TABLE OF CONTENTS


Introduction


The aim of the shingles immunisation programme is to reduce the prevalence of shingles and the risk of serious health complications in the higher risk groups, such as those who are immunosuppressed. There has been a considerable change to the Shingles vaccination programme this year, as it expands its eligibility criteria. The main change is that from the 1st of September 2025, anyone who is severely immunosuppressed and aged 18 years or over, will be eligible to receive two doses of Shingirx.



Note: "The Shingles severely immunocompromised cohort will be automatically identified via the GPES payment extract. However, due to the restrictions in the way data can be extracted from GP clinical systems, it is not possible to extract data in accordance with the Green Book  definitions or the shingles severely immunocompromised cohort. The Shingles severely immunocompromised cohort has therefore been developed in the GPES extract to be largely over-inclusive for payment purposes and will include some patients who do not strictly meet the Green Book shingles definition for severe immunosuppression. The reason the GPES extract is largely over-inclusive is to support clinical discretion and reduce the need for manual payment claims that would otherwise be required if the GPES extract was not over-inclusive. However, there are also some areas of under-inclusion where technical and coding limitations mean it is not possible to fully identify all eligible patients (for example a dose of steroids or a combination of drugs). Practices wishing to use the GPES immunocompromised logic to identify eligible patients for call and recall should be mindful of the over-inclusive and under-inclusive nature of the count and review the patient list accordingly to offer vaccination to eligible patients only." Extract from NHS England's - General practice shingles vaccination programme technical guidance, last updated August 2024, NHS Digital are still yet to confirm GPES extraction from the 1st September 2025.



Stages of shingles vaccination programme:


  • Those turning 65y and 70y between 1st September 2023 and 31st August 2028 will continue to be able to get the vaccine after their birthday, and will stay eligible until they are 80y. This is Stage 1 of the catch up invites.


  • From 1st September 2028 and 31st August 2033 everyone turning 60y and 65y will be eligible. This is Stage 2 of the catch up invites.


  • Thereafter, from 1st September 2033, Shingrix will routinely be offered to all patients at 60y. 



Review Before


Due to the difficulties in being able to accurately identify every type of condition within the immunosuppressed cohort as defined by the Green Book. We have created a set of searches to identify those patients who are currently not showing as eligible but could potentially be eligible.


Back in October 2023, we made some updates to our reports following a meeting that we had with the Vaccination & Immunisations team of NHS England. The takeaway from the meeting was that as long as a practice can demonstrate and evidence a method for reviewing patients from the wider GPES payments criteria to ensure eligibility, then there will be no consequences for practices.  Patients falling outside the Greenbook eligibility, a PSD would be required.


We have therefore created some 'review before' reports which can be found under 'Shingles | 2 Review Before' as seen below.  These reports will look at each of the categories in the GPES extraction and allow for a clinical review to be conducted.  If the patient needs to be vaccinated, then the Requires vaccination against shingles 'Y406b' code can be added to the patients record. Once that code is added patients will fall into the invitation suites, ready to be invited.


The 'For review before ordering and invitations | Shingrix Part 1 | For planning - All turning 65y or 70y in next 6m' report is useful to run as this will show patients that will drop into the eligibility in the future but can't be invited now, so practices can forward plan who will be invited in.


The 'For review before invitations | Previously vaccinated with Zostavax outside of national programme + eligible for Shingrix' report shows patients that have previously received the Zostavax vaccine outside of the national programme. These patients are eligible for the vaccination under the national programme, however you may wish to invite them differently to other patients. Patients will only come out of this report once they've had either an exclusion (such as a decline) or a vaccination recorded. These patients still appear in the main invitation reports.





Please Note: There is no code to add that will remove patients from the review before reports if they are assessed as not needing the vaccine. Therefore these patients will still appear in the search results.


Shingles Invitation Reports


To identify patients who may be eligible for a Shingles vaccination, go to 'Clinical Reporting > Ardens Ltd > Vaccinations. The invitations reports have been split out into folders for part 1 and part 2. These are all broken down so that you can send invitations out by email, SMS or post. The relevant read code is also displayed in the report title.


The 'Part 1' folder has been built to show those requiring a 1st, 2nd or 3rd invitation who are either 'routine' or 'catch-up' turning 65y or 70y between 1/9/23 - 31/8/28'.  



The 'Part 2' folder will look for all patients who need Part 2. 



There is now a separate folder for patients who may require visits to have their Shingles vaccination - these are listed in the 'Shingles | 4 Visits' folder. This will include any patient that has been coded as living in a Care Home or Housebound. These patients will not appear in the 'Shingrix Part 1'  and 'Shingrix Part 2' invitation folders mentioned above.


Please Note: For severely immunosuppressed individuals 18y or over, the second dose should be given 8 weeks to 6 months after the first dose. For the immunocompetent individuals over 60y, the second dose of Shingrix may be offered 8 weeks after the first dose but for operational reasons a longer interval is being used with an interval of 6 months to 12 months between the 2 doses.


Review after vaccination


We have created several reports in the Shingles 5 | Review After folder that require review. Below is a detailed description of each report, to help you understand how to interpret each report and what action to take: 


For review after vaccination | Herpes Zoster vaccination duplicate recorded this report is reviewing patients who have a duplicate coding of a live shingles vaccine, as they should of only had one. Although live shingles vaccines have now been taken out of circulation this report is still relevant for data accuracy. Check through these patients to see if it is a duplicate coding issue, if this is the case remove the code and the patient will drop off this report. If the patient was given more than one dose of a live vaccine in error, the patient will just remain of this report.


For review after vaccination | Shingles vaccination recorded as incorrect read code only - add as a vaccination type this report is reviewing patients who have been coded with the wrong code and haven't had the vaccination recorded. This is important as practices won't receive payment unless this is rectified. Mark in error the incorrect code and record as a vaccination.


For review after vaccination | Shingles vaccination recorded as read code only - add as a vaccination type similar to the report above this report is reviewing patients who have the shingles vaccine recorded on their record as a read code only and not as a vaccination. The action you should take is to record it as a vaccination as this is the correct way to record a vaccine within SystmOne and to ensure you don't receive duplicate payment.


For review after vaccination | Shingrix Part 1 recorded and in immunocompromised group without 'requires shingles' - review record and code as appropriate this report is identifying patients that would likely fall into the GPES extraction rules as being 'immunocompromised', they have already been vaccinated however, they have not had a code of 'requires shingles' added to their record. The action to take would be to add the code 'requires vaccination against shingles (Y406b)' to demonstrate you have clinically reviewed this patient and they meet the eligibility for vaccination.



Please note: You should only record the vaccination as a 'vaccination' within SystmOne. It will then automatically read code that vaccine. You do not need to add a separate read code, doing this could result in duplicate recording and payment. Click here to read our support article on recording vaccinations.



Data Quality


The 'Data Quality' folder provides one report to find patients where the 'Vaccination offered' code (Xaam1) has been used instead of the invitation codes (as shown in the invitation reports). Practices should re-code these patients with an appropriate invite code. 




Administering the Shingles vaccination


When you open up a patient's record who may be eligible for the Shingles Vaccination, you will see this icon under the patient demographic box. Click this to open the Shingles template.


On this main page you have a link on the right hand side to the 'NHS Shingles eligibility calculator' if you would like to check eligibility. You can also record that advice has been given on immunisation and whether the patient is fit and well at the time of immunisation.


Click the link 'Shingrix PL' to access the shingles patient advice leaflet.


you can also record declined or vaccination refusal within this template.


The bottom box of this screen will provide you with the patients previous vaccination history and eligibility alerts for vaccinations they are eligible for.


 

Click on Shingrix to record the vaccination



Further support


If you would like any training on planning and delivering your vaccination programmes please contact the Ardens Training Team on: training@ardens.org.uk to book.


Check out our support article on recording vaccinations here.


Alternatively if you have any queries on the process above, please contact the Ardens Support Team on: support@ardens.org.uk