Guidance

Shingles (herpes zoster): the green book, chapter 28a

Shingles immunisation information for public health professionals.

• From: UK Health Security Agency
• Published: 12 July 2013
• Last updated: 3 April 2024 — See all updates

Documents

Shingles: the green book chapter 28a (from 1 September 2023)

Ref: UKHSA publications number GOV-15100

PDF, 135 KB, 13 pages

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Shingles: the green book chapter 28a (up to 31 August 2023)

Ref: PHE publications number 2021499

PDF, 150 KB, 15 pages

Details

Shingles (herpes zoster) is caused by the reactivation of a latent varicella zoster virus (VZV) infection, sometimes decades after the primary infection.

Primary VZV infection typically occurs during childhood and causes chickenpox (varicella). Following primary VZV infection, the virus enters the sensory nerves and travels along the nerve to the sensory dorsal root ganglia and establishes a permanent latent infection. It is not known what causes reactivation of the latent virus, which leads to the clinical manifestations of shingles, but reactivation is usually associated with conditions that depress the immune system such as immunosuppressive therapy, HIV infection and/or old age.

The incidence of shingles in England and Wales is estimated to be around 790 to 880 cases per 100,000 people per year for those aged 70 to 79 years.

The risk and severity of shingles increases with age.

Changes from 1 September 2023

Changes to the shingles programme includes new eligibility criteria for the Shingrix® vaccine for those who are turning 65 and 70 after 1 September 2023. Individuals who are severely immunocompromised aged 50 years and over also become eligible.

Further information on changes to the programme are available within a letter published on GOV.UK by the UK Health Security Agency (UKHSA) and NHS England.

Published 12 July 2013

Last updated 3 April 2024 + show all updates

1. 3 April 2024

   Updated 'Shingles: the green book chapter 28a (from 1 September 2023)' to clarify dosage and schedule information.

2. 26 July 2023

   Added the correct interval for people receiving the vaccine in Northern Ireland.

3. 17 July 2023

   Added chapter to be used from 1 September 2023.

4. 23 August 2021

   Extensive revisions to chapter to include the Shingrix vaccine.

5. 26 February 2016

   Updated to include information on intramuscular administration, in line with amended product license.

6. 9 October 2015

   Updates on the contraindications and special considerations for the shingles vaccine.

7. 28 July 2015

   Added the new age cohorts eligible for the vaccination from 1 September 2015.

8. 23 September 2014

   Shingles (herpes zoster): the green book, chapter 28a has been updated.

9. 12 July 2013

   First published.