Shingles Vaccine Coverage Report : England
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This publication is available at https://www.gov.uk/government/publications/herpes-zoster-shingles-immunisation-programme-2021-to-2022-evaluation-reports/shingles-vaccine-coverage-report-adults-eligible-from-april-to-december-2021-and-vaccinated-to-the-end-of-march-2022-england
What Is Mrna And What Is An Mrna Vaccine
Messenger RNA is a bit of genetic code that teaches the bodys immune system how to make antigens, which are proteins that prompt an immune system response.
Messenger RNA vaccines carry this code inside a fatty covering that is injected into muscle tissue. If you contract the virus later, your body will already know how to fight it.
BioNTech co-founder Ãzlem TÃ¼reci told The Atlantic that mRNA vaccines were like showing our immune system a wanted poster of a foe and instructing the immune system to target that outlaw for destruction.
How Long After Ive Received The Shingles Vaccine Am I Contagious
With the currently authorized shingles vaccine, Shingrix, you wont be contagious. The old vaccine, Zostavax, used a weakened form of the live varicella-zoster virus. Therefore, people worried about spreading the disease to the people around them.
Shingrix doesnt use a live version of the varicella-zoster virus. It is inactivated, which means it uses a dead version of the virus. Therefore, you have no risk of transmitting the disease to anyone.
A note from Cleveland Clinic
No one likes to get shots, especially for something youve already been vaccinated for. But the newer version of the shingles vaccine is one youll want to offer up your arm for. The Shingrix vaccine is more than 90% effective at helping you prevent shingles. Since most of us have had chickenpox in the past, the shingles vaccine is an easy way to prevent the dormant chickenpox virus from creeping up and hitting you again with shingles.
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Can You Describe The Vaccine How Long Has It Been Around Is There A New Brand On The Market Thats Showing Better Efficacy
One shingles vaccine, Shingrix, is available in the United States. It was licensed by the FDA in 2017. The manufacturer of a previous vaccine, Zostavax, discontinued making this vaccine in 2020.* In clinical trials, Shingrix was 97% effective at preventing shingles in adults ages 50-69 and 91% for adults 70 years and older. Shingrix is not a live vaccine.
For Patients Who Previously Received Zostavax
Zostavax is no longer available for use in the United States, as of November 18, 2020. Consider the patients age and when he or she received Zostavax to determine when to vaccinate with Shingrix. Studies examined the safety of Shingrix vaccination 5 or more years after Zostavax vaccination. Shorter intervals were not studied, but there are no theoretical or data concerns to indicate that Shingrix would be less safe or effective if administered less than 5 years after a patient received Zostavax.
You may consider an interval shorter than 5 years between Zostavax and Shingrix based on the age at which the patient received Zostavax. Differences in efficacy between Shingrix and Zostavax are most pronounced among older patients. Studies have shown that the effectiveness of Zostavax wanes substantially over time, leaving recipients with reduced protection against herpes zoster. For example, the vaccine efficacy among adults aged 70 to 79 years and adults aged 80 years and older is 41% and 18%, respectively, on average during the first 3 years following Zostavax vaccination.
You should wait at least 8 weeks after a patient received Zostavax to administer Shingrix.
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Mild Side Effects Of Shingles Vaccine:
- Redness, soreness, swelling, or itching at the site of the injection .
It is safe to be around infants and young children, pregnant women, or people with weakened immune systems after you get the shingles vaccine. There is no documentation of a person getting chickenpox from someone who has received the shingles vaccine .
Some people who get the shingles vaccine will develop a chickenpox-like rash near the place where they were vaccinated. As a precaution, this rash should be covered until it disappears.
Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems by CDC and FDA.
Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination. If you have a severe allergic reaction or other emergency that cant wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.
Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS website, or by calling 1-800-822-7967.
The shingles vaccine does not contain thimerosal .
This information was taken directly from the Shingles Vaccine Information Statement dated 10/06/2009.
For more information on possible side effects from vaccination, visit CDCs Possible Side Effects from Vaccines page.
Who Should Get The Shingles Vaccine
The CDC recommends all healthy adults ages 50 years and older get two doses of the shingles vaccine to prevent shingles and problems that can develop after youve had the disease. The two doses should be separated by two to six months. You should get the shingles vaccine even if you:
- Have had shingles: If youve had shingles in the past, you should get the shingles vaccine to help prevent getting the disease again. You should wait until the shingles rash is gone before getting the vaccine.
- Arent sure if youve had chickenpox: Studies show more than 99% of Americans ages 40 and older have had chickenpox at some point in their lives. You should get the shingles vaccine whether or not you remember having chickenpox because theyre caused by the same virus.
- Received the old shingles vaccine : Before November 18, 2020, people were vaccinated with a shingles vaccine called Zostavax. You cant get Zostavax in the United States anymore. If you were vaccinated with Zostavax, you should get vaccinated with the new shingles vaccine, Shingrix.
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Dear Doctor: Is There An Age When Older People No Longer Need The Shingles Vaccine
Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital. He writes an educational column on infectious diseases, public health and sports medicine.North America Syndicate
DEAR DR. ROACH: Regarding shingles, is there a chronological benchmark for older people where shingles vaccination in no longer a major concern and/or provides no longer needed protection? — J.Q.
ANSWER: There is no upper age limit for the shingles vaccine. The risk of complicated shingles continues to increase with older age, meaning that older people are more likely to develop postherpetic neuralgia, which is a terrible and life-altering pain syndrome that may develop after a case of shingles. Worse, the older a person is, the longer the pain may last. For this reason, the vaccine is even more important for our oldest people. Having seen several patients in horrible pain after shingles, I am a very strong proponent of the vaccine.
ANSWER: Congratulations on your exercise. Thats a big investment in your health, and I am glad it is paying off for you in being able to lose a few pounds. Regular exercise of any kind improves a persons health and reduces the risk of developing many chronic diseases, even without a single pound of weight loss, so I always tell people not to get discouraged if there isnt any weight lost.
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Make A Plan To Get 2 Doses
- You can get Shingrix at your doctors office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Five years later, I still take prescription medication for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalized. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.
A 63-year-old harpist who was unable to continue playing due to shingles
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Persons With No Documented History Of Varicella Varicella Vaccination Or Herpes Zoster
Shingles is caused by VZV . After a person recovers from varicella, the virus stays dormant in their body. The virus can reactivate years or decades later, causing shingles.
- Persons who have neither experienced varicella nor received varicella vaccine are not at risk for shingles.
- More than 99% of Americans born before 1980 have had varicella, even if they dont remember it .
- Children and adolescents who have received live-attenuated varicella vaccines are at lower risk for shingles than are those who experienced varicella .
RZV is not indicated and has not been studied for the prevention of varicella.
- Receipt of RZV is not considered proof of prior varicella disease or varicella immunity.
- RZV cannot be considered as either of the two doses of the varicella vaccine series.
For immunocompromised persons, evidence of immunity to varicella includes:
- Documentation of two doses of varicella vaccine, or
- Laboratory evidence of immunity or laboratory confirmation of disease, or
- Diagnosis or verification of a history of varicella or herpes zoster by a healthcare provider.
It is important to note that:
For immunocompromised adults with no documented history of varicella, varicella vaccination, or shingles:
What Shingles Vaccines Are Available
According to the Centers for Disease Control and Prevention , there are 2 vaccines licensed and recommended to prevent shingles in the U.S.: Shingrix and Zostavax.2 The CDC recommends that healthy adults 50 years and older get 2 doses of Shingrix, separated by 2 to 6 months, to prevent shingles and the complications from the disease.3
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Does Medicare Cover The Shingles Vaccine Will I Have To Pay For The Shot
The CDC recommends people 50 years and older get the shingles vaccine. The shot is widely available and the cost may be covered if you have Medicare Advantage or Medicare Part D. Depending on your plan, you may have to cover a deductible, co-pay, or pay for the shot out of pocket and get reimbursement.
Shingles can cause serious complications, like painful long-term nerve damage. To stay safe from such complications, you may want to consider the new shingles vaccine . An older vaccine once widely administered in the U.S. was less effective and is no longer on the market.
Why More Adults Arent Getting The Super
Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things. First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that singles can be incapacitating, causing severe pain that can really limit peoples functioning.
Whats more, difficulty in getting the vaccine may have discouraged those who sought out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.
Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.
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How Do You Get Immunised Against Shingles
You can only get the shingles vaccine on its own, not as a combination vaccine. It is given as a needle.
Shingles vaccines include:
Note the Zostavax vaccine contains a small amount of the live virus. Some people may not be able to receive a live vaccine for medical reasons, please discuss with your doctor or immunisation provider for further information.
Contraindications And Precautions For Herpes Zoster Vaccination
Shingrix should not be administered to:
- A person with a history of severe allergic reaction, such as anaphylaxis, to any component of this vaccine.
- A person experiencing an acute episode of herpes zoster. Shingrix is not a treatment for herpes zoster or postherpetic neuralgia . The general guidance for any vaccine is to wait until the acute stage of the illness is over and symptoms abate.
There is currently no CDC recommendation for Shingrix use in pregnancy therefore, providers should consider delaying vaccination until after pregnancy. There is no recommendation for pregnancy testing before vaccination with Shingrix. Recombinant vaccines such as Shingrix pose no known risk to people who are breastfeeding or to their infants. Providers may consider vaccination without regard to breastfeeding status if Shingrix is otherwise indicated.
Adults with a minor acute illness, such as a cold, can receive Shingrix. Adults with a moderate or severe acute illness should usually wait until they recover before getting the vaccine.
To learn more, see Contraindications and Precautions, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices .
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Does The Vaccine Work
In December 2017 Public Health England published an evaluation of the first three years of the shingles vaccination programme in England . This showed that the shingles vaccine was 62% effective against shingles and 70 to 88% effective against post-herpetic neuralgia in this period. Public Health England estimates that there were 17000 fewer GP consultations for shingles than expected in this 3-year period.
In the early 2000s researchers carried out a very large study of Zostavax, the shingles vaccine used in the UK, involving over 38,000 adults aged 60 or older. The results showed that:
- In adults aged between 60 and 70, the vaccine reduced the number of cases of shingles by 51.3%
- In adults aged over 70, the vaccine reduced the number of cases of shingles by 38%
- The vaccine reduced the incidence of post-herpetic neuralgia by over 66% in all age groups
- For those who did get shingles, the vaccine reduced the severity of the disease.
Read the abstract of this study , published in 2005 by Oxman et al.
Adults aged 80 or over are not offered the shingles vaccine. This is because the effectiveness of the vaccine declines with age in older age groups.
Administration With Other Vaccines
CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines, including COVID-19 vaccines. Concomitant administration of Shingrix with Fluarix Quadrivalent , 23-valent pneumococcal polysaccharide vaccine and Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed , and 13-valent pneumococcal conjugate vaccine has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns. Coadministration of Shingrix with adjuvanted influenza vaccine and COVID-19 vaccines is being studied.
Shingrix and pneumococcal vaccine can be administered at the same visit if the person is eligible for both. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and can be administered concomitantly with Shingrix.
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What Are The Possible Reactions After The Vaccine
The shingles vaccines are very safe. Common reactions to the vaccines include headache as well as soreness, redness and swelling where the vaccine was given. Itching and a rash may also occur after getting ZostavaxÂ® II. Other reactions that may occur after getting ShingrixÂ® include fever, muscle soreness, fatigue, shivering, nausea, vomiting and diarrhea.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
It is important to always report serious or unexpected reactions to your health care provider.
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What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
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Talk With Your Health Care Provider
Tell your vaccine provider if the person getting the vaccine:
- Has had an allergic reaction after a previous dose of live shingles vaccine or varicella vaccine, or has any severe, life-threatening allergies.
- Has a weakened immune system.
- Is pregnant or thinks she might be pregnant.
- Is currently experiencing an episode of shingles.
In some cases, your health care provider may decide to postpone shingles vaccination to a future visit.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting live shingles vaccine.
Your health care provider can give you more information.
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