The reason it's not recommended for all ages is money. Not safety concerns.

Same reason you can't get Shingrix under a certain age.

I would happily pay for Shingrix.

Prepare your happy for a very profit-laden high three-figure bill.

You can get it in the UK, unsubsidised from a profit driven private company, for a mid-three figure amount.

https://www.boots.com/online/pharmacy-services/shingles-vacc...

> Price per dose:£230

> Full course (2 doses):£460

Medium 3-figure at most. $400-600 for the full two-dose series.

Worth it.

I think my insurance covered it, even though I was 33. But yes, I would have happily paid $400-600.

Your average HN reader can absolutely afford paying a few hundred bucks to avoid getting a potentially life-changing disease, and should. I know multiple young adults who got messed up by shingles.

Luckily, I can afford $999 to avoid experiencing Shingles.

I think the main reason it isn't recommended for all ages is that it wears off. If you get it before 50, when your immune system starts declining, you might end up getting shingles when you're 60 or 70.

Insurance companies used to only pay for the vaccine at 60. They've reduced it to 50 now because people (like me) were getting it in their 50's. I got it in my left eye and because my immune system is kinda shit, I still have it, though it doesn't give me too much grief now. But it did trash my cornea in that eye, so it's messed my vision up pretty good. And since there's still an active infection (after 8 years), I can't get a cornea transplant.

https://www.health.harvard.edu/staying-healthy/two-dose-shin...

My PCP actually recommended holding off until later in the 50s for this reason. There's not currently a booster so his suggestion was to play the odds & delay a bit in order to get longer protection in my elderly years.

You are betting:

(1) a booster won't be invented in next say 20 years and

(2) you will live next 20 years (likely if you are healthy and have a healthy lifestyle)

Beg for forgiveness, don't ask permission. I got Shingrix when I was under the age of 40, and at no cost to myself even, simply by scheduling a Shingrix vaccine at CVS. It wasn't until I went back for the booster shot months later that the nurse was like "Wait, aren't you too young for this?", but they nevertheless gave me the second dose to complete the vaccine course. You can just so things.

I was unable to get a first dose just by asking the pharmacy -- they were happy to enforce the arbitrary 50 year age rule. But my PCP was happy to just prescribe it off-label. Do it; shingles is terrible and there's no reason to suffer it under 50.

If by “money” you mean “spending limited health dollars on treatments where the benefit justifies the amount spent” then you’d be correct.

They also did it by gender in the US when I was in college. Boys could not get it. At the same time that Europe was vaccinating everyone.

That’s not how drug approvals work. You don’t make assumptions about safety, you make decisions based on data.

The original trials were for a specific population - no prior HPV infection, young women. Hence the approval was for that population.

Additional trials have been run expanding the population, but the decision was based on data not “yeah, I’ll bet this is safe/works for this other group”