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HIQA Initiates Assessment for Shingles Vaccine Inclusion in Irish Adult Immunization Schedule

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The Health Information and Quality Authority (HIQA) has taken the first step towards potentially adding the shingles vaccine to the adult immunization schedule in Ireland. HIQA recently published the protocol for its health technology assessment (HTA) of shingles vaccine for adults, outlining its approach to this important evaluation.

HIQA embarked on this HTA at the request of the Department of Health, which was prompted by a recommendation from the National Immunisation Advisory Committee (NIAC). The primary objective of this assessment is to provide informed advice to the Minister of Health, helping them decide whether shingles vaccine should be included in the adult immunization schedule for the Irish population.

Shingles: Causes, Complications, and Targeted Vaccination Approaches

The varicella-zoster virus is a member of the herpes virus family, responsible for two distinct clinical conditions: varicella, commonly known as chickenpox, and herpes zoster, which is often referred to as shingles. After the initial chickenpox infection, the virus becomes dormant, potentially reactivating as shingles, typically several decades later. Shingles are characterized by a painful rash with blisters, lasting for about seven to 10 days, followed by complete resolution within two to four weeks. The European Medicines Agency approved the first shingles-prevention vaccine in 2006.

One of the most common complications of shingles is post-herpetic neuralgia (PHN), which is a chronic and persistent pain that lingers long after the rash and blisters have healed. PHN can affect up to three in 10 individuals and significantly impact their quality of life, affecting daily activities, mood, sleep, and mobility. The risk of developing PHN is notably higher in older patients.

Shingles become more prevalent and severe with age, with the majority of cases occurring in individuals aged 50 years and older. Moreover, individuals with compromised immune systems are at an elevated risk of contracting shingles and experiencing severe complications. As part of the HTA, potential vaccination strategies for both adults aged 50 years and older, as well as those aged 18 years and older at higher risk of shingles, will be assessed.

Shingles Vaccine

Review of Shingles Vaccine for Ireland’s Adult Immunization Schedule

Dr. Conor Teljeur, HIQA’s Chief Scientist, emphasized the impact of shingles on individuals who have had chickenpox in their lifetime, leaving a substantial portion of the population vulnerable. Approximately one in three people with a history of chickenpox will eventually develop shingles. Currently, the vaccine is recommended for specific risk groups, with individuals having to cover the cost privately. Dr. Teljeur stated, “This HTA will review the evidence for adding shingles vaccine to the adult immunization schedule in Ireland.”

HIQA’s comprehensive review will examine the clinical effectiveness and safety of shingles vaccines, while also considering their cost-effectiveness and budgetary implications. Additionally, ethical, social, and organizational aspects of incorporating the vaccine into the adult immunization schedule will be evaluated. The outcomes of the HTA will be presented as guidance to inform the Minister for Health’s decision-making process. The complete health technology assessment will be made available to the public in due course, shedding light on the potential inclusion of shingles vaccination in the adult immunization schedule in Ireland.

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