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GPs told to offer shingles vaccines all year round amid falling uptake

GP practices have been told to offer shingles vaccinations ‘opportunistically’ to patients throughout the year as they become eligible.

Guidance issued by Public Health England and NHS England said the change, which came into effect this month, was related to increased central vaccine availability.

Previous advice asked GPs to immunise the ‘majority of patients’ in the autumn months but the new guidance said that the shingles vaccine can be ‘offered opportunistically to patients throughout the year as they become of eligible age’.

In the past, eligibility was based on people being 70 after 1 September, however this update means that it is now based on their birthday rather than their age at the time of the yearly cross over.

The joint letter reported a decline in the vaccine uptake, and stated that just under half of eligible 70- and 78-year-olds had been vaccinated by the end of August last year.

PHE and NHS England wrote: ‘We are seeing a year-on-year decline in shingles vaccine uptake, but hope that simplifying eligibility will assist in helping practices to identify eligible patients, including those who have missed out previously.’

The letter also warned of continuing reports of immunosuppressed individuals receiving the vaccine inadvertently, which PHE has said can lead to potentially ‘severe’ side effects.

PHE head of immunisations Dr Mary Ramsay said: ‘Because the vaccine contains weakened living virus, it is estimated that around 3% of eligible people, who have conditions that suppress their immune system, should not receive it. If an immunosuppressed person does inadvertently receive the vaccine, side effects can potentially be severe.

‘It is important for all healthcare professionals to be aware of who should and shouldn’t receive the shingles vaccine before proceeding with immunisation.

Dr Ramsay added that to help immunisers feel confident, they should refer to the shingles patient group direction and check their patient’s medical history, as well as the Green Book.

Earlier this year, PHE urged GPs to encourage patients to get the vaccine, after it found that there had been a decrease in uptake since its inception in 2013.

This was despite a new study which showed that the incidence of shingles had reduced by 35% in the three years following its introduction for those aged 70.

The vaccine should be offered to:

  • patients aged 70 years, on or after their 70th birthday
  • patients aged 78 years, on or after their 78th birthday
  • patients who were eligible for immunisation in the previous programme years but have not yet been vaccinated against shingles. These are:
    • anyone in their 70s who was born on or after 2/9/1942
    • 79 year olds (until their 80th birthday).

Care must be taken not to miss the patients who have already turned 70 or 78 years of age since 2 September 2017.

Patients remain eligible until their 80th birthday due to the reducing efficacy of the vaccine as age increases.

Source: NHS England and PHE


          

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