New shingles vaccine awaits decision on NHS use

Shingrix, which is now available privately in the UK, was previously recommended by the Joint Committee on Vaccination and Immunisation (JCVI) for inclusion in the routine shingles vaccination programme.

Shingles vaccines aim to boost pre-existing immunity to varicella zoster virus (VZV) and prevent reactivation of latent VZV, which causes herpes zoster. | GETTY IMAGES
Shingles vaccines aim to boost pre-existing immunity to varicella zoster virus (VZV) and prevent reactivation of latent VZV, which causes herpes zoster. | GETTY IMAGES

Shingrix contains recombinant varicella zoster virus glycoprotein E antigen, adjuvanted with AS01B. As a subunit vaccine it carries no risk of causing disease, making it particularly suitable for use in people who are immunocompromised and so cannot receive Zostavax, the live vaccine currently used in the routine immunisation programme.

In February 2019, the JCVI recommended that the routine shingles vaccination programme be changed to offer Shingrix routinely at the age of 60 years. The committee recommended that people aged between 60 and 70 years also be offered Shingrix.

The JCVI proposed that the programme be implemented in stages, starting with vaccination at ages 65 and 70 years. It said: 'This should continue until vaccine had been offered to all those aged 65 to 70 years of age. Once that group had been offered vaccination, the routine age for vaccination should then move to 60 years of age, with vaccination continuing at 65 years of age, until vaccine had been offered to all those aged 60 to 65 years of age.' 

The JCVI said that people aged 86 or over who had not previously been offered Zostavax should also be considered for vaccination with Shingrix.

In addition, the committee recommended that Shingrix be offered to immunocompromised individuals aged 50 and over. 

The JCVI emphasised that all its recommendations were 'subject to procurement of Shingrix at a cost-effective price.'

Shingrix requires two doses two months apart, whereas Zostavax is given as a single dose. 

In trials, Shingrix reduced the risk of shingles by 97.2% compared with placebo in people aged 50 years or older, and by 91.3% versus placebo in people aged 70 years or older.

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