Region of Murcia starts shingles vaccination campaign for 65-year-olds

Campaign will finance vaccinations starting with those born in 1958 and registered with the regional health service (Servicio Murciano de Salud – SMS)

The Region of Murcia is starting a shingles vaccination campaign. Initially beginning with people registered with the health authority and who reach the age of 65-years-old this year (in 2023 starting with those born in 1958). Upon reaching that age, you will receive a reminder letter, which will also inform you that you should also check your pneumonia vaccination status and that you are eligible for an influenza vaccination in season.

When you reach the age of 65, you can request an appointment with your nursing professional at your health centre or your usual vaccination dispenser for a vaccination. It is not essential to have received the reminder letter to get vaccinated if you are in the eligible group.

Below are questions and answers about the shingles vaccination programme published by the Murcia Health Authority:

What is Shingles (Herpes Zoster)?

Shingles or Herpes Zoster is a disease caused by the varicella zoster virus (VZV), the same virus responsible for chickenpox, from the herpes virus family (human herpes virus type 3).

During chickenpox, the virus spreads into the bloodstream and reaches the nerve ganglia of the spinal or cranial nerves. Once in the nodes, the virus can remain in an inactive (latent) state and not cause symptoms again, or it can reactivate many years later.

When reactivated, the virus travels down nerve fibres to the skin, where it produces a painful rash. After a few days, small vesicles (a thin-walled sac filled with a fluid, usually clear and small) appear that can last for several weeks. A shingles outbreak almost always appears in a strip of skin innervated by the nerve fibres where the virus was located, which is known as a dermatome. It usually appears only on one side of the body, although it can also appear in the dermatomes located next to the affected dermatome.

Why does Shingles appear?

Anyone who has had chickenpox is at risk of developing shingles. However, shingles occurs more frequently in older and immunosuppressed people. Approximately 30% of people who have had chickenpox will develop shingles during their lifetime and up to 50% of adults who reach 85 years of age or older.

The possibility of developing shingles increases with age, due to the loss of immunity. In fact, more than two-thirds of cases occur in people over the age of 50. Although shingles can appear at any age, it is more common after the age of 50. In addition, the severity of the disease associated with shingles and its complications also increases markedly with age.

The reason why the virus reactivates is often unknown, but sometimes reactivation occurs when the immune system is weakened by another condition, such as HIV infection or Hodgkin lymphoma, or by medications that suppress the system. immune system (for example, to prevent rejection of a transplanted organ).

What complications can be related to Shingles?

Most people recover completely from shingles, but in 30% complications appear. Post-herpetic neuralgia (a lasting pain in the areas of your skin where you had shingles) is the most common complication which affects 10-15% of cases, where pain may persist beyond 3 months after the rash heals which is very limiting for the person.

Other potential complications include ocular shingles, neurological complications, pneumonia, hepatitis or bacterial superinfections, among others. All these complications can affect the person's quality of life.

The spread of the disease is more likely to occur in older people. Most shingles related deaths are attributable to pneumonia

Why is it important that I get vaccinated against shingles?

As people get older the number of cases of shingles is higher, due to ageing of the immune system, with two thirds of cases being in people older than 50. This is the reason why the Region of Murcia has initiated vaccinations against shingles for people in the none risk group aged 65 years, starting in 2023 for those born in 1958 and continuing with the following birth groups in the successive years.

In addition, post-herpetic neuralgia and other complications are also more common in older people.

The vaccine used, Shingrix®, is inactivated and can be used both in people of 65 years healthy as with pathologies, being especially recommended in case of immunosuppression. Vaccination with Shingrix® significantly reduces the risk of suffering from shingles and protects against complications derived from the disease.

Who is eligible for the Shingrix® vaccination financed by the Regional Health Authority?

People in risk groups (see below) and people registered with the Murcia Health Authority (SMS) who turn 65, beginning in the year 2023 with those born in 1958 and continuing in consecutive years with the following birth year groups, appointments can be made for people born in 1958 after they reach their birth date.

Is Shingrix® useful for the population who turns 65?

Shingrix® is a licensed vaccine for people aged 50 and over without immunosuppression. The region of Murcia begins vaccination in people at 65 years of age for the oldest number of shingles cases at this age.

Shingrix® has been shown to be a safe and highly effective vaccine in studies conducted on people from 50 years. In fact, they have already administered millions of doses in other countries.

How many doses will I need?

You will need two doses of the vaccine 2 months apart for correct protection. Like most vaccines, it must be administered in the arm.

What adverse effects can appear?

The most frequent adverse effects are pain in the area of ​​the injection, muscle aches, fatigue or headache. They are usually mild and of short duration. It is not recommended to take antipyretics or analgesics preventively, only if necessary. If the effects persist for more than a few days, you should consult your healthcare professional.

Even if an adverse reaction is suffered after the first dose, you should take into account the importance of completing the vaccination with your second dose for complete protection. Also, you should know that the adverse reactions are not more frequent with this second dose than with the first.

Like other vaccines, Shingrix® has been extensively studied and meets the safety requirements.

Shingrix® is secure administered with vaccines such as the vaccine against the flu, any of the vaccines pneumococcal, dTpa/Td or vaccines against COVID-19.

How do I apply for my vaccination?

If you turn 65 this year, apply for appointment with your nurse once have reached that age. The Regional Vaccinations Program Centre we will send you an information letter. It is not necessary to have received it to get vaccinated. Appointments can be made by visiting reception in your Health centre or Consultorio, by phone to your Health centre or Consultorio or online through the Cita Previa (Appointment) service in Spanish or English.

Who shouldn’t get vaccinated?

People who:

• Have ever had a severe allergic reaction (anaphylaxis) to any component of the vaccine or after a dose of Shingrix®.
• Currently have shingles.
• Are pregnant. Women who are pregnant should wait to get Shingrix.

If you have a minor illness, such as a cold, you may get Shingrix. But if you have a moderate or severe illness, with or without fever, you should usually wait until you recover before getting the vaccine.

What should I do if more have passed than 2 months from my previous dose?

In cases where the interval has passed the recommended 2 months, contact your nurse practitioner to administer the vaccine as soon as possible.

I am in a risk group how do I request the vaccine?

If applicable, your Primary or Hospital Care doctor or nurse will make a request for the vaccine by filling in a form designed for this purpose and attaching an updated report based on your risk condition. Risk groups include:

• Hematopoietic stem cell transplant recipients.
• Solid organ transplant recipients and people on the waiting list.
• People being treated with anti-Jak drugs such as tofacitinib, ruxolitinib, baricitinib, and upacitinib).
• People with HIV. In case CD4 ≥200/µl it is not necessary to wait any period of time after HIV diagnosis for vaccination. If CD4 <200/µl, the moment of vaccination will be decided after assessment individual medical treatment, if an improvement in the immune status is expected in a short period of time (2-3 months) after the initiation of antiretroviral treatment.
• People with blood malignancies such as leukemias, lymphomas, or lymphoproliferative disorders.
• People with solid tumors being treated with chemotherapy

The vaccinations will be carried out in Primary Care or at the patient's usual vaccination point.

Is the Shingles vaccination available privately?

Yes. Currently, the Shingrix® vaccine can be purchased at pharmacies for those people who wish to be vaccinated from the age of 50 but are not within the age group or risk group for which the vaccination is provided by the health authority.

Vaccines are products that require a prescription to be dispensed, so you should take a prescription from your health practitioner to the pharmacy if you wish to purchase the vaccine.

If you do not present any risk condition and have not reached 65 years of age (beginning in 2023 with those born in 1958 and progressively thereafter in successive years) and wish to receive the vaccine privately, your vaccine must be administered at your health centre or usual vaccination post with the corresponding record of the dose entered in the clinical history and submitted to the Regional Vaccination Registry of the Region of Murcia.