The shingles jab should be extended to over 80 and immunocompromised younger people

The shingles vaccination program should be extended to adults aged over 80, the Joint Committee on Vaccination and Immunization (JCVI) has recommended.

In addition, all severely immunocompromised adults age 18 and older should be eligible for the Shingrix jab, an update based on newer models said.

It follows a move announced last year that the NHS will switch to two doses of the non-live Shingrix shingles vaccine instead of one-dose Zostavax for everyone.

A phased introduction of the Shingrix vaccination program began last September in Englandfor those turning 65 and 70, based on recommendations first made by the JCVI in 2019.

Over time, there are plans to move eligibility to those aged 60 and 65.

Now updated modeling provided to the committee showed a “clear cost benefit” in preventing shingles and secondary outcomes such as post-herpetic neuralgia from giving a single dose of Shingrix to those over 80.

There was also likely additional benefit from a second dose, but some uncertainty remains regarding long-term vaccine efficacy in older age groups and the incremental increase in vaccine efficacy that would be achieved.

Overall, “providing a second dose of vaccine would prevent more cases of shingles and post-herpetic neuralgia overall and would therefore be epidemiologically preferable,” the JCVI concluded.

“It would also mean that the same two-dose offer would be given across the entire zoster vaccination schedule.”

People should be eligible regardless of whether they were previously eligible or were vaccinated with Zostavax, the committee added.

The committee previously recommended Shingrix for immunocompromised people over the age of 50 because that was its licensed indication at the time.

But a review this year by the UK’s Health Security Agency found that the risk of hospitalization in younger age groups with immunosuppression from shingles or resulting post-herpetic neuralgia was similar to other cohorts who were already eligible for vaccination.

Based on this, 18-49 year olds in this category should be considered for vaccination, the JCVI concluded.

Cohorts receiving vaccination at a relatively young age due to immunosuppression may benefit from revaccination later in life, but this should be evaluated, the update said.

The recommendations have been forwarded to the Department of Health and Social Care whose role is to set vaccination policy.