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from vaccination to prevent further attacks.’ Shingles is a recurrence of a viral infection of a nerve, with a painful skin rash that develops into itchy blisters. It is caused by the virus varicella-zoster, which lies dormant until it is reactivated. What triggers this is unclear, but it is associated with lowered immunity.
Higher incidence
Help to ease the pain
People over 70 are benefiting from a new vaccination programme against shingles. Susan Mayor reports
SUMMARY
Last year the NHS began phasing in a shingles vaccine programme for older people in the UK, beginning with those who were aged 70 or 79 on September 1 2013. The programme is staggered because it would be impractical to vaccinate everyone who is 70 in a single year. Kathryn Gedman, a practice nurse in Caldicot, Monmouthshire, was impressed by the positive response to the vaccine when she ran her practice’s first shingles vaccination clinic in October. ‘We ran a search within the age group and then wrote to each patient explaining the shingles vaccination and
Shingles vaccination Offered to everyone aged 70 and 79 on September 1 2013 as part of routine vaccination. Given by subcutaneous injection. Can be given at the same time as the seasonal influenza vaccine, at separate sites ideally in different limbs. Should not be given to people who have primary or acquired immunodeficiency states due to conditions such as leukaemia or HIV/AIDS; who are on immunosuppressive therapy (including high-dose corticosteroids but not topical/inhaled steroids or low-dose oral steroids); who have active, untreated TB; who are pregnant; and/or who have had a confirmed anaphylactic reaction to any component of the vaccine. offering them a five-minute appointment at the clinic,’ says Ms Gedman. ‘We had a good take-up.’ More than 80 per cent of practice patients aged 70 (176
A shingles vaccination programme is gradually being introduced across the UK for people in their seventies, the age group most at risk of experiencing severe symptoms following reactivation of the virus. Practice nurse Kathryn Gedman explains how she set up a shingles vaccine clinic. Author Susan Mayor is a freelance journalist. Her attendance at the European Union Geriatric Medicine Society, where data on shingles vaccination were presented, was supported financially by Sanofi Pasteur MSD.
out of 215) were vaccinated against shingles, along with a similar proportion of those aged 79 (97 out of 123). Typical questions that patients asked included: ‘Will the vaccine give me a dose of shingles?’ and ‘What if I have already had shingles?’ Ms Gedman says: ‘We were able to reassure patients that the vaccine would definitely not cause shingles, but would protect them against getting it or reduce the severity if they did. People who have had shingles before still benefit
The risk and severity of shingles increases with age. Incidence increases from around two to three per 1,000 person years in people aged 50, to eight per 1,000 person years in the over seventies. Shingles affects a specific area on either the left or right side of the face or body, along the nerve where the virus has reactivated, usually starting with abnormal skin sensations and pain. The commonest complication is post-herpetic neuralgia, which is pain persisting or recurring 90 days or more after the shingles rash appears. The pain may be severe and can last for months; in older people this may accelerate decline in functioning. In a clinical trial of people over 60, the new shingles vaccine Zostavax reduced the incidence of shingles by 51 per cent and post-herpetic neuralgia by 67 per cent. The vaccine’s benefits and cost effectiveness are believed to be greatest in people aged 70 to 79 years. According to the NHS Choices website, side effects are mild and short-lived. Given the potential severity of shingles in older people, Ms Gedman is pleased to offer patients the chance to protect themselves. In future years she plans to give the shingles vaccine at the same time as the seasonal flu vaccine. ‘But we will give them in different arms,’ she says NS
NURSING STANDARD january 29:: vol 28 no 22 :: 2014 25 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
from vaccination to prevent further attacks.’ Shingles is a recurrence of a viral infection of a nerve, with a painful skin rash that develops into itchy blisters. It is caused by the virus varicella-zoster, which lies dormant until it is reactivated. What triggers this is unclear, but it is associated with lowered immunity.
Higher incidence
Help to ease the pain
People over 70 are benefiting from a new vaccination programme against shingles. Susan Mayor reports
SUMMARY
Last year the NHS began phasing in a shingles vaccine programme for older people in the UK, beginning with those who were aged 70 or 79 on September 1 2013. The programme is staggered because it would be impractical to vaccinate everyone who is 70 in a single year. Kathryn Gedman, a practice nurse in Caldicot, Monmouthshire, was impressed by the positive response to the vaccine when she ran her practice’s first shingles vaccination clinic in October. ‘We ran a search within the age group and then wrote to each patient explaining the shingles vaccination and
Shingles vaccination Offered to everyone aged 70 and 79 on September 1 2013 as part of routine vaccination. Given by subcutaneous injection. Can be given at the same time as the seasonal influenza vaccine, at separate sites ideally in different limbs. Should not be given to people who have primary or acquired immunodeficiency states due to conditions such as leukaemia or HIV/AIDS; who are on immunosuppressive therapy (including high-dose corticosteroids but not topical/inhaled steroids or low-dose oral steroids); who have active, untreated TB; who are pregnant; and/or who have had a confirmed anaphylactic reaction to any component of the vaccine. offering them a five-minute appointment at the clinic,’ says Ms Gedman. ‘We had a good take-up.’ More than 80 per cent of practice patients aged 70 (176
A shingles vaccination programme is gradually being introduced across the UK for people in their seventies, the age group most at risk of experiencing severe symptoms following reactivation of the virus. Practice nurse Kathryn Gedman explains how she set up a shingles vaccine clinic. Author Susan Mayor is a freelance journalist. Her attendance at the European Union Geriatric Medicine Society, where data on shingles vaccination were presented, was supported financially by Sanofi Pasteur MSD.
out of 215) were vaccinated against shingles, along with a similar proportion of those aged 79 (97 out of 123). Typical questions that patients asked included: ‘Will the vaccine give me a dose of shingles?’ and ‘What if I have already had shingles?’ Ms Gedman says: ‘We were able to reassure patients that the vaccine would definitely not cause shingles, but would protect them against getting it or reduce the severity if they did. People who have had shingles before still benefit
The risk and severity of shingles increases with age. Incidence increases from around two to three per 1,000 person years in people aged 50, to eight per 1,000 person years in the over seventies. Shingles affects a specific area on either the left or right side of the face or body, along the nerve where the virus has reactivated, usually starting with abnormal skin sensations and pain. The commonest complication is post-herpetic neuralgia, which is pain persisting or recurring 90 days or more after the shingles rash appears. The pain may be severe and can last for months; in older people this may accelerate decline in functioning. In a clinical trial of people over 60, the new shingles vaccine Zostavax reduced the incidence of shingles by 51 per cent and post-herpetic neuralgia by 67 per cent. The vaccine’s benefits and cost effectiveness are believed to be greatest in people aged 70 to 79 years. According to the NHS Choices website, side effects are mild and short-lived. Given the potential severity of shingles in older people, Ms Gedman is pleased to offer patients the chance to protect themselves. In future years she plans to give the shingles vaccine at the same time as the seasonal flu vaccine. ‘But we will give them in different arms,’ she says NS
NURSING STANDARD january 29:: vol 28 no 22 :: 2014 25 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
