Public health experts call for expansion of shingles vaccination
Those at the highest risk of developing shingles are currently not eligible for the vaccination, researchers have warned.
People with severely weakened immune systems are most likely to develop the infection, but are not entitled to the immunisation because of safety concerns, they said in the BMJ.
Shingles − caused by the herpes varicella-zoster virus − is a common skin infection among the elderly, which causes an acute painful rash and can lead to a complication which results in pain lasting from months to years.
“The people arguably in most need of protection against zoster cannot currently benefit from vaccination”
Researchers wanted to examine other conditions that lead to an increased risk of the condition. They analysed data concerning 145,000 UK adults diagnosed with shingles between 2000 and 2011, and compared this with a group of patients without shingles.
The team, from the London School of Hygiene and Tropical Medicine, found that on average patients were around 62 when diagnosed.
People with rheumatoid arthritis, chronic obstructive pulmonary disease, or inflammatory bowel disease were 30% to 50% more likely to have a shingles diagnosis than individuals without these conditions, they found.
Other conditions which were linked to a smaller increased risk were asthma, chronic kidney disease, type 1 diabetes and depression, they said.
They also found that the increased risks were generally greater among younger age groups.
The researchers said that those at the highest risk of shingles are patients with conditions causing severe immunosuppression, such as HIV and leukaemia. But, because of safety concerns, these patients are not eligible for vaccination.
They said that there is a need to identify strategies to reduce the risk of shingles among patients with severe immunosuppression.
They also questioned whether younger people with the conditions associated with a higher risk of developing the condition should be vaccinated against it.
“A range of conditions were associated with increased risk of zoster,” they said. “Severe immunosuppression is known to be associated with an increased risk of zoster.
“What this study has highlighted, however, is that the strongest clinical risk factors for zoster are contraindications to its vaccine; the people arguably in most need of protection against zoster cannot currently benefit from vaccination.
“Alternative risk reduction strategies in these patients would help those at greatest risk of this disease and its complications.”
The authors added: “This study also raises the question of whether younger age groups at high risk of zoster may benefit from vaccination.”
In September 2013 a new vaccination campaign was launched by NHS officials focused on getting older people immunised. The shingles vaccine is given as a single injection for anyone aged 70 or 79.