Shingles

Background

Shingles, also known as herpes zoster, is caused by reactivation of latent varicella zoster virus. Varicella zoster is the same virus that causes chickenpox. Following initial infection, usually in childhood, the virus can lie inactive in the body’s nervous system. Reactivation of the virus can take place later in life, when the immune system has been weakened by:

  • age
  • stress
  • illness
  • immunosuppressant treatments such as for cancer

Shingles is characterised by a painful skin rash.

The main complication from shingles is post-herpetic neuralgia (PHN), a long lasting neuropathic pain after the rash has disappeared. PHN can persist for months or years and the risk and severity increases with age. Its effect can be very debilitating.

More information on shingles can be found on the NHS Inform website.

Guidance

For all infection prevention and control guidance visit the A-Z ​pathogens section of the National Infection and Prevention Control Manual.

Publications

Screening tool for contraindications for shingles vaccine

Shingles vaccine is a live attenuated vaccine and therefore some patient groups are contraindicated and unable to receive the vaccine.

The screening tool for contraindications for shingles vaccine may be used to aid identification of patients who are excluded from having it and includes explanatory notes for healthcare practitioners. The questions in the screening tool are designed to be completed by either the patient or the healthcare practitioner in a structured interview with the patient.

Please note that the screening tool is designed to help healthcare practitioners identify patients who may be excluded from having the shingles vaccine and doesn't replace clinical judgment.

Shingles vaccine programme annual reports

Read our shingles vaccine programme annual reports below:

Data and surveillance

Surveillance update for October to December 2020

The Scottish Morbidity Record 01 (SMR01) is a national dataset held by the NHS Information Services Division and provides data on inpatient and day case admissions. It is used to investigate the burden of disease on hospital inpatient and day case discharges from acute specialties from hospitals in Scotland. Figure 1 shows the rate of admissions per 100,000 population for shingles and related complications by age group between 2010 and 2017. This graph shows that the rate of admissions is higher among the older age groups.

Figure 1: Rate of admissions per 100,000 population for shingles and related complications (first position) by age group and year, 2010 to 2017

Line graph showing that the rate of admissions for shingles and complications increases with increasing age.

GP consultations

An aggregated dataset is received quarterly from approximately 50% of GP practices in Scotland on consultations for shingles and related complications. Figure 2 presents the number of consultations for shingles by age group between 2011 and 2017.

Figure 2: Number of GP consultations for shingles and related complications by age band and year

Bar chart which shows the number of GP consultations for shingles and related complications by age group between 2011 and 2017.

Figure 3 shows the rate of GP consultations for shingles per 1,000 population by age group between 2011 and 2017. As with the data in Figure 1, this chart suggests that the burden of shingles is higher among the older age groups.

Figure 3: Rate of GP consultations for shingles per 1,000 population by year and age group, 2011 to 2017

Line graph showing that the rate of GP consultations is higher among the older age groups.

 

Vaccination

In September 2013, a national shingles vaccination programme was introduced using Zostavax®. As Zostavax® is a live attenuated vaccine, it can't be given to patients who've a known primary or acquired immunodeficiency state, or patients who are receiving current immunosuppressive therapy including:

  • high-dose corticosteroids
  • biological therapies
  • combination therapies

The vaccine is offered routinely to those aged 70 years. Opportunistic vaccination is offered to eligible individuals aged 71 to 79 years who have not previously been vaccinated. For further information, see chapter 28a of the Green Book.


Vaccine uptake

Table 1 presents coverage of the shingles vaccine among individuals aged 70 years by NHS Board between September 2019 and August 2020.

Shingles vaccination coverage during this timeframe (40.1%) is marginally lower when compared to the same period in 2018/2019 (41.8%%).

Table 1: Shingles vaccination coverage among individuals aged 70 years by NHS board, for season 2019 to 2020 (September 2019 to August 2020)
NHS board Number of individuals aged 70 years* Number of individuals vaccinated Shingles vaccination coverage among individuals aged 70 years
Ayrshire & Arran 4457 1659 37.22%
Borders

1596

635 39.79%
Dumfries & Galloway 2135 1053 49.32%
Fife 4225 1856 43.93%
Forth Valley 3386 1500 44.30%
Grampian 5746 2447 42.59%
Greater Glasgow & Clyde 10704 3612 33.78%
Highlands 4270 1905 44.61%
Lanarkshire 6550 2296 35.05%
Lothian 7714 3108 40.29%
Orkney 190 126 66.32%
Shetland 271 126 39.48%
Tayside 4681 2126 45.42%
Western Isles 362 159 43.92%
Scotland 56,287 22,589 40.1%
*The figures in this column are based on the number of individuals registered at a GP practice and may thus be slightly lower than the overall population in this age group.