What is shingles?
Shingles (Herpes zoster) is a painful blistering rash caused by reactivation of the varicella zoster virus – the same virus that causes chickenpox. The shingles rash occurs when the dormant chickenpox virus is reactivated in the nerve tissue, causing inflammation of the nerves. Sometimes pain in the affected region can be severe and prolonged. When it lasts more than three months it is called post herpetic neuralgia (PHN). Other less common complications may include scarring, skin infections, loss of vision or hearing, pneumonia, or neurological complications.
Am I really at risk of shingles?
One in three people will develop shingles in their lifetime. As you get older, the risk of getting shingles and neurological complications increases.
A previous history of chickenpox infection is not a pre-requisite for receiving Zostavax®. The vast majority of adults aged over 60 years in Australia have had primary infection with the varicella zoster virus (VZV) and are therefore at risk of reactivation of latent VZV, causing shingles. Although an individual over 60 years may not remember having had chickenpox, they can still receive the shingles vaccine.
Why should I get vaccinated against shingles?
Shingles is uncomfortable, and for some people can be very painful and last a long time. Although most people recover within a few weeks, some go on to develop chronic nerve pain called post-herpetic neuralgia. This is an ongoing, severe nerve pain, which can sometimes go on for months or even years.
Who can have a free shingles vaccine?
The National Shingles Vaccination Program will provide free shingles vaccination to all people aged 70 years old, with a five-year catch‑up program for people aged 71-79 years old until 31 October 2021. Those who are not eligible for a free vaccine can purchase it with a prescription from their vaccination provider.
Why is the vaccine only available for 70-79 year old?
As a person gets older the chance of developing shingles and long-term complication such as post-herpetic neuralgia increases.
While the vaccine is more effective in younger cohorts, the risk of developing complications from shingles is higher for those over 70 years of age. For people 80 years of age the vaccine is much less effective. This means the vaccine provides the greatest benefit for protecting against the risks associated with shingles for people aged 70-79 year olds.
Under the National Health Act 1953, the Government cannot consider funding a vaccine on the National Immunisation Program (NIP) unless it has first been recommended by the Pharmaceutical Benefits Advisory Committee (PBAC).
The PBAC considers cost-effectiveness of a vaccine, including disease burden for particular groups of people, before making any recommendation. This is a legislated process, which the Government adheres to.
The PBAC assessed Zostavax® in November 2014 and recommended that it be available on the NIP for 70 year olds with a time limited catch up for 71-79 year olds for 5 years. The PBAC has assessed the inclusion of Zostavax® on the NIP for other age cohorts and concluded that a population based program for older and younger age groups was not cost effective.
The vaccine is available on the private market and individuals may wish to consult with their doctor regarding whether the vaccine is clinically appropriate for their circumstances.
What is the government doing to support uptake of the vaccine for Aboriginal and Torres Strait Islander people?
There is no data to suggest that Aboriginal and Torres Strait Islander people are at an increased risk of developing shingles earlier than non-indigenous Australians. The Pharmaceutical Benefits Advisory Committee (PBAC) did not separately consider a proposal for an Aboriginal and Torres Strait Islander specific program.
Aboriginal and Torres Strait Islander people between the age of 70-79 years old are eligible to receive the free shingles vaccine. A range of resources have been developed specifically for Aboriginal and Torres Strait people including a consumer brochure and poster, to promote the new vaccine. These resources are available to download from www.immunise.health.gov.au
Where can I get the shingles vaccine?
The vaccine is available from 1 November 2016 from your GP, Aboriginal Medical Service or vaccination provider.
What is the Government doing to ensure vaccine supply?
The National Shingles Vaccination Program is an ongoing program for 70 year olds with a five year catch up program for 71-79 year olds until 31 October 2021.
The Government is working with the vaccine supplier and states and territories to make the vaccine available to all eligible Australians in a reasonable time frame.
The shingles vaccine is a single dose that you can have any time of the year. We encourage patient’s check the availability of the vaccine with their vaccination provider before making an appointment, as there may be high demand at the commencement of the program.
If I’ve had shingles before should I still get vaccinated?
Discuss with your GP or vaccination provider. Vaccination is still recommended for those who have had shingles infection in the past. It is recommended to wait at least a year between an episode of shingles and having the vaccine.
Is the vaccine safe?
The shingles vaccine is safe for most people aged 70-79 years old, including those people with chronic diseases. A few people may be unable to have the vaccine, please speak with your general practitioner for advice.
The shingles vaccine is generally well tolerated. The most common mild side effects include: redness, soreness, swelling, or itching at the site of the injection, headache and fatigue.
The possible side effects from the vaccine are not as significant as having shingles.
What should you do if there is an adverse event
You are encouraged to report any adverse event following the shingles vaccine to your general practitioner, to the Adverse Medicines Events Line on 1300 134 237, or to the Therapeutic Goods Administration (TGA) through the ‘Report a problem’ link on the TGA website.
You should also contact your state and territory government health authorities as detailed in the Australian Immunisation Handbook 10th Editionhttp://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10-tools~handbook10-appendices~handbook10-appendix.
How effective is the vaccine?
The Shingles Prevention Study assessed efficacy in >38,000 subjects aged 60 years and older and found that Zostavax® reduced the risk of shingles by 51.3 per cent and the risk of post-herpetic neuralgia (PHN) by 66.6 per cent.
Shingles can still occur in people who have received the vaccine, but it is likely to be milder and less likely to result in PHN.
One dose of the vaccine is thought to be protective for approximately 5-10 years, and possibly longer. Studies to monitor the duration of protection of the vaccine are being undertaken.
A booster dose is not currently recommended. If this changes in the future, vaccine recipients and immunisation providers will be advised. This is why it is important to report shingles vaccination to the Australian Immunisation Register (AIR). If required in the future, the register can be used to ensure individuals can be informed of any changes.
Can I receive the shingles vaccine at the same time as other vaccines?
Zostavax® can be given at the same time as the influenza vaccine or pneumococcal polysaccharide vaccine and other live vaccines, using separate syringes and injection sites. If zoster vaccine is not given on the same day as other live viral vaccines (e.g. MMR, yellow fever) separate administration by 4 weeks.
Zostavax® can be administered at the same visit as, or at any time before or after receipt of, inactivated vaccines (e.g. tetanus-containing vaccines).
If given at the same time as the above vaccines, care should be taken to ensure that the appropriate route of injection is used for all vaccinations.
Note: recommendations for co-administration have been taken from The Australian Immunisation Handbook http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home and may differ from the product information.
Can I receive the shingles vaccine at the same time as other medications?
Discuss with your GP or vaccination provider as some medications such as high dose steroids may interact with the Zostavax® vaccine.
Will a record of my vaccination be made?
When you receive your shingles vaccination speak to your vaccination provider to ensure they are reporting the vaccination in the newly expanded Australian Immunisation Register (AIR).
As a vaccination provider, do I record administration of the shingles vaccine in the Australian Immunisation Register?
The name change and expanded capacity of the register does not affect the way you report vaccinations in the AIR. You should report the vaccination the same way you do for all childhood vaccinations.
For more information see the Australian Immunisation Register factsheet http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/fs-immune-registers.cnt.
Your vaccinations don’t stop at childhood. It is important for adults to be vaccinated too. When you get your shingles vaccine, it is a great time to speak with your general practitioner about other vaccines you may need. The influenza and pneumococcal vaccines are also provided free to people aged 65 years and over.
Where can I find more information?
For more information about the shingles vaccine, speak to your general practitioner or visit www.immunise.health.gov.au.
Information brochures for the public and providers have been produced to support the introduction of this vaccine. You can order or print copies of these resources through the Immunise Australia website at www.immunise.health.gov.au.
- Immunise Australia website (www.immunise.health.gov.au).
- Australian Immunisation Handbook 10th Edition- 4.24 Zoster (herpes zoster) (http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-24) (The Handbook), provides information on immunisation practice, new vaccines and vaccine preventable diseases in Australia.
- NCIRS – Zoster Vaccine Factsheet: Information for Providers (http://www.ncirs.edu.au/assets/provider_resources/fact-sheets/zoster-vaccine-FAQ.pdf) produced by the National Centre for Immunisation Research and Surveillance (NCIRS), a research organisation that provides independent expert advice on all aspects of vaccine preventable diseases.