The benefits of the shingles vaccination programme need to be “effectively communicated” to health professionals and the public to reverse a fall in uptake, according to researchers.
The introduction of shingles vaccination in England has led to a “substantial” reduction in cases and long-term complications, according to the first evidence published on the impact of the programme.
“Communication of the public health impact will be important to reverse the recent trend of declining vaccine coverage”
The herpes zoster vaccination programme was introduced in England in 2013 for adults aged 70 years, with a phased catch-up campaign for those aged 71–79 years.
To minimise workload in primary care, the programme is delivered in general practice alongside the seasonal influenza vaccination programme. The vaccine used is Zostavax, made by Merck.
The new study, carried out by researchers at Public Health England, shows a substantial decrease in shingles cases and associated complications in the first three years since the introduction of the immunisation programme.
The analysis of the programme estimated that the vaccine was 62% effective against shingles and 70-88% effective against post-herpetic neuralgia, or long-term pain – one of its main complications.
“Our population is aging and the risk from getting shingles and complications is higher as you get older”
The study, published on Thursday in the Lancet Journal of Public Health, estimated that GP visits for shingles and associated neuralgia reduced by 35% and 50%, respectively, in those aged 70 during 2013 to 2016.
An estimated 17,000 GP visits for shingles were avoided among the 5.5 million individuals who were given the vaccination in the first 3 years of the programme across England, according to the study.
But, in spite of the “very positive” results, PHE noted that uptake of the vaccine had declined, with a 13% decline in people aged 70 since the start of the programme and an 8.4% decline in people aged 78 years since 2014.
The researchers said: “Despite the encouraging coverage early in the vaccination programme, coverage has declined by 6.9 percentage points since the start of the programme, from 61.8% in 2013-14 to 54.9% in 2015-16.
“Given the demonstrated impact of the programme on herpes zoster and postherpetic neuralgia, the benefits of the programme need to be effectively communicated to health professionals and the public to maximise protection from this potentially debilitating condition in those most at risk,” they said.
PHE noted that the shingles vaccination programme currently targeted adults aged 70 and 78 with a catch-up programme for those aged 71 to 79.
It said it was encouraging healthcare professionals and the public to be aware of the complications surrounding shingles and to encourage those within the eligible groups to get vaccinated.
Dr Mary Ramsay
“It’s the best way to avoid this very nasty disease and the long-term complications that can develop from having it,” said Dr Mary Ramsay, head of immunisations at PHE and one of the study authors.
“Our population is aging and the risk from getting shingles and complications is higher as you get older,” she added.
Over 50,000 cases of shingles occur in people aged 70 years and over each year in England and Wales, with around 50 cases being fatal, according to data cited by PHE.
Shingles is characterised by a skin rash on one side of the body resulting from reactivation of chicken pox virus that has been lying dormant in the body.
It can last on average for two to four weeks and be significantly debilitating, causing loss of sleep and and interference with day-to-day activities. Symptoms can include sharp stabbing pain and burning of the skin in the affected area, feeling unwell, a bad headache and a fever.