Shingles vaccination administration: FOI release

Information requested

1) The health evidence which supports the decision to go straight to 65 and ignore those between 65 and 70.

2) All correspondence, minutes and notes of meetings which relate to the decision to reduce the age to 65 and the approach to implementing the change.

This request has been interpreted as you seeking information to help you understand the rationale behind the decision to offer the Shingles vaccination to individuals aged 65 earlier than those aged 66 to 69 years of age.

Your request has enabled me to narrow the scope of the request to a timescale of between February 2022 (the point at which the UK Health Security Agency (UKHSA), Public Health Scotland, NHS Health Boards and the Scottish Government collaborated to plan and introduce the programme) to the start of September 2023 when the shingles programme included those aged 65 years of age as an eligible cohort for the first time.

Response

Health Evidence & Papers relating to the decision on those aged 65 years of age

The Scottish Government’s decision-making throughout all vaccination programmes is guided by the expert clinical advice of the Joint Committee on Vaccination and Immunisation (JCVI).

The Joint Committee on Vaccination and Immunisation (JCVI) published minutes of the meeting held on 6 February 2019 in which they recommended a new 10 year rolling implementation of a new Shingrix Vaccination Programme. I have included a link here. I refer you specifically to paragraphs 24 to 45 which are relevant to your request.

This recommendation was then translated into advice published within the Green Book Chapter (GBC) on Shingles. This explains the rationale for the change in vaccination from Zostavax (a live vaccine) to Shingrix, a 2 dose schedule non live vaccine and documents the relevant health advice and structure of the programme from 1 September 2023 onwards. The addition of those aged 65 years of age was not looked at in isolation. The recommendations from the JCVI focussed on the overall scheduling of the full programme together with the health benefits and protection it aimed to achieve, consequently there are no papers or notes of minutes that look at this aspect specifically that I can provide in response to your request.

While our aim is to provide information whenever possible, in this instance we are unable to provide the information you have requested because the Scottish Government does not hold the specific information you are seeking.

This is a formal notice under section 17(1) of FOISA to confirm that the Scottish Government does not have the information you have requested.

As noted above, Vaccine ‘Green Book Chapters’ (GBCs): Immunisation against infectious disease: the green book front cover and contents page - GOV.UK (www.gov.uk) are produced by the UK Health Security Agency (UKHSA) for each vaccine programme, whether new or extended. These provide the clinical and scientific evidence that underpin any decisions on what a programme should look like, who it is intended for and which vaccines are to be used, as well as the dosing schedule associated with each programme.

These decisions are based on a combination of factors including the risk of the disease and the effectiveness of the vaccine in different age groups. The phased approach is based on the advice of the JCVI and to ensure that NHS Scotland can deliver the programme effectively alongside other immunisation programmes.

To help you understand the journey of how a vaccination programme evolves from the initial recommendations made I hope the following information is helpful.

The way vaccination services are delivered in Scotland has changed. The delivery of vaccination programmes has moved away from a GP-based model to delivering services by specialist vaccination teams through Health Boards and Health and Social Care Partnerships (HSCP).

Scottish Ministers, along with Ministers in the other devolved nations accepted this advice and arrangements were put in place to deliver the programme.

The JCVI recommended that the eligible age for immunocompetent individuals should change from 70 to 60 years of age for the routine cohort, in a phased implementation over a 10 year period as outlined below:

Implementation stages	Delivery period	Eligible for first dose
Stage 1 (5 year duration)	1 Sept 2023 to 31 Aug 2028	Vaccination of 65 and 70 year olds (defined by the person’s age at 1 September) each year.
Stage 2 (5 year duration)	1 Sept 2028 to 31 Aug 2033	Vaccination of 60 and 65 year olds (defined by the person’s age at 1 September) each year.
Ongoing routine offer	1 Sept 2033 onwards	Vaccination of 60 year olds (defined by the person’s age at 1 September).

The Chief Medical Officer for Scotland published a letter providing direction to Health Professionals instructing the order of the cohorts and this letter included clear advice on the priority for Scottish NHS Boards to offer the 2 dose vaccination programme. I have attached a link to this letter here.

To plan and develop the shingles vaccination programme across the UK, the UK Health Security Agency (UKHSA) convened a Shingrix for All Project Board which ran from 14 February 2022 and all nations were represented on this Board. You may wish to contact them directly should you have any further questions on that approach. They can be contacted by email at: InformationRights@UKHSA.gov.uk.

In Scotland, Public Health Scotland has overall responsibility for the oversight and delivery of vaccination programmes and convened a Task & Finish Group to take planning forward which ran in parallel with the UK Group noted above which included representation from all 14 Health Boards who would be administering the vaccinations. In that regard you may wish to contact them should you have any further questions. They can be contacted by email at: PHS.FOI@phs.scot.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at https://www.gov.scot/foi-responses.