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:
- 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.
- For more information on shingles immunisation, including updates, please refer to the Public Health England (PHE) Green book, chapter 28a.
- To view a letter from the Chief Medical Officer (CMO) outlining the 2017 to 2018 shingles vaccination programme, visit the Scottish Executive Health Department (SEHD) website.
- Training slides and educational materials relating to shingles are available on the NHS Education for Scotland (NES) website.
- View our screening tool for contraindications for shingles vaccine document.
For all infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.
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.
Shingles vaccine programme annual reports
Read our shingles vaccine programme annual reports below:
Data and surveillance
Surveillance update for January to March 2020
The Scottish Morbidity Record 01 (SMR01) is a national dataset held by the Public Health Scotland Data and Intelligence 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.
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 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.
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.
Table 1 presents coverage of the shingles vaccine among individuals aged 70 years by NHS Board between September 2019 and March 2020.
Shingles vaccination coverage during this timeframe (39.3%) is slightly higher when compared to the same period in 2018-2019 (36.9%).
|NHS board||Number of individuals aged 70 years*||Number of individuals vaccinated||Shingles vaccination coverage among individuals aged 70 years|
|Ayrshire & Arran||4828||1769||36.6%|
|Dumfries & Galloway||2151||1052||48.9%|
|Greater Glasgow & Clyde||10760||3596||33.4%|
|*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.|