I had a Shingrix (shingles) vaccine today, from the NHS (free), because I'm immune-suppressed and over 50

[AutumnCrow]

Just that really. I'm on an immune-suppressing biologic drug for auto-immune disease(s), and after a bit of a tussle with my GP surgery <waves, and thanks> I finally got jabbed with Shingrix #1 this morning.

Next one (2 of 2) is in 8 weeks.

Please may I encourage anyone in the same category as me - immune-suppressed and over 50 years old - to take advantage of this vaccine programme that was introduced by the NHS on the 1st September this year. Boots do offer it privately but the cost for the course is £450 thus prohibitive for many. The NHS jabs via your GP are free. You must go through your GP to receive the jabs for free. This is not an active vaccine and is safe for immune-suppressed people.

Please don't wait to be called in. My GP surgery is having some real time and admitted issues with flagging up patients on immune-suppressing biologics on its (new-ish) data system. If in doubt, ring and explain.

I'm happy to help to look up anyone's meds for them in the 'Green Book'. Mine is Adalimumab, a commonly used TNF-blocker for psoriasis and psoriatic arthritis that for some reason my GP surgery didn't recognise or compute.

Unfortunately that means your practice data is unfit for purpose and the searches being made are inherently flawed - there's a failure to input the correct codes and a failure to search using correct parameters.

The practice manager should be taking responsibility to ensure the data is full and complete - additional reports of consultant referrals, communications and suchlike would also be useful in the cleansing process.

Searches of 50+, autoimmune diagnosis and referral would bring up additional lists of people likely to be in the category of eligibility. Not that hard when you can do exactly the same for 50+ checks of people with factors making T2 diabetes a higher risk.

@NeverDropYourMooncup not really, we do regularly refine the searches and our data team input coding from hospital letters. However the searches need checking and reviewing regularly. For example patients on lower doses of methotrexate, azathioprene etc aren’t eligible and higher doses are. When a consultant changes a patients dose it will be noted by the GP, and if we prescribe it it will be picked up in searches, but new meds not prescribed by us won’t automatically be unless the data team task it to me querying eligibility and I add the read code. You can see how some patients might slip through the net between searches.

It’s not perfect, but we do regular searches and invite new eligible patients accordingly. I’m just trying to explain why not all patients might have been called sooner.

Well, my GP's coding debacle (lack of) continues. I am nearly at the six month mark since my first Shingrix and can I get an appointment for my 2nd? Can I buggery. Will report back from my sit-in at the surgery next week.

TL:DR, I have been jabbed with Shingrix #2!

My GP practice earlier today finally, after nearly four years, confirmed that I am now coded as immune-suppressed and searchable as such on the system.

I think that part of the issue perhaps is that the GP staff have not been seeing the actual name 'Adalimumab' in the Green Book. I don't know if maybe @Sidge can cast any light on this, but surely there is a master list of 'TNF blockers/receptors' that GP practices hold? The other part of the problem seems to be that consultants' letters about my being on Adalimumab and thus immune-suppressed have been disregarded for coding purposes.

Anyway I had my 2nd and final Shingrix vaccination about 45 minutes ago. The practice nurse was very kind and efficient, and I thanked her profusely.

The relief is significant.

@AutumnCrow I’m glad you’ve finally been jabbed. What a palaver, it’s daft that it’s taken so long.

You’re right in that the green book isn’t clear cut, and practices don’t have a master list of drugs. There are dozens and dozens and often they’re dose dependent too. I’ve attached the green book table below for anyone that’s interested and you can see it’s rather lacking in the finer details! Admin/data team staff don’t have the clinical knowledge to understand eligibility, and rely on the GP and practice nurse to assign it. GPs are generally not great with vaccines, and may (or may not!) send it to the nurse who may seek clarification from the hospital causing further delays.

It’s an imperfect system I know, and we’re drowning in primary care so this is another thing to add to our workload. No excuse, just an attempt at an explanation.

Picture.

Thanks, @Sidge for the info. That's really interesting.

Can I ask how you all felt after that 2nd jab? I was really rough after my first for a good 4 days. Am booked in for my 2nd one on Monday but feeling like I have a cold starting. Am at the end of my 6 month window next week so not sure what to do. Was supposed to have had the 2nd one last week but the surgery cancelled due to staff shortage.

I felt absolutely shocking with the first vaccine - barely noticed the second, other than my arm being quite tender for a couple of days.

Oh that's reassuring @NeverDropYourMooncup thank you! Glad you didn't feel rough. That first one wasn't fun!
Am at the very end of my 6 month window for this jab and I how much does that matter? What happens if I get it done at say 6 months and 3 weeks? Obviously I need/want to get it done (despite the awful side effects last time) but getting worried about the timeframe.

I had mine very close to the 6 month window - think I had about 2 days to go! From what I remember reading, if you do miss the 6 month mark, you should still get the 2nd jab as soon as you feel able; you don't need to start the course again.

I don't recall feeling particularly affected by jab #2 - just a sore arm for a couple of days and a bit of short-term lethargy the day or two after.

Thank you @AutumnCrow that's reassuring too!

@AutumnCrow - thank you for this thread. My mother who survived cancer got shingles 13 years post cancer. We were not aware of the risks. The shingles was horrific! She has life long nerve damage and pain due to this now.
My DH 53 is on hypertension meds and statins - how do I find out if he is immune suppressed?

I think there's also uncertainty as to how long the Shingrix lasts for if given to this age group? I was reading that in older people it's definitely a one time vaccine but recent research shows uncertainty whether a 50yr old would require further vaccination after 7 years?

I don't think your DH will qualify for Shingrix under the NHS scheme, @SoftPillowAllNight, on 'just' BP meds and statins with the underlying issues; but if he doesn't you can pay for it at (say) Boots pharmacies. Last I looked it was £425 for the course of 2 jabs. It's not a price ticket to be sniffed at, obvs.

The NHS scheme qualifying criteria for immune-suppression are in the 'Green Book' discussed upthread ^^ and you can also ring your GP surgery to check - most surgeries seem to be getting the hang of it now.

Yes, that's definitely going to be one to watch. I can imagine there may be some sort of booster on offer in the future?

I live in France where my medical care is usually excellent.
I have cll and according to my online health account should have the Shingrix vaccine, I’m state pension age from last year.
For some inexplicable reason my usually good doctor says no, I don’t need it.
I’m totally bemused and a bit worried.

I'm pleased you got yours op. My healthcare is paid for by the uk government under S1 rules so I am allowed to use the NHS but feel a bit guilty when they’re so under pressure.