SHINGLES 2025/26 Vaccination Programme

Updated On March 16, 2026

Shingles Vaccination Programme 2025/26

https://www.nhs.uk/conditions/shingles/

POSTER

Eligibility Criteria Poster

Management of Shingles

🟣 Herpes Zoster (Shingles) Management:

      1. ➟ Herpes zoster (shingles) is caused by reactivation of the varicella-zoster virus (VZV)—the same virus that causes chickenpox.
      2. ➟ After chickenpox, the virus stays “sleeping” in nerve cells and can reactivate later as shingles.
      3. ➟ The main goals of treatment are:
      4. → Reduce the severity and duration of the rash
      5. → Reduce pain
      6. → Prevent complications (especially postherpetic neuralgia and eye/nerve problems)

🟣 1) Recognize shingles early (treatment works best early)

      1. ➟ Typical pattern:
      2. → Burning/tingling pain on one side of the body (a “stripe” area)
      3. → Followed by a rash of fluid-filled blisters in the same area
      4. → Rash usually stays on one side and does not cross the midline
      5. ➟ Common sites: chest/back, abdomen, face, scalp

🟣 When it may be shingles before the rash appears

      1. ➟ 1–5 days of:
      2. → Burning, stabbing, or deep aching pain
      3. → Sensitivity to touch (even clothes hurt)
      4. → Itching or tingling
      5. → Mild fever or fatigue

🟣 2) Antiviral treatment (the core medical treatment)

      1. ➟ Antivirals are most effective when started:
      2. → Within 72 hours of rash onset
      3. ➟ Antivirals can still be helpful after 72 hours if:
      4. → New blisters are still forming
      5. → The patient is older (often ≥50)
      6. → Pain is severe
      7. → Face/eye involvement
      8. → Immunocompromised state

🟣 Common antiviral options (doctor-prescribed)

      1. ➟ Valacyclovir, famciclovir, or acyclovir
      2. ➟ These medicines:
      3. → Reduce viral replication
      4. → Shorten outbreak duration
      5. → Reduce new lesion formation
      6. → May reduce severity of acute pain

🟣 3) Pain control (very important in shingles)

      1. ➟ Pain can be intense because the virus inflames the nerve.

🟣 Mild to moderate pain

      1. ➟ Acetaminophen (Tylenol)
      2. ➟ NSAIDs (ibuprofen/naproxen) if safe for you
      3. → Avoid NSAIDs if you have kidney disease, ulcers, or blood thinners unless advised

🟣 Moderate to severe nerve pain (doctor-guided options)

      1. ➟ Gabapentin or pregabalin
      2. ➟ Certain antidepressants used for nerve pain (e.g., tricyclics)
      3. ➟ Short-course stronger pain meds in selected cases
      4. ➟ Topical options after skin is intact (not on open blisters):
      5. → Lidocaine patches/gel (clinician guidance)

🟣 4) Skin care (helps healing and prevents infection)

      1. ➟ Keep rash clean and dry:
      2. → Gentle soap + water
      3. → Pat dry, don’t scrub
      4. ➟ Cool compresses can reduce burning and itching
      5. ➟ Calamine lotion can help itch (avoid thick occlusive creams on blisters)
      6. ➟ Do not pop blisters
      7. ➟ Watch for secondary bacterial infection:
      8. → Increasing redness, warmth, pus, fever (needs evaluation)

🟣 5) Prevent spreading the virus to others

      1. ➟ Shingles itself is not “caught” as shingles from someone else, but the virus can spread and cause chickenpox in someone who has never had it or isn’t vaccinated.
      2. ➟ Spread happens by direct contact with fluid from blisters.

🟣 Precautions until all blisters crust over

      1. ➟ Keep rash covered when possible
      2. ➟ Avoid touching/scratching; wash hands frequently
      3. ➟ Avoid close contact with:
      4. → Pregnant people who are not immune
      5. → Newborns
      6. → Immunocompromised individuals
      7. → People without chickenpox history or vaccination

🟣 6) High-risk situations (seek care urgently)

🟣 A) Shingles on the face or near the eye (Herpes zoster ophthalmicus)

      1. ➟ Warning signs:
      2. → Rash on forehead, eyelid, or tip of the nose
      3. → Eye redness, pain, light sensitivity, blurred vision
      4. ➟ This needs urgent ophthalmology evaluation to prevent vision loss

🟣 B) Ear involvement (Ramsay Hunt syndrome)

      1. ➟ Signs:
      2. → Ear pain + blisters in/around the ear
      3. → Facial weakness/droop, hearing loss, dizziness
      4. ➟ Needs urgent evaluation

🟣 C) Immunocompromised patients

      1. ➟ Cancer chemo, transplant meds, high-dose steroids, HIV, advanced diabetes
      2. ➟ Higher risk of severe or widespread disease → may need IV antivirals

🟣 D) Disseminated shingles (widespread rash)

      1. ➟ Blisters appear in multiple body regions or cross many dermatomes
      2. ➟ Requires urgent medical care

🟣 E) Postherpetic neuralgia (PHN): the main long-term complication

      1. ➟ PHN is nerve pain lasting >90 days after rash onset
      2. ➟ Risk increases with:
      3. → Age >50
      4. → Severe rash or severe early pain
      5. → Immunocompromised status
      6. ➟ Management includes:
      7. → Gabapentin/pregabalin, tricyclic antidepressants
      8. → Topical lidocaine/capsaicin (doctor-guided)
      9. → Pain specialist care if persistent

🟣 F) Vaccination (best prevention strategy)

      1. ➟ The shingles vaccine (commonly recombinant zoster vaccine, Shingrix) significantly reduces:
      2. → Risk of shingles
      3. → Risk of postherpetic neuralgia
      4. ➟ Often recommended for adults 50+ and some immunocompromised adults (per clinician guidance).
      5. ➟ You can still get vaccinated even if you had shingles before (timing should be discussed with your clinician).

🟣 G) Bottom line

      1. ➟ Start antivirals early (ideally within 72 hours) and treat pain aggressively to reduce suffering and complications.
      2. ➟ Eye/ear involvement, widespread rash, or immunocompromised status requires urgent evaluation.
      3. ➟ Vaccination is the most effective long-term prevention.

⚕️ Medical Disclaimer

This information is for educational purposes only and does not replace medical advice, diagnosis, or treatment.

Shingles vaccination – all year round! Eligibility poster (publishing.service.gov.uk) (PDF)

Please see the PDF information leaflet in the viewer below. To view the original accessible PDF in a new browser window, please click here.