The shingles vaccination programme should be expanded to adults over the age of 80 years, the Joint Committee on Vaccination and Immunisation (JCVI) has recommended.

In addition, all severely immunosuppressed adults aged 18 years and over should be eligible for the Shingrix jab, an update based on newer modelling said.

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

A phased introduction of the Shingrix vaccination programme began in September last year in England, for those turning 65 years and 70 years, based on recommendations first made by the JCVI in 2019.

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

Now updated modelling provided to the committee showed a ‘clear cost-effective benefit’ in the prevention of shingles and secondary outcomes such as post-herpetic neuralgia from offering a single dose of Shingrix to the over 80s.

There was also a likely additional benefit from a second dose, but there remains some uncertainty around the longer-term vaccine effectiveness in the oldest age groups, and the incremental increase in vaccine effectiveness that would be gained.

On balance ‘offering a second dose of vaccine would prevent more cases of shingles and post-herpetic neuralgia overall, and therefore would be preferable epidemiologically’, the JCVI concluded.

‘It would also mean that the same offer of two doses would be given across the entire shingles vaccination programme.’

Individuals should be eligible regardless of whether they have previously been eligible for, or have been vaccinated with, Zostavax, the committee added.

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

But an analysis done this year by the UK Health Security Agency found the risk of hospitalisation in younger immunosuppressed age groups 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 would need to be evaluated, the update said

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

A version of this article was first published by our sister title Pulse