Martin Heydon (Kildare South, Fine Gael) | Oireachtas source

I thank the Senator Horkan for raising this important issue. I too know people close to me who have suffered from shingles. It can have a debilitating impact. As is outlined in the response I have, which I will deliver on behalf of the Minister for Health who is unable to make it today, it can have serious implications, particularly for older people.

Varicella is a common, highly infectious disease caused by the varicella zoster virus. This virus is associated with two distinct clinical syndromes: varicella, commonly known as chickenpox, and herpes zoster, commonly known as shingles. Primary infection with the varicella zoster virus results in varicella, after which the virus becomes latent in the body’s nervous system. The virus may reactivate after a period, sometimes several decades later, resulting in herpes zoster or shingles. Approximately one third of people who have had a varicella infection will develop a shingles infection at some point during their lifetime due to reactivation of the virus. Morbidity associated with herpes zoster increases with age. The most common complication is post-herpetic neuralgia, which is a persistent pain in the area around the rash. This has the potential to cause significant reductions in quality of life, activity, mood and sleep.

Two thirds of cases occur in those aged 50 years and older. The risk of developing the disease in those aged 85 years and over is 50%.Older adults are most likely to have post-herpetic neuralgia and to have longer lasting and more severe pain.

There are two shingles vaccines currently available in Ireland. One is a recombinant vaccine called Shingrix, which is given as a two-dose vaccine. The other is a live vaccine called Zostavax, which is given as single dose. The national immunisation advisory committee, NIAC, guidelines state that the Shingrix vaccine may be considered for those aged 50 years and older due to the greater burden and severity of disease and post-herpetic neuralgia in this age group and for those aged 18 years and older who are at increased risk of contracting shingles. The NIAC guidelines also state that the Zostavax vaccine may be considered for those aged 50 years and older as a result of the greater burden and severity of disease in this age group. The shingles vaccine is not currently provided as part of the national immunisation programme. It is open to those aged 50 years and older who wish to receive the vaccine to consult with their GP or pharmacist in order to arrange to receive the vaccine privately for a fee.

Following a request from the Minister for Health, HIQA is carrying out a health technology assessment on the herpes zoster vaccine, which protects against shingles. This assessment will examine the evidence on the clinical effectiveness and safety of shingles vaccines. The cost-effectiveness and budgetary impact will also be reviewed, along with the ethical, social and organisational implications of including the vaccine in the adult immunisation schedule. It is anticipated that this assessment will be completed by July 2024. The outcome will inform future decision-making in the context of whether any amendments are required to the national immunisation programme. I again thank Senator Horkan for raising this timely issue, particularly this week.