Shingles Vaccine adult immunisation update and report

Jul 26, 2024

Chronic Pain Ireland Statement on Herpes Zoster (Shingles) Vaccine Report

July 26 2o24

Last Friday saw the publication of HIQA’s health technology assessment (HTA) on including the herpes zoster (HZ) vaccination in Ireland’s adult immunisation programme. Chronic Pain Ireland was pleased to be represented on the Expert Advisory Group however, we are disappointed with the recommendations which found that while the vaccine is proven safe and effective, its benefit decreases over time and at the current price, adding the shingles vaccination to the routine immunisation schedule for those aged 50+ would not be an efficient use of HSE resources.

We have long campaigned to raise awareness of the dangers of shingles and postherpetic neuralgia especially as we age, and we advise anyone concerned to speak to their healthcare professional. Unfortunately, the cost of the vaccine is not covered, leaving individuals to pay out of pocket, which is unaffordable for many. Currently, HZ vaccination is only available through GPs to families who can afford to pay for it, contributing to healthcare inequity.

According to the report findings, the probability of postherpetic neuralgia (PHN) after HZ increases with age, from a one in 10 chance in 50- to 59-year-olds to one in five in those aged over 80. People who are immunocompromised are also at increased risk of shingles and experiencing a severe disease course. Feedback from the public consultation highlighted the significant impact that shingles can have on individuals who experience longer-term complications. However, Chronic Pain Ireland felt that the number of responses from the general public was very low. This may be due to the fact that for those people over the age of 65+ who are not proficient in using the internet, that this feedback mechanism was a barrier. The language and level of detail in the report while welcome was another barrier and those that are most at risk may not have participated or even known about the opportunity to engage and participate in the consultation process within the 6 week window.

Overall being part of this process was a significant learning curve and surprising to see that the study relied on international figures in respect of the prevalence of shingles as Ireland does not capture the full picture (see section 3.3 of the report). ‘In Ireland, HZ is not categorised as a notifiable disease and only hospitalised cases of varicella are listed as notifiable. HZ in the community in Ireland is estimated from data obtained from the sentinel surveillance programme for HZ, one of several sentinel general practice surveillance programmes for clinical diseases in Ireland. The sentinel programme comprises a network of 90 general practices (representing 9 to 10% of the population) that report, on a weekly basis, the number of clinical episodes with HZ or varicella’. It is concerning that we don’t have an adequate mechanism in place to fully report on the Irish data required to determine the prevalence of shingles and postherpetic neuralgia. Greater work needs to be carried out to ensure that Ireland effectively captures the necessary data in respect of its own health population to better determine cost effectiveness of treatments, interventions etc., and to better inform and support decision making.

Given the limited prevalence of data for the Irish population, Chronic Pain Ireland would welcome any potential opportunities to partner with other organisations and researchers in applying for a funded nation-wide research study to gather the necessary data that could provide more accurate information regarding the prevalence of shingles, post-herpetic neuralgia or chronic pain so as to determine the burden of disease in this country.

Read full Report Here

Read plan language Report Here

Chronic Pain Ireland will continue to advocate and raise awareness in respect of the incidence and severity of shingles which increases with age, with most cases occurring in people over the age of 50 years. People who are immunocompromised are also at an increased risk of shingles. The most common complication of shingles is post-herpetic neuralgia (PHN) which is experienced as nerve pain that persists after the shingles rash has healed. It can be more common and more severe in older people than in younger people. After the age of 50 years, about 20% of patients with shingles will develop post-herpetic neuralgia (PHN).

Older news – 21/03/24

Decision on whether to add shingles vaccination in the adult immunisation schedule in Ireland – Public Consultation NOW CLOSED

Chronic Pain Ireland, as part of the multidisciplinary Expert Advisory Group (EAG), collaborated in the assessment conducted by HIQA at the request of the Department of Health, following a recommendation from the National Immunisation Advisory Committee (NIAC). The final assessment will provide advice to the Minister for Health to inform a decision on whether to include shingles vaccination in the adult immunisation schedule in Ireland.”

Chronic Pain Ireland are calling for the general public and those within our community to take part in this public consultation and provide feedback.

For more information and to provide feedback visit HIQA https://www.hiqa.ie/reports-and-publications/consultation/herpes-zoster-shingles-vaccination-health-technology

HIQA Press release available: https://www.hiqa.ie/hiqa-news-updates/hiqa-launches-public-consultation-assessment-adding-shingles-vaccine-national

What is Shingles?

Shingles is a viral infection caused by the same virus that causes chickenpox. Shingles causes a painful, blister-like rash. While some people experience severe disease or continue to experience pain for months, or even years, for most people, symptoms normally clear up within a month.

The incidence and severity of shingles increases with age, with most cases occurring in people over the age of 50 years. People who are immunocompromised are also at an increased risk of shingles. The most common complication of shingles is post-herpetic neuralgia (PHN) which is experienced as nerve pain that persists after the shingles rash has healed. It can be more common and more severe in older people than in younger people. After the age of 50 years, about 20% of patients with shingles will develop post-herpetic neuralgia (PHN).