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Shingles vaccine

14 Oct 2019 – Currently, we have no stock of the new non-live shingles vaccine. If you want to be immunised by the new non-live shingles vaccine at our clinic, please join our waiting list by EMAILING us your full name and mobile number (this is not possible via telephone) at info@hhpharmacy.co.uk  No acknowledgment will be sent back.  We do keep an accurate list of people who have emailed us and we contact you as soon as we have the vaccine.


Shingles Vaccination Service

We offer vaccination against shingles with the new non-live shingles vaccine (Shingrix manufactured by GSK) and we were the first provider to offer this vaccination in the UK since June 2018.  This vaccine is not yet widely available in most countries including the UK.  This vaccine is imported for us under UK regulations by one of the most established medicines importers in the UK.  It is not clear when the manufacturer will be able to make enough of the new non-live shingles vaccine to launch it in the UK.  This vaccine is authorised in all EU member states, however, the manufacturer has only managed to launch it in three countries so far.  This is because, currently the supply is considerably less than the high levels of demand for this vaccine. 

For more information about the NEW shingles vaccine, visit the following official websites:

The cost is £230 per dose (£460 for the full course of two vaccines given two months apart – no other fees).  The vaccination course consists of 2 doses given 2-6 months apart.  To be able to guarantee the supply of both doses of this vaccine for you, we have to charge you for the full course in advance when you book your first appointment over the phone.

The stock / appointment is going to be allocated on first come first serve basis.

To book an appointment, please call 020 7435 7075.  We cannot arrange appointments via email.

Currently we have appointments, Mon-Fri (17:30 to 18:30) and Saturday (09:00 to 15:00) clinics.

We are based at 35 South End Road, London, NW3 2PY (right opposite the Hampstead Heath Overground Station). 

Because of  cold chain requirements and issues related to prescribing responsibility, we cannot sent out the vaccine to you or supply the vaccine to you to be given elsewhere.


https://www.cdc.gov/shingles/fact-sheets/shingles-factsheet-adults.html

Shingles is a painful and unpredictable disease. Shingles is debilitating, very common and it can be associated with serious complications. Vaccination is the best way to help protect yourself against shingles (from www.cdc.gov – a US resource).


Vaccination against shingles

What’s the difference between the old live shingles vaccine and new non-live shingles vaccine?*

The live shingles vaccine (i.e. the shingles vaccine currently used by the NHS) is given as a single subcutaneous dose and can reduce the risk of shingles by 51%, post-herpetic neuralgia by 67%, and the overall burden of illness by 61%.  The live shingles vaccine becomes less effective with increasing age, and efficacy wanes completely approximately 10 years after vaccination.

The new non-live shingles vaccine requires two intramuscular doses 2 to 6 months apart, and has a substantially higher efficacy than the live vaccine, reducing risk of shingles by 97%.  Early studies suggest a single dose does not produce a robust immune response, so attendance for both doses is important.  

Unlike live shingles vaccine, the efficacy of new non-live shingles vaccine is high even for patients over 70. Protection declines slightly four years after vaccination but longer term efficacy is unknown.

The new non-live shingles vaccine might carry a greater risk of side effects (non-serious) at injection sites such as pain, redness and swelling. Side effects of the new non-live shingles vaccine are more frequent after the second dose than after the first.

The new non-live shingles vaccine is safe and effective in patients previously vaccinated with the live shingles vaccine.

*Reference:  Le Phuc, Rothberg Michael. Herpes zoster infection


Postherpetic neuralgia

“Five years later, I still take medicines for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalised. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.” – A 63 year old harpist who was unable to continue playing due to shingles.

shingrix-shingle-pain

The pain from shingles has been compared to childbirth or passing a kidney stone. It can last for months or years after the rash goes away. Shingles vaccine can help prevent shingles and the complications from the disease.


Can the new non-live shingles vaccine be given to immunocompromised individuals?

The new non-live shingles vaccine can be given to people who are immunocompromised. You can still get the new non-live shingles vaccine if you are taking immunosuppressive medication, anticipating immunosuppression, or have recovered from an immunocompromising illness. 
People who are immunosuppressed, as occurs with leukemia, lymphoma, and human immunodeficiency virus (HIV) infection, and people who receive immunosuppressive drugs, such as steroids and cancer chemotherapy are at greater risk of shingles.
The live shingles vaccine (the old shingles vaccine; one available on the NHS for over 70s) should not be given to someone who is immunocompromised.

Can someone who has had shingles be vaccinated with the new non-live shingles vaccine?

Yes, if you had shingles in the past, you can get Shingrix to help prevent future occurrences of the disease.  There is no specific length of time that you need to wait after having shingles before you can receive Shingrix, but generally you should make sure the shingles rash has gone away before getting vaccinated.


Can the new non-live shingles vaccine be given to people who have already received the old live shingles vaccine? If so what interval should separate them?

Yes, people who previously received the old shingles vaccine, can receive two doses of the new shingles vaccine. The first dose of the new shingles vaccine should be given at least 2 months after the old version given.


Is there an upper age limit for receipt of new non-live shingles vaccine?

There is no upper age limit for either shingles vaccine.


Do you need to have the new non-live shingles vaccine every year? 

No, it is a one-off course of two injections.


Can the new non-live shingles vaccine be given at the same time as other vaccines?

Yes, the vaccine can safely be given at the same time or any time before or after other vaccines including the seasonal flu vaccine and the pneumonia vaccine.


How safe is the new non-live shingles vaccine?

There is good evidence showing that the new shingles vaccine is safe.  It is already been used in three countries, and no safety concerns have been raised.  The vaccine has few side effects.


Will there be any side effects from the new non-live shingles vaccine?

  • Most people had a sore arm.
  • Many people had redness and swelling where they got the shot (wider than 4 inches for some people).
  • Many felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. 

Side effects usually go away after 2 to 3 days. Remember that the pain from shingles can last a lifetime, and these side effects should only last a few days.

For the full list of side effects and restrictions with the new shingles vaccine, see the package leaflet ( page 25 to 28).

The first post-marketing safety data is reassuring (published by CDC in Feb 2019); serious adverse events were rare, and no unexpected patterns were detected.


How is the new non-live shingles vaccine given?

It is given as an injection into the upper arm.


Do I need the new non-live shingles vaccine if I’ve never had chickenpox?

Yes, the chances are that you have had chickenpox at some point without knowing it.  Some people have chickenpox without displaying any of the typical chickenpox symptoms like rash.


Is the new non-live shingles vaccine available on the NHS?

No, currently the old live shingles vaccine offered on the NHS for over 70s only. The live shingles vaccine was launched around 10 years ago.

In addition to provision of shingles vaccination with the new non-live shingles, we provide vaccination with the live shingles vaccine privately for people 50 years of age and over: £160 – given as a single dose.


Who will be able to have the shingles vaccination (with the old live shingles vaccine) free on the NHS from their GP practice?

Both shingles vaccines are indicated for those aged 50 and over but it is only the old live vaccine available on the NHS. See the who’s eligible for NHS shingles vaccination? poster.


I am under 50 years of age, can I get vaccinated against shingles?

Currently, both shingles vaccines do not have a UK marketing authorisation for use in people under 50 years of age.  This generally means that the safety and effectiveness of these vaccines have not specifically tested in licensing clinical trials in people under 50 years of age.  Generally, the younger people were not studied, because, although shingles can occur at any age, incidence increases with age with an estimated lifetime risk of one in four.  The increasing incidence with age is thought to be associated with age related immune senescence.

We may consider shingles vaccination for adults under 50, in exceptional circumstances.  If you are under 50, you need an initial telephone consultation, before booking your appointment.


 

Benefits & side effects of the new shingles vaccine (from www.cdc.gov – a US resource).

The new non-live shingles vaccine is the only shingles vaccine to achieve ≥90% efficacy across all age groups studied (from GSK press release 23/03/18: https://goo.gl/T9XXjs).


 

Shingles

I feel healthy; am I really at risk for shingles?

If you’re one of the 99% of adults over 50 years old who have had chickenpox, the virus that causes shingles is inside your body and can reactivate at any time. It is estimated that around 1 in 4 people will get shingles in their lifetime. No matter how healthy you feel, your immune system declines as you age, and that puts you at an increased risk for shingles.


How do you catch shingles?

Shingles is not caused by exposure to another person with shingles. People with shingles can only possibly cause a susceptible person to develop chickenpox, not shingles.

There is no evidence that shingles can be acquired from another individual who has chickenpox.


What is post-herpetic neuralgia (PHN)?

After the shingles blisters heal, pain can last for months or years and may be severe.  This long-lasting nerve pain is called post-herpetic neuralgia or PHN.


Is shingles serious?

Yes, it can be.  Not only can shingles be very painful and uncomfortable, some people are left with long-lasting pain called postherpetic neuralgia (PHN) for years after the initial rash has healed.  Very occasionally, shingles can be fatal.

Shingles, in some cases, disseminate into the lungs, liver, gut, and brain, leading to pneumonia, hepatitis, encephalitis. Disseminated shingles is more likely to occur in those who are severely immunocompromised, with a case fatality rate reported to be between 5 and 15%, and most deaths being attributable to pneumonia.


Who is at an increased risk of shingles?

The incidence and the burden of shingles increases with age.  The risk of shingles is also increased in individuals with certain conditions, including systemic lupus erythematosus, rheumatoid arthritis, diabetes and Wegener’s granulomatosis.


Efficacy of the live shingles vaccine (one available on the NHS). Reduction of shingles incidence compared with placebo (https://goo.gl/sjJEFR).

You may have already got a different shingles vaccine before. If you did, you can still get the new shingles vaccine.

The Shingles Support Society offers support to people with shingles & postherpetic neuralgia: 0845 123 2305 or https://shinglessupport.org.uk/


Cost of vaccinations against shingles with the NEW non-live vaccine: £230 per dose – 2 doses required 2-6 months apart (i.e. there is no consultation fees).

Cost of vaccinations against shingles with the OLD live vaccine: £160 – 1 dose required (i.e. there is no consultation fees).

To book an appointment please call 020 7435 7075

Our telephone line is open Mon – Fri 9:00 to 18:30 & Saturday: 9:00 to 17:30

For more information email: info@hhpharmacy.co.uk