It's not been formally evidenced as beneficial in younger, healthy people (there just haven't been studies) so receiving it is "off label".
It's possible to find someone who would write a prescription for it anyway, as with many off label prescriptions with low perceived risk of harm, but insurance is unlikely to cover it.
Many/most doctors won't do that, though, especially without at least some kind of specific reason (like having recurrent cases already).
As someone who got shingles in his 30s, it seems weird that a vaccine requires formal evidence to be beneficial to a younger population. Are there known side-effects that might outweigh the benefits? Shingles sucks at any age, making people wait to get the vaccine just because shingles is more common in the elderly seems odd.
I also had it in my 30's (and now again in my 40's) so I get it.
But there's a whole "evidence based medicine" thing that many of us usually try to champion, and it turns out the collecting such evidence is something expensive and priority-constrained. Due to lack of suitably targeted studies, there's just not formal evidence that the vaccine will be effective or lasting for us, or on what risks might apply to younger people with more robust immune systems.
There's also just a consideration about rationing the drug itself (it's seen shortages), and so prioritizing availability to more at-risk populations is not totally unreasonable.
All that said, it's not like it's impossible or illegal to get. You just need to find a prescriber who'll sign off for it (they exist), and you might need to pay cash rate for it at the pharmacy.
So, I understand this, and I absolutely support evidence-based medicine. I guess I'm at a loss as to why decades of giving this vaccine to folks 50+ is not sufficient to assess risk for people under that age, or never inspired more study into side effects. I also think that people who are 50+ are living long enough these days that we could probably make a good assessment as to how long the vaccine lasts (if we're not assessing that, I'd be kind of surprised and concerned as to why not).
Prioritizing drugs in the event of shortages is totally understandable, though pretty easily fixable if you give the manufacturers time to plan for general availability (hopefully they would see it as an opportunity to make money by broadening market share, not an opportunity to make money by restricting supply).
> As someone who got shingles in his 30s, it seems weird that a vaccine requires formal evidence to be beneficial to a younger population. Are there known side-effects...
We don't know the side effects or the beneficial effects since it hasn't been studied/approved for that (we likely have studied it, but not with enough rigor for FDA approval). It is, in all likelihood, fine, but when it comes to medication, we typically want a study rather than a guess.
"Low risk" unfortunately doesn't mean no risk. I wish to be vaccinated against all disease, but rationally I must acknowledge very low probability event of harm from vaccination. It's why they're recommended only for 50 and older.
Seems the price where I live is about 500 euros for two doses, not extremely expensive, though a few times more than e.g. Twinrix and some other common vaccines that aren't covered by regular insurance.
It's not clear from the information on local private clinic web pages whether they'll make a fuss or not but I kind of doubt it. It's not uncommon that people manage to pay themselves to prescriptions for methylphenidate and amphetamine, it would be weird if shingles vaccine was more gatekept than those.
It's possible to find someone who would write a prescription for it anyway, as with many off label prescriptions with low perceived risk of harm, but insurance is unlikely to cover it.
Many/most doctors won't do that, though, especially without at least some kind of specific reason (like having recurrent cases already).