Introduction
The shingles vaccination programme changed in September 2023, expanding the inclusion criteria for those who are immunosuppressed as well as changes to the age eligibility criteria.
The expectation is that all Practices are actively inviting in eligible patients, ensuring that all patients receive at least 3 invitations. To do this, reports are run quarterly, and patients are contacted as eligible.
Step 1: How to find reports.
. Select EMIS (top Left corner of home screen)- Reporting – Population Reporting – Ardens-3.23 shingles.
. To run the report-Highlight ‘3.23 Shingles’ and right click and select ‘Run’. This will then run all reports within the shingles folder. This needs to be done each quarter.
There are 3 folders 1, 2 and 3 that need to be reviewed.
.Folder 1- ‘Review before inviting’-Contains patients who may be eligible as recorded as immunosuppressed. These patients need to be reviewed individually considering the Green Book criteria below.
Box: Definition of severe immunosuppression for the Shingrix vaccine programme Individuals with primary or acquired immunodeficiency states due to conditions including:
- acute and chronic leukaemia’s, and clinically aggressive lymphomas (including Hodgkin’s lymphoma) who are less than 12 months since achieving cure
- individuals under follow up for chronic lymphoproliferative disorders including haematological malignancies such as indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias (N.B: this list not exhaustive)
- immunosuppression due to HIV/AIDS with a current CD4 count of below 200 cells/μl.
- primary or acquired cellular and combined immune deficiencies – those with lymphopaenia (20mg per week (oral and subcutaneous), azathioprine >3.0mg/kg/day; 6-mercaptopurine >1.5mg/kg/day, mycophenolate >1g/day) in the previous 3 months
- certain combination therapies at individual doses lower than stated above, including those on ≥7.5mg prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine) and those receiving methotrexate (any dose) with leflunomide in the previous 3 months Individuals who have received a short course of high dose steroids (equivalent >40mg prednisolone per day for more than a week) for any reason in the previous month.
Not included within criteria
The list of conditions which are not included:
Pancytopenia
Leukopenia
Myasthenia Gravis
Monoclonal Paraproteinemia
Coeliac
Essential thrombocythemia
Plasmacytoma
Polyclonal hypergammaglobulinemia
Selective IgA immunodeficiency
Review any consults under ‘Active Immunisation’-as if previously reviewed notes will be included.
. If not and the patient does meet the criteria code ‘Requires Shingles vaccination’(this can be found on the ardens Adult immunisation template)-Always helpful to free text why. If they do not meet criteria, then add notes and just free text to confirm they do not meet immunosuppressed criteria and therefore eligible based on age related criteria.
. Once this list has been reviewed you will need to repeat the initial step of running all lists-Highlighting ‘3.23 Shingles’, right click – Run.
Step 2: Sending messages.
We are offering 3 invites then no further proactive invitations.
. Once all reports have been run you will need to review each one-Please note there are multiple lists within each ‘Coded Requires Shingles Vaccine’ and ‘Eligible due to age’.
For each list: Highlight – Right Click ‘View Results’- ‘Export’ – CSV – Ok.
Save to YDrive – Enhanced services – 2024-2025 – Imms and Vacs shingles combined. Rename list to make easier to find.
This step will need repeating for each list.
. Once this is complete you can send batch messages out including either ‘You are due your shingles vaccination, you can have this at Charlotte Keel Medical Practice’ or ‘You are due your second shingles vaccination, you can have this at Charlotte Keel Medical Practice’.
. Select Accurx – Your initials- Batch messaging – Send batch message – Self Book- TRN All-select F2f reasons – Include message – Add ‘Herpes Zoster Vaccination Invite (Under invite code)- Allow Decline – Add code Herpes Zoster Vaccination declined’ -Add patient list (This will be found under Y Drive etc as per steps above and ensure you are adding correct list
. Once the batch message is sent record this under YDrive – Enhanced services – 2024-2025 – Imms and Vacs shingles combined – Pt invitations.
. For those messages that weren’t delivered-Please download the list and save as YDrive – Enhanced services – 2024-2025 – Imms and Vacs shingles combined – Failed Delivery and then let GXF know as he will contact patients accordingly.
GXF to contact patients who have not been able to receive text message/no mobile number.
Version Control
| Date | Version | Author | Change Details |
| 01/04/24 | 1 | K Shepherd | New SOP. |