There has been a considerable change to the Shingles vaccinations programme this year. The age of eligibility is now patients between 70-79 years old and a new 2 part vaccine called Shingrix has been introduced which can be administered 6 months apart to patients who are immunocompromised. 

To identify patients who may be eligible for a Zostavax Shingles vaccination, go to 'Clinical Reporting > Vaccinations > Shingles I 4 Invitations'. These reports have been split out so that you can send invitations out by email, SMS or post.

To identify immunocompromised patients who may be eligible for a Shingrix Shingles vaccination, go to 'Clinical Reporting > Vaccinations > Shingles I 4 Invitations I Immunosuppressed'. These reports are for part 1 and part 2 and have also been split out so that you can send invitations out by email, SMS or post.

Due to the complexity of the contraindications for the Shingles Vaccinations, patients will appear on this report even if they have a potential contraindication. This is checked on the template instead - see 'Check Contraindications below.

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

On here is a 'Check Contraindications' button to check the patient's record for any potential contraindications, such as immunosuppression. This will then show one of the pop-up messages below. On here are links for further information about the contraindications from The Green Book and RNHRD.

If the patient has a contraindication to a live vaccine you may see this 

If the patient is immunocompromised you may see this 

If the reports have been unable to identify a contrainidication you may see this

Further reports are available by going to Clinical Reporting > Ardens > Vaccinations > Shingles 

CQRS Reporting Issue

Patients may appear in the Ardens CQRS report for SHROU03 but not in the TPP Data Extraction CQRS reports

Likely Scenario: Patient comes in for the Shingles vaccination and as part of the prechecks it is discovered that there is a contraindication to live immunisation and in line with the Green Book the decision is made to offer Shingrix instead. The clinician then records from the Shingles Immunisation template 'Contraindications to live immunisation 81230’ 

Problem: Although appropriate clinically to record this code does not automatically make the patient eligible for Shingrix and are potentially not coded with any immunocompromised codes.  Therefore, although the patient is eligible for a Shingles vaccination because of age they are not strictly eligible for a Shingrix Shingles vaccination and payment.  

Resolution: To help practices, we have a report in ‘Vaccinations > Shingles I 5 Review after’ called ‘For review after vaccination | Shingrix vaccination recorded but not in immunocompromised group - review record and code as appropriate'. 

This will flag up any patients that you have vaccinated with Shingrix who are not considered eligible for payment.  Some of these patients will possibly be immunocompromised in some way due to hospital medications or things like chemotherapy which are perhaps not coded in the record. 

Once the records have been reviewed and any coding issues corrected you should then be able to justify why they were vaccinated with Shingrix. A manual adjustment claim will then need to be submitted to your CCG/Local NHSE team.