.
other than that...I wouldn't stress about what happened too much.
other than that...I wouldn't stress about what happened too much.
I guess my general rule in that case would have been a check the absolute minimum age/cdc guidelines as stated above. I personally havent checked that but i havent actually had the shot available in months so i havent had that issue yet. And if i was still feeling iffy on it i would call the doctor and ask their reasoning. They should be able to give you something that makes you feel that there is a reason for it like they have already had shingles or will be on a medication that will compromise their immune system. If they are mean about it basically tell them that if i give it it is my butt on the line along with yours so i have to feel ok about it too. If you feel funny about something it is better to check it than to go home feeling bad.
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You should feel great about it IMO. Giving vaccines is one of the best things you can do for your patients. Why do you feel bad? What harm do you think you might have done?
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Cool, off-label use...probably not a big deal unless you violated protocol restrictions vs. Rx from MD/order.
Recent change with Gardasil 9 (before <age 26yo, now </= 45yo) just goes to show you how much age cut points are pretty trivial often (some of which never made sense to begin with why you couldn't vaccinate a 27yo with gardasil 9).
Recent change with Gardasil 9 (before <age 26yo, now </= 45yo) just goes to show you how much age cut points are pretty trivial often (some of which never made sense to begin with why you couldn't vaccinate a 27yo with gardasil 9).
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Yeah, as long as it was legal in your state, and you had a prescription, I don't see the problem.
The only reason the shingles vaccines are 50+ is because historically, only people 50+ got shingles. But since lots of younger people are getting shingles these days, it only makes sense to lower the age (and I expect it will be....if at some point there is actually enough Shingrix to go around.)
The only reason the shingles vaccines are 50+ is because historically, only people 50+ got shingles. But since lots of younger people are getting shingles these days, it only makes sense to lower the age (and I expect it will be....if at some point there is actually enough Shingrix to go around.)
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They are usually based on the population included in clinical studies since that's the best information anyone has. A lot of different things go into who you would or would not include into the trial, some of which are related to the disease studied, some are not.
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I think you are fine. You had a prescription, so state protocol doesn’t necessarily apply. If it makes sense clinically for the patient and doesn’t go against CDC restrictions, I wouldn’t worry about it.
You’ll probably see this more in younger patients; my friends with immunossion have already hit me up with pharmacy-related Shingrix questions as their docs want them protected, but Zostavax wasn’t an option for them due to the immunosupression. I’d be shocked if the age range and indications for giving it on protocol don’t expand.
You’ll probably see this more in younger patients; my friends with immunossion have already hit me up with pharmacy-related Shingrix questions as their docs want them protected, but Zostavax wasn’t an option for them due to the immunosupression. I’d be shocked if the age range and indications for giving it on protocol don’t expand.
Our wait list is over 9 pages long probably close to 150 patients. Everyone that asks I am telling them it will prbably be next summer or later. I have had several people get mad at me like i am lying. I have had people waffle about going on the list so i basically say its no harm no foul to go on the list. If we get to your name and you got it elsewhere awesome. If we get to your name and you say no what never mind i dont want it, cool. I really dont care but if you have any desire to get it from us at all i am telling you to get on the list now because otherwise you may be 25-50 names further down. One doctors office keep writing us scripts for it and it drives me nuts because i dont need a script for any of these people i need to actually have the shot. By the time i get around to giving it to them the script will be useless anyway
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Actually state law would supercede a prescription, but hopefully the OP knew the state law and didn't give a vaccine outside of the legal limits. IE, in illinois pharmacists can't give vaccines to children under the age of 12, it doesn't matter if the child has a prescription or not for the vaccine.
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Well, of course, if your state specifically mandates something, that’s the case. That’s not the same as state protocol necessarily though. (I.E., it’s possible Shingrix is not part of state protocol for this patient population, but that doesn’t necessarily make giving the vaccine illegal unless your state has a law about that. And if you lack the training (like vaccinating peds, as in your example), then obviously you are disqualified from giving that vaccine.
