Correspondence

Shingles immunisation programme: introduction of Shingrix® letter

Published 18 August 2021

NHS England and NHS Improvement Regional Directors

NHS England and NHS Improvement Directors of Commissioning

NHS England and NHS Improvement Directors of Public Health and Primary Care

NHS England and NHS Improvement Heads of Public Health Commissioning

NHS England and NHS Improvement Heads of Primary Care

NHS England and NHS Improvement / Public Health England Screening and Immunisation Leads

Clinical Commissioning Groups Clinical Leaders

Clinical Commissioning Groups Accountable Officers

General Practitioners

Local Medical Committees

Local Authority Chief Executives

Local Authority Directors of Public Health

For information:

Chief Pharmacists of NHS Trusts

NHS Foundation Trusts

NHS Trusts

Clinical Immunologists

Rheumatologists

Oncologists

18 August 2021

Introduction of Shingrix® for immunocompromised individuals for whom Zostavax® is clinically contraindicated.

Dear Colleague,

From 1 September 2021, GPs should offer the non-live shingles vaccine Shingrix® to all those who are eligible for shingles vaccination but are clinically contraindicated to receive the live vaccine Zostavax® due to their immunocompromised status. This is based on the recommendation made by the Joint Committee on Vaccination and Immunisation (JCVI).

In line with the current requirements of the shingles programme, the vaccine will be offered via a proactive call to those becoming eligible at 70 years old and will be offered opportunistically or if requested for those over 70 years until the age of 80.

The introduction of this inactivated shingles vaccine follows the recommendation made by the JCVI that Shingrix® should be offered to all immunocompromised people for whom Zostavax® is contraindicated but who are eligible for vaccination under the current programme, so that they can gain a similar level of protection to those who are not immunocompromised.

The Committee noted that vaccination in this group was particularly important, due to the higher incidence of herpes zoster. This advice was consistent with the original recommendation for vaccination of all adults aged 70 to 79 years with herpes zoster vaccine. There is now sufficient supply of the Shingrix® vaccine to be able to implement the JCVI recommendation.

Key points about the change to the programme:

• Shingrix® will be able to be ordered online via the ImmForm website for those who are eligible for shingles vaccination but are clinically contraindicated to receive the live vaccine Zostavax® due to their immunocompromised status. Shingrix® should be used for those who are eligible from 1 September 2021
• Shingrix® requires a 2 dose schedule, with the second dose administered from 2 months following the first dose
• it is important that Shingrix® is given only to those who are clinically contraindicated for Zostavax® due to their immunocompromised status in order to have sufficient supply for those who need to receive it
• GPs should continue to offer Zostavax® to eligible patients who are not contraindicated
• any individual who reaches their 80th birthday is no longer eligible for a shingles vaccination due to the reducing efficacy of the Zostavax® vaccine as age increases. This reflects the 2010 recommendation made by JCVI. However, where an individual has turned 80 years of age following their first dose, a second dose should be provided to complete the 2-dose schedule for Shingrix®
• further detailed information and guidance for healthcare professionals relating to this change is set out in Annexe A
• details on ImmForm vaccine coverage data collection are set out in Annexe B

If you have any queries about this letter please contact immunisation@phe.gov.uk

Ongoing efforts are needed to identify and vaccinate all Zostavax® eligible individuals who have not been vaccinated to ensure a continuing reduction in the number of cases of this condition. We encourage providers to take every opportunity to offer shingles vaccination to eligible patients throughout the year to help to protect as many older people as possible.

We are grateful for your continued support of the shingles immunisation programme.

Yours faithfully,

Deborah Tomalin

NHS England and NHS Improvement, Director of Public Health Commissioning and Operations

Dr Mary Ramsay

Public Health England, Head of Immunisation