We Lifestyle Elves are pretty keen on encouraging people to do all those things we know are good for health and reduce our risk of illness and disease. We particularly like tackling those ‘modifiable risk factors’, things we can choose to do something about for the benefit of our health, so we’re always banging on about the benfits of exercise as we jog around the woodland and flourishing the the latest research paper on healthy eating as we bring out the broccoli at dinner, again. But today we are finishing our look at recent research on older people’s health with a sideways step into vaccination and a recent Cochrane systematic review on whether vaccinating against shingles is effective and safe.
Shingles (herpes zoster) is a painful condition caused by the reactivation of varicella zoster virus, the one that causes chicken pox, and it can last for weeks or months. Although people of any age can get it, older people are particularly susceptible. The review brought together evidence from eight randomised controlled trials (RCTs) with over 52,000 people aged over sixty, but a single large trial with over 38,000 people, followed up for over three years, provided the data on the main outcomes – the effectiveness and safety of the herpes zoster vaccine. Here’s what they found:
- Fewer people who had received the vaccine had confirmed cases of shingles than those who received a placebo
- The vaccine was more effective in people aged 60 to 69 years, but individuals in this age group were also more susceptible to adverse effects compared to those 70 years or over
- Injection site reactions were more common in people receiving frozen vaccine than in those given a refrigerated vaccine; there were no differences in other adverse effects
- No difference was found between groups in pain-related interference in daily life
- Study quality was mixed but the large trial which provided the data for the main outcomes was judged to be at low risk of bias
The authors concluded:
Herpes zoster vaccine is effective in preventing herpes zoster disease. Although vaccine benefits are larger in the younger age group (60 to 69 years), this is also the age group with more adverse events. In general, zoster vaccine is well tolerated; it produces few systemic adverse events and injection site adverse effects of mild to moderate intensity.
So can older people living here in the UK choose to have this vaccination? This question keeps resurfacing in the press. This review was published in October 2012 and at the beginning of November we heard that The Department of Health had given approval for GPs to vaccinate against shingles on the NHS for the first time, for individuals whom they judged needed it and would benefit from it, and was considering whether to go ahead with a national vaccination campaign for older people. A shortage of the vaccine seemed to be delaying matters and yesterday the issue came to the fore again, with problems with vaccine supply meaning that plans for a national vaccination programme are still on hold.
So for now, it’s back to the things we can do something about. We were excited to see a large new study in the benefits of walking, so we’ll be bringing you that and more very soon. Meanwhile, have a healthy weekend.
Gagliardi AMZ, Gomes Silva BN, Torloni MR, Soares BGO. Vaccines for preventing herpes zoster in older adults. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD008858. DOI: 10.1002/14651858.CD008858.pub2.
Cochrane summary and podcast http://summaries.cochrane.org/CD008858/vaccines-for-preventing-herpes-zoster-in-older-adults
GPs given green light to give shingles vaccination. Pulse; 2nd November 2012.
Shortage of shingles vaccine delays jabs for elderly. The Telegraph; 7th February 2013.