Stay Awesome
SHINGLES
Find most of the information you need in these resources
Always refer to your local signed PGD's in practice, and remember the Green Book takes priority over the SPmC - and sometimes WHO takes priority over the Green Book! They don't always say the same!
News and (and a handful of historical) things to know in practice currently:
5th September: Updated shingles eligibility posters. Posters updated to reflect the expansion of the Shingles programme from 01 September 2025 to all immunocompromised individuals from 18 years of age.
2nd September: New shingles eligibility calculator and updated 'visual guide to vaccines' poster to account for the 18+ expansion. Both of which I have replaced screenshots of in the tools section. Also updated is this patient-facing information: Vaccination against shingles guide.
28th August: GO SHINGRIX!! (again): Shingles jab may reduce risk of heart attack, pioneering research reveals
19th August: The Green Book chapter for Shingles has been updated to account for the expansions in the programme. From 1st September around 300,000 people in England will become eligible for a shingles vaccination once it is available to people aged 18 to 49 who have a severely weakened immune system.
14th August: Update to the Shingles vaccination: guidance for healthcare practitioners: This guidance has been updated due to expansion of the programme to include immunosuppressed individuals aged 18 years and over. The content has been reviewed, reorganised and updated to align with the revised Green Book chapter. New slide set added to reflect the new eligibility.
22nd July: And here we go with following Wales... Expansion of Shingrix® vaccine eligibility to all those who are severely immunosuppressed and aged 18 years and over letter. The new PGD template is here and ready to read. No doubt a Green Book update will be next...
10th July: Look what Wales are doing! Expansion of shingles immunisation for severely immunosuppressed people aged 18 to 49. I wonder if England will follow suit?
25th June 2025: Fabulous news! Lower risk of dementia with AS01-adjuvanted vaccination against shingles and respiratory syncytial virus infections
24th April 2025: The shingrix uptake quarterly data was published today. Seems to be slightly down from comparisons to this time last year. The immunosupressed over 50 group concerns me the most (20% uptake).
30th Jan 2025: The uptake data is out for Shingrix between 1st Sept 2023 and 31st August 2024 (the full first year of the programme). Here's the summary:
coverage for Shingrix dose 1 was 29.9% in those who turned 65 from September 2023 to August 2024
coverage for Shingrix dose 1 was 41.2% in those who turned 70 from September 2023 to August 2024
coverage for Shingrix dose 1 was 19.3% in severely immunosuppressed individuals who turned 50 and over from September 2023 to August 2024
uptake in those who turned 65 from September 2023 to November 2023 (Quarter 1) was highest in the first 4 months after they became eligible
uptake in those who turned 71 from April 2023 to March 2024 was highest in those of White British ethnicity (14.2%) and lowest in those of Black or Black British – Caribbean ethnicity (5.7%)
Some of those figures are rather disappointing but it doesn't represent every region and hopefully 2025 will be better now everyone has got the hang of the new programme.
28th Nov: You might get asked about this by a patient who has seen the news. This article 'Researchers Are Exploring the Role of Shingles—and a Protective Role of Shingles Vaccine—in Dementia' was written last month and explores some of the considerations when spotting correlations between seemingly-linked observations that may or may not be connected. A good one to read if you are interested in critical analysis, referring to a familiar vaccine 'Shingrix' in relation to the recent (and very exciting) claims that is can lower dementia risk.
25th Nov 2024: Shingles: guidance and vaccination programme updated along with the guidance for healthcare practitioners now zostavax is obsolete.
20th Nov: There's a new postcard from UKHSA to remind people about getting their shingles vaccines- check it out!
15th Nov: Vaccine update has landed today. Also the Shingrix PGD has been updated to remove Zostavax, which is now obsolete.
13th Nov 2024: Check out this very important bit of advice around potential changes to Shingles vaccine eligibility from the JCVI - and watch that space!
9th October 2024: Interested in a bit of a debrief on where we are at with Shingles vaccination? I delivered a webinar last week which was recorded and available to watch here.
12th September 2024: Shingles: guidance and vaccination programme document updated
29th August 2024: Shingrix vaccine uptake report (adults eligible from September 2023 to February 2024 and vaccinated to the end of April 2024) published.
23rd August 2024: Some clarity in the Shingles programme! Clarifications made in the 2 sections about severely immunosuppressed individuals who received Zostavax prior to becoming immunosuppressed in the guidance for healthcare practitioners document. Here are some extracts (but do get familiar with the whole thing): "Severely immunosuppressed individuals (definition in the Green Book Shingles chapter 28a) who were given Zostavax, pre immunosuppressive treatment, should be given 2 doses of Shingrix vaccine when they reach, or if they have reached, the eligible age for vaccination on the national programme. Immunocompetent and mildly immunosuppressed individuals given Zostavax prior to becoming eligible for the national programme should be offered shingles vaccine once they reach the eligible age for the routine programme, leaving an interval of at least one year since they received Zostavax vaccine...Immunocompetent individuals who received Zostavax previously on the routine immunisation programme (between 70 and 79 years of age) are not eligible for additional doses of shingles vaccine and should not be revaccinated or offered Shingrix now. However, individuals who were given Zostavax routinely as part of the national programme and who have since become severely immunosuppressed can be offered 2 doses of Shingrix vaccine at a minimum interval of 8 weeks apart.. There is no reason to leave any interval after previous Zostavax vaccine for this group."
APRIL 2024 Green Book chapter updated to clarify eligibility
SEPT 2023 Eligibility changes, vaccine changes, schedule changes. Read all about it in the Green Book.
JULY 2023 Shingles letter July 4th 2023
Useful links and resources
Vaccine info, invites, and record cards:
Go deeper here
2019 study 'Determinants of shingles vaccine acceptance in the United Kingdom'
Article: The impact of herpes zoster and post-herpetic neuralgia on quality-of-life
Shingles vaccine lowers risk of heart disease for 8 years, study finds
Uptake of shingles vaccination is more likely if proactively offered in primary care
Determinants of shingles vaccine acceptance in the United Kingdom
The impact of herpes zoster and post-herpetic neuralgia on quality-of-life
Shingles vaccine lowers risk of heart disease for 8 years, study finds
Bits and bobs to casually drop into conversation
Did you know....
Shingles can occur at any age, but as people get older, their chance of getting the disease increases. Complications also become more common. People with a weakened immune system are also at higher risk of shingles.
Although rare, it is possible to have shingles more than once.
Around one in four adults will experience shingles in their lifetime
Shingles is often referred to as a 'rash' - but this is just one of the symptoms. It is not a skin condition - it is a 'nerve' condition.
