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What is Shingles and why does it occur?

Shingles is a 'reawakening' of the chickenpox virus in your body - varicella-zoster. After a person recovers from chickenpox, the virus remains in the nerves in your body for life. The virus may reactivate years later as shingles, often characterised by a painful, blistered rash in a particular nerve of the skin. Shingles may also cause fever, headache and light sensitivity. A shingles infection can be very painful and although it is rarely life threatening it can be debilitating and may take a long time to resolve.

Shingles most commonly occurs when someone’s immune system is weakened. This may be due to serious illness, or occur as a result of exhaustion and/or stress. Those over 50 are at increased risk of developing the disease.

Why is the shingles vaccine only offered to those aged 70-79 on the NHS at present?

It may seem unusual for a vaccine to be offered to such a narrow cohort - especially as those who are older than 79 are still vulnerable to shingles. However, the selected age-group has been chosen due to the efficacy of the vaccine and the likely benefits. "Research shows that shingles vaccine efficacy can reduce by more than half after the age of 80 - as compared with those aged in their 70s - therefore it is not routinely given after this age. On the NHS the vaccination has to be reserved only for those who most need it as there simply aren't the resources available to give it to everyone including low risk individuals. However, this practical approach is very much backed up by data available from research studies," explains GP and Medical Advisor Dr Samar Mahmood.

Can I have a shingles jab at the same time as/close to Covid19 and flu safely?

At a time when many vaccines are being rolled out, should we look to space out our shots a little? Or would it be safe to have our shingles, flu or Covid19 vaccines at the same appointment? "Technically, it is OK to have the Shingles and flu vaccines at the same appointment, although the inflammatory response seen in the CV-19 vaccine can interfere with the body's response to the shingles vaccine, so this should be avoided," says Mahmood. "Even in the case of the flu jab, it would be recommended to ideally leave a week between shingles and flu vaccinations because it is normal to experience some degree of side effects. It is better to recover from these before taking the next jab," he says.

I've been unwell recently with a winter virus - should I wait before having my shingles jab?

Some winters, it can seem as if we catch cold after cold. So if we’re feeling under the weather is it best to delay our shot until we’re in better health?
"This depends on the severity of the virus. If it is a mild virus - such as the common cold - then it's fine to have shingles jab even if still having symptoms. If it is a viral infection that has caused fever, or made you to feel generally weak and unwell, then it is better to wait up to a week to recover from this infection before getting the shingles jab. It is better to not have the vaccine if your body is already run down from another infection, unless in the case of a mild infection," advises Mahmood.

Is shingles more prevalent in the winter?

The flu vaccine is usually offered at the start of the winter. Covid19 boosters are also being rolled out around this time. But whether shingles worsens at this time of year isn’t straightforward: "Shingles is an illness that tends to occur when we are generally unwell or rundown. This could add to the risk of developing the disease during the colder months when other illnesses are on the rise. There is no convincing evidence that it is more prevalent in any season. However, we might indirectly see more cases during winter because shingles is a reactivation of a latent varicella infection - this re-activation is more likely to occur when somebody's immune system is not working at its best - this is often in during winter.

"So while the infection itself is not more prevalent in winter, the mechanisms through which the infection becomes active - or technically reactivated - are more likely to be more prevalent," explains Mahmood.

Should I book my Shingles jab?

If you've been offered a Shingles jab on the NHS, it's important that you take up the offer. Shingles can be a painful and drawn-out infection, and is more likely to occur during times when you are run-down or your immune system is compromised. For those also being offered flu and Covid19 jabs, it may seem like one vaccine too many. But as with all vaccinations, having the jab will help to protect you from the unpleasant and sometimes serious symptoms associated with developing the disease.