Around one in four adults will experience shingles in their lifetime. Shingles is a viral infection that causes a painful rash. Usually, the rash is on one side of the chest or belly. But it can also appear anywhere including the face. Shingles can also have other symptoms like headaches and feeling generally unwell. Shingles symptoms usually resolve within 4 weeks. But some people experience continuing pain and other serious complications. This ongoing, or more often intermittent, pain is called ‘post-herpetic neuralgia’. One of the main reasons for giving a shingles vaccine is to prevent this lasting pain.
Shingrix® replaced Zostavax® in the routine vaccination schedule in September 2023. It is recommended for those aged 60-79, but rollout is over a period of years and has started with those aged 65 and 70. Zostvax® was previously offered to those aged 70-79, and these individuals remain eligible for Shingrix® (or Zostavax® while supplies remain) until their 80th birthday.
As a live vaccine Zostavax® was not recommended for those with weak immune systems, Shingrix has been recommended for these individuals aged 70-79 since September 2021.
We want to report initial uptake of first dose of shingles vaccine in those eligible by age from September 2023 onwards.
Our aim is to assess whether the uptake is lower than planned for, and if there would capacity to expand the rollout faster than anticipated to other ages within the recommended band. This would give more people the opportunity to be vaccinated against shingles.
Our study aims to describe the coverage of Shingrix® vaccine uptake in eligible adults in England. We will conduct a cohort study of Shingrix®-eligible adults (from 01-Sept-2023 to latest data available) of those
- aged 65 and 70 – rollout cohort
- those aged 71-79 to monitor catch up uptake- catch up cohort
Individuals will enter the study from the latest of: study start (01-Sept-2023), the year they become eligible, and one year after current practice registration. We will exclude any individual in the rollout cohort (age 65 and 70) who has received any shingles vaccine prior to 1st September 2023. (Shingrix® or Zostavax®)
Individuals will be excluded from the catch- up cohort (age 71-79) if they have received any shingles vaccine prior to age 70 eligibility (as part of historical vaccine campaigns).
Individuals will be eligible for inclusion until the earliest of end of study (date latest data available until), age 66 or 71 for rollout cohort, 80 for catch up cohort, death, practice no longer contributing to CPRD, or end of registration.
We will describe the number and proportion vaccinated of eligible adults in each cohort (rollout and catch up) overall and stratified by age, sex, region, ethnicity and index of multiple deprivation (IMD).
This analysis will be presented to JCVI to inform vaccination policy. If we find that uptake of vaccination is lower than planned for then there may be the capacity to expand the rollout faster than anticipated to other ages within the recommended band of 60-79 year olds. This would give more people the opportunity to be vaccinated against shingles- lowering both the incidence and severity of shingles in older people.
This analysis will be a baseline and will be repeated yearly for surveillance purposes.
Shringrix® vaccine uptake overall and cumulatively by month for the rollout cohort; and shingles vaccine uptake for the catch up cohort.
Gayatri Amirthalingam - Chief Investigator - UK Health Security Agency (UKHSA)
Jemma Walker - Corresponding Applicant - UK Health Security Agency (UKHSA)
Colin Campbell - Collaborator - UK Health Security Agency (UKHSA)
Colleen Chambers - Collaborator - UK Health Security Agency (UKHSA)
Julia Stowe - Collaborator - UK Health Security Agency (UKHSA)
Lisa Byrne - Collaborator - UK Health Security Agency (UKHSA)
Nick Andrews - Collaborator - UK Health Security Agency (UKHSA)
Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation