Readers have reported difficulties finding a clinic that would administer Zostavax, the vaccine aimed at preventing shingles in people 60 years and older. In a prior column, I asked readers to relate their experiences trying to run down the shot. That struck a chord and the mailbox filled up. Turns out there is a patchwork of procedures in play to get and pay for the shot. Reader experiences run the gamut from smooth sailing to shoal waters.

-Special storage/administration requirements and billing/coverage issues have created barriers for people seeking the vaccination.

- The Zostavax vaccine must be kept frozen at an average temperature of 5 degrees F. and administered within 30 minutes of reconstitution.

- People who had to pay in full quoted prices as high as $350.

- Some get the vaccination from their doctor with no problem. The doctor orders the vaccine and gives the shot.

Some pharmacies work with doctors to make the shot available.

-The pharmacy orders Zostavax when you present a prescription. You pick up the vaccine and take it to your doctor, who administers it.

- Some pharmacies order the vaccine and have an onsite shot-giver administer the shot.

- In some instances, you might be asked to pay up front and file the insurance claim yourself.

- Readers report that some doctors shrugged off giving Zostavax because it was too much trouble.

You see why I used the term "patchwork."

Then there's the

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Zostavax billing issue for Medicare Part D recipients.

The administration fee was billed to Medicare Part B, while the product cost was billed to Medicare Part D.

Thankfully, that changed beginning Jan. 1. Now both can be billed to Medicare Part D.

As demand for Zostavax climbs, expect to see more independent and chain pharmacies stepping up to administer and bill for Zostavax.

Check with your insurance carrier to see if Zostavax is covered and how much of the cost you have to pay. In some cases, the shot may be covered if your physician signs a "prior authorization" form.

Medicare Part D recipients can go online (medicare.gov/pdphome.asp) and click on "Medicare Prescription Drug Plan Finder." On the next page, one way to proceed is to click on "Find & Compare Plans." Continue until you get to a box that says "Enter My

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books.