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Shingles Vaccination (Risks of Live Vaccination in Immunocompromised Patients)


For full details see The Green Book (shortcut below)


About the National Shingles Immunisation Programme for adults aged 70-79 years

Aim: to lower the incidence and severity of shingles in older people.

Two vaccines are licensed and available in the UK;

  • Zostavax® (a live vaccine) which is given as a single dose
  • Shingrix® (recombinant sub-unit vaccine) which is given as a two-dose schedule.

The routine programme for people aged 70 years, using Zostavax®, has been in place since 2013. At the same time a catch-up programme was rolled out to those aged 70-79 years in a phased approach.

Immunocompromised Patients aged 70-79

Individuals eligible for shingles vaccine (adults aged 70-79 years), but who are contra-indicated to the receipt of the live vaccine should be offered Shingrix®

If there is any doubt, individual patients should be discussed with their specialist.




Shingrix® should not be administered to an individual with a confirmed anaphylactic reaction to any component of the vaccine.


  • Confirmed anaphylactic reaction to a previous dose of varicella virus
  • Women of childbearing age.
  • Pregnancy

Primary humoral immunodeficiencies, such as X-linked agammaglobulinemia, are not of themselves a contra-indication for Zostavax® unless associated with T cell defects.

Immunosuppression at doses equivalent to ≤40mg prednisolone per day for an acute episode of illness such as asthma, chronic obstructive pulmonary disease (COPD) or COVID19 may be vaccinated with Zostavax® when they have recovered

Zostavax® may also be offered to those on replacement corticosteroids for adrenal insufficiency, or to those topical or inhaled corticosteroids or corticosteroid replacement therapy.

If primary healthcare professionals administering the vaccine have concerns about the nature of therapies (including biologicals) or the degree of immunosuppression they should contact the relevant specialist for advice.

Shingles Vaccination Toolkit


Further Information Follow Link



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