nhs hpv vaccine for adults :: Article CreatorNHS Shingles Vaccine Could Halt Dementia – How Does It Work?
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The shingles vaccine could decrease risk of dementia by 17%, a new study suggests.
University of Oxford researchers found that the Shingrix vaccine is linked to a "significantly" lower risk of dementia in the six years after vaccination than the previously-used Zostavax jab, following a study on more than 200,000 people.
The finding – which experts say is "convincing" – shows the Shingrix vaccine is linked to at least a 17% drop in dementia diagnoses.
University of Oxford researchers said this equates to five to nine more months of life without dementia for those given the Shingrix jab compared with other vaccines.
Both men and women benefited from the newer jab, but the effects were greater in women, the study found.
Shingles occurs most often as people get older and is more likely to cause serious problems in older age groups.
Dr Maxime Taquet, academic clinical lecturer in the department of psychiatry at Oxford, who led the study on more than 200,000 people, said: "The size and nature of this study makes these findings convincing and should motivate further research.
"They support the hypothesis that vaccination against shingles might prevent dementia.
"If validated in clinical trials, these findings could have significant implications for older adults, health services and public health."
Shingles is caused by the reactivation of the varicella zoster virus (Alamy/PA)
Dr Taquet said the team's interpretation of the data is that the jab works to delay dementia rather than prevent it altogether, although more work is needed.
On the NHS, people are offered two doses of Shingrix when they turn 65, as long as their birthday was on or after September 1 2023.
Those who turned 65 before this date are eligible for the shingles vaccine when they become 70, while all people aged 70 to 79 are also eligible.
People aged 50 and over with a severely weakened immune system are offered a vaccine.
Evidence shows Shingrix, made by GlaxoSmithKline (GSK), can provide at least a decade of protection against shingles after the first jab.
For the new study, published in the journal Nature Medicine, researchers wanted to use emerging but limited evidence that the previous vaccine, Zostavax, might also protect against dementia.
In the US, Zostavax was replaced by Shingrix in October 2017, giving a good opportunity to compare the two vaccines.
Researchers looked at people's risk of dementia in the six years following the introduction of Shingrix and compared them with otherwise similar people who had received Zostavax.
Some 103,837 people were in each group.
Shingrix was also compared with people who had received vaccines against other infections (flu and tetanus, diphtheria and pertussis).
The results showed Shingrix was associated with a 17% lower risk of dementia than Zostavax, and 23%-27% less than with the other vaccines.
There was more benefit in women than men, with women enjoying 22% versus 13% more time lived without a diagnosis of dementia.
Dr Sheona Scales, director of research at Alzhei
The UK Health Security Agency (UKHSA) no longer supplies Zostavax but there may still be a small number of doses in GP surgeries for use.
What exactly is shingles and how does the vaccine work?
What is shingles?
"Shingles, also known as herpes zoster, is a viral infection characterised by a painful, vesicular rash," says Carolina Goncalves, superintendent pharmacist at Pharmica.
It is caused by the reactivation of the varicella zoster virus, the same virus that causes chickenpox, according to the NHS.
If you had chickenpox as a child, you could get shingles later in life (Alamy/PA)
"After a person gets chickenpox, the virus stays dormant inside the body for life, not causing any problems or symptoms," explains Dr Sasha Dhoat, consultant dermatologist at Stratum Clinics. "But our immune system naturally weakens over time as we age, with illness, stress or immunosuppressant medications, which may allow the usually inactive virus to reactivate, causing shingles along a nerve strip, hence only one side of the body."
What are the symptoms?
The first signs of shingles are a tingling, burning sensation, sensitivity to touch, or painful feeling in an area of skin, explains Dhoat.
"This is often accompanied by headache or feeling generally unwell. A few days later, the classic single stripe of blisters that wraps around the left side or the right side of your torso usually appears, but can occur anywhere on the body including the face," says Dhoat.
Blisters often appear on your torso if you have shingles (Alamy/PA)
Marian Nicholson MBE, director of the Shingles Support Society, adds: "If you develop some weird nerve sensations on your body, usually face or ribs, and looking back on it you can't think of any good reason for it, then it could well be the beginning of a shingles outbreak.
"Sometimes the nerve sensations are pretty mild and rarely cause any irritations, but in other people these pains are absolutely intolerable."
Who is most at risk?
As we age, the likelihood of developing shingles increases.
"Individuals at higher risk of developing shingles include older adults, particularly those over 50, due to the natural decline in immune function known as immunosenescence, which facilitates the reactivation of the varicella zoster virus," explains Goncalves.
"Immunocompromised individuals are also at elevated risk, including those with medical conditions such as HIV/AIDS, leukaemia, lymphoma and other cancers. Physical or emotional stress and trauma to the area of the affected nerve can also precipitate an outbreak."
Old people are more likely to get shingles (Alamy/PA)
Nicholson adds: "Other trigger factors for developing shingles are the same as all the usual ill-health causes, such as being ultra-tired, ultra-stressed and in bad health for one reason or another."
Can there be complications?
The most common complication the virus can trigger is post-herpetic neuralgia.
"Post-herpetic neuralgia is a persistent pain lasting for around 90 days after the rash and blisters heal," explains Goncalves. "Shingles can also cause scarring and pigmentation changes on the skin as the reactivated varicella zoster virus damages skin cells, leading to intense inflammation and blistering.
"Lastly, superinfection of skin lesions can occur as a result of shingles due to the blisters breaking open, creating a pathway for bacteria to enter and infect the damaged skin."
When should you see a doctor?
Seek professional advice (Alamy/PA)
It's important to seek advice, especially if symptoms are severe or you may be more at risk of complications, and the sooner you get medication, the better.
"You should see a doctor if the pain and rash occur near an eye, if you are 50 or older, if you or someone in your family has a weakened immune system (e.G. Cancer or chronic illness), or the rash is widespread and painful," advises Dhoat. "If you are not sure, call 111 for advice."
What treatments are available?
There is no definitive cure for shingles but oral antivirals are often prescribed by GPs.
"Early treatment with prescription oral antivirals, such as Aciclovir, may reduce the infection period and lessen the chance of any complications arising," says Dhoat. "These are best taken within three days on onset of symptoms."
Paracetamol can help ease pain, if suitable, and keeping a rash clean is also important to prevent infections.
How does the vaccine work?
To lower the risk of shingles, the Shingrix vaccine is available on the NHS for certain groups.
"Shingrix prevents shingles by boosting the immune system's ability to fight the varicella zoster virus," explains Goncalves. "It uses a viral protein and an adjuvant to stimulate the production of antibodies and T-cells, which help prevent the virus from reactivating, thereby reducing the likelihood of developing shingles or associated complications."
Nicholson adds: "It is a two-dose vaccine, several months apart, and GPs are delivering it to people who reach 65 and people in their 70s [who've not previously had it]. Anyone who is over 50 is allowed to buy it for themselves at their local chemist."
Talk to your doctor if you are concerned.
Canada's Vaccine Advisers Now Recommend 1 Dose Of HPV Shot For Younger Groups
Canada's federal vaccine advisory body is now recommending a single dose of the HPV vaccine for children and youth, bringing the country in line with multiple others that have already reduced the number of required doses for young people. (John Amis/Associated Press)
Canada's federal vaccine advisory body is now recommending a single dose of the HPV vaccine for children and youth, bringing the country in line with multiple others that have already reduced the number of required doses for young people.
The new guidance, out Wednesday from the National Committee on Immunization (NACI), strongly recommends that individuals nine to 20 years of age should receive one dose of the vaccine for human papillomavirus, instead of two or three.
Research over the last decade has shown that one dose of this "highly effective vaccine" can provide comparable protection against HPV infection and disease among female individuals in that age group, NACI noted.
The advisory body still calls for two doses of the HPV vaccine for Canadians aged 21 to 26, along with a three-dose schedule for people who are immunocompromised or living with HIV.
Analysis
More countries are dropping the number of doses needed for HPV vaccines. Should Canada? In people without protection, persistent infection with high-risk types of HPV has been linked to cervical, oropharyngeal, vaginal, vulvar, penile and anal cancers.
"Individuals who are 27 years of age and older who were not vaccinated may benefit from vaccination, even at an older age," NACI's guidance continues.
WATCHCountries shifting to one-dose HPV vaccine: England shifts to single-dose HPV vaccine. Should Canada follow? England recently announced it will move to a single-dose HPV vaccine, following similar moves in Scotland and Australia. There are calls to do the same in Canada, but some immunologists say there still isn't enough evidence to show that one dose is enough.
The new recommendations follow the World Health Organization (WHO) announcing back in 2022 that a single dose delivers "solid protection" against HPV that's comparable to two or three shots, based on a growing body of global evidence.
As CBC News reported in July 2023, multiple other countries — including England, Ireland, Scotland, Wales and Australia — had already made the switch to a one-dose approach.
"When you look at the studies that have been published worldwide ... The effectiveness of one dose of the HPV vaccine is actually quite high," Quebec-based physician and former NACI chair Dr. Caroline Quach said at the time.
"In terms of prevention of HPV infections that may lead to cancer, whether you give one dose or two doses basically gives you the same amount of protection."
In Canada, the HPV vaccine is authorized for people between the ages of nine to 45.
Current immunization coverage among adolescents and young adults varies across the country and is below the national target of 90 per cent, NACI's guidance said.
Covid: NHS Plans Booster Jab For Those 50 And Over Before Winter
All adults aged 50 and over in the UK are likely to be eligible for a third booster dose of a Covid vaccine in the autumn
The NHS has been given the green light to start planning a Covid vaccine booster programme in the UK ahead of this winter.
A bigger flu season than normal is expected, meaning extra protection against Covid is likely to be needed.
More than 30 million of the most vulnerable should receive a third dose, vaccine experts are advising.
They will include all adults aged 50 and over, and anyone over 16 who qualifies for a flu jab.
Health service bosses had previously said they needed lots of warning of an autumn Covid-19 booster rollout in order to plan the logistics alongside vaccinating millions of people against flu.
Interim advice from the Joint Committee on Vaccination and Immunisation (JCVI) is that boosters will help maintain protection against Covid-19 and new variants for those most at risk, before winter comes.
The vaccines are thought to protect most people against serious illness for at least six months, but a lack of data on exactly how long immunity lasts is prompting a safety-first approach.
No decisions have yet been made on which vaccines will be used.
Winter flu comeback
Prof Jonathan Van-Tam, deputy chief medical officer for England, said: "We want to be on the front foot for Covid-19 booster vaccination to keep the probability of loss of vaccine protection, due to waning immunity or variants, as low as possible - especially over the coming autumn and winter."
He said other respiratory viruses, particularly flu, "will make a comeback" and be an additional problem this winter.
"We will need to ensure protection against flu, as well as maintaining protection against Covid-19," Prof Van-Tam said.
Health and Social Care Secretary Sajid Javid said ministers were working with the NHS to rapidly deliver the programme from September.
"Our first Covid-19 vaccination programme is restoring freedom in this country, and our booster programme will protect this freedom," he said.
Scotland's health secretary Humza Yousaf said the government had been working closely with NHS boards to plan for the booster campaign, while the current vaccination programme "continues at pace and remains on schedule".
Wales' Health Minister Eluned Morgan said she was working with Welsh health boards to ensure they can deliver a booster programme "from the start of September".
"In line with the other nations of the UK, the Welsh government welcomes the JCVI advice," she said. "It very much aligns with our thinking and our planning assumptions to date."
The JCVI's final advice will be published before September, when better data will be available on how long protection from the first two doses of the vaccines lasts. The latest figures on hospitalisations, emerging variants and trials will also be taken into account at that point, and could change their advice.
Who could get a third dose?
In the meantime, the JCVI's advice is to offer a third Covid jab (and a flu jab) to the following people from September 2021:
adults aged 16 and over who are immunosuppressed or clinically extremely vulnerable residents in care homes for older adults all adults aged 70 and over frontline health and social care workers After those groups, it will be:
all adults aged 50 and over adults aged 16-49 who are in a flu or Covid-19 at-risk group those living in the same house as people who are immunosuppressed Prof Wei Shen Lim, Covid-19 chair for JCVI, said all these groups would also be eligible for the annual flu vaccine and were strongly advised to have it.
Younger adults will be not be given a third dose, because they will only have had their second dose in the summer, although this decision will be revisited at a later time, the JCVI said.
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