• Aged 50+ and have a weakened immune system (immunocompromised)
• Aged 70-79
• If you turn 65 on or after 1^st September 2023

If you are not sure if you are the right age, you can use NHS Scotland’s calculator for age eligibility here.

For this vaccine, the definition of “immunocompromised” includes:

• People on immunosuppressive or immunomodulating therapy including:

Those who are receiving (or have received in the last 3 months) targeted therapy for autoimmune disease, such as JAK inhibitors or biologics such as B-cell targeted therapies (including rituximab for which there is a longer period of the past 6 months).

Those who are receiving, or have received in the past 6 months, immunosuppressive chemotherapy or radiotherapy.

Those who are receiving, or have received in the past 6 months, immunosuppressive therapy for a solid organ transplant.

• People with chronic immune mediated inflammatory disease who are receiving, or who have received, immunosuppressive therapy, including:

Moderate to high dose corticosteroids (equivalent to 20mg+ prednisolone per day) for more than 10 days in the past month.

Long-term moderate does corticosteroids (equivalent to 10mg+ prednisolone per day for more than 4 weeks) in the past 3 months.

Any non-biological oral immune modulating drugs in the past 3 months. Eligible doses include more than 20mg of methotrexate per week, more than 3mg/kg/day of azathioprine, more than 1.5mg/kg/day of 6-mercaptopurine, more than 1g/day of mycophenolate.

• Certain combination therapies at individual doses lower than stated above, including those on more than 7.5g of prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine), and those receiving methotrexate (any dose) with leflunomide.
• People who have been on a short course of high dose steroids (equivalent to more than 40g of prednisolone per day for more than a week) in the past month.
• People with primary or acquired immunodeficiency states due to conditions including acute and chronic leukaemias and functional lymphocyte disorder.

You can read the full list of people who are eligible on page 7 of the vaccine green book.

You should be invited by your GP practice if you are eligible. If you don’t receive an invitation but think you are eligible, you can contact your GP.

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What vaccine is used and how is it given? 

There are currently two vaccines used – Shingrix and Zostavax. The vaccine used will depend on your age and immune status. Both provide effective protection, but Zostavax is being discontinued so only Shingrix will be used in the future.

Shingrix will be used for all those who are newly eligible for the vaccine, and everyone who is immunocompromised. It is given in two doses. The doses are 8 weeks to 6 months apart if you are immunocompromised, and 6 months to 12 months apart if you are not immunocompromised. Shingrix is not a live vaccine, it is an “inactivated vaccine” which means it uses a killed version of the virus.Zostavax may be given if you are aged 70-79. It is given in one dose. Zostavax is a live vaccine, which means it uses a live version of the virus. It is not suitable for people with a weakened immune system.

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Can I have the shingles vaccine at the same time as other vaccines? 

Speak to your doctor about what would be best for you. You can have the shingles vaccine at the same time as the pneumococcal vaccine (PPV), COVID-19 vaccines, and inactivated flu vaccines. Ideally, there should be a 7-day gap between getting the shingles and the aQIV flu vaccine, which is licensed for use in the over 65s.

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Who should not have the shingles vaccine? 

You should not have the vaccine if you have had a severe reaction to any of the vaccine’s ingredients. You can see the full list of ingredients in the Shingrix patient information leaflet and the Zostavax patient information leaflet. Speak to your doctor if you’re not sure if you should have the shingles vaccine.

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If I haven’t had chickenpox, should I get the shingles vaccine? 

Yes. Some people have had chickenpox without realising because they didn’t have rash.

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Can I have the vaccine if I have already had shingles? 

Yes, but you should talk to your GP to see how long you should wait before having the vaccine to make sure you are fully recovered. The vaccine may help to boost your immunity against further shingles attacks.

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Will I need a booster dose? 

There is currently no booster dose of the shingles vaccine. After having two doses of Shingrix or one dose of Zostavax you are considered to be protected against shingles.

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Why can’t younger people get the shingles vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) make recommendations to the government about vaccines. They make recommendations by looking at the evidence for how well a vaccine works in what age groups, how long any protection from a vaccine lasts, the impact of an illness on the individual and on health services, and how much the vaccine costs. The “cost-effectiveness” of a treatment is the balance of health outcomes, benefits, risks, and costs. Based on the evidence for the shingles vaccine, the JCVI decided that it would be most cost-effective in adults who are immunocompromised aged 50 and older, and in adults who are not immunocompromised aged 60 to 79.

You can read the minutes of the meeting where they made this decision here.

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Why can’t people aged over 80 get the shingles vaccine if they don’t have a weakened immune system?

The vaccine is less effective over the age of 80, so it is not recommended for people aged over 80 who do not have a weakened immune system. However, there is no upper age limit for people who are immunocompromised. This is because before September 2021, the only vaccine available (Zostavax) was not suitable for immunocompromised people, so they have not been able to protect themselves until now. The Shingrix vaccine is suitable for people who are immunocompromised.