Shingrix (Herpes Zoster vaccine Recombinant, adjuvanted)

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Your severely immunocompromised (IC) patients may be eligible for a non-live shingles vaccination1,2

Why wait? Take action to help protect your patients as soon as they become eligible for a non-live shingles vaccine.2

Rheumatology specialist digital referral checklist for shingles vaccination

Download this checklist to help determine which of your severely immunocompromised patients are eligible for shingles vaccination under the National Immunisation Programme. Eligibility is captured according to the Green Book. Please always refer to the latest guidance.

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Did you know that severely immunocompromised individuals aged 18 years old and over are eligible for a shingles vaccination?1,3

Given their risk of severe disease, the UK Health Security Agency has stated that the severely immunocompromised cohort (as defined in the Green Book) represents the highest priority for shingles vaccination within the Shingles National Immunisation Programme.1

Vaccine coverage data for the Shingles National Immunisation Programme in England found that 26.4% of eligible severely immunocompromised patients who turned 50 and over from 1 September 2024 to 31 August 2025, had received the first dose of their shingles vaccine by 23rd October 2025.4

Which of your severely immunocompromised patients should you refer to primary care for shingles vaccination?1,3

Eligible severely immunocompromised patients
(As defined in the Green book)1

  • Individuals with primary or acquired immunodeficiency states

    • Acute and chronic leukaemias, and clinically aggressive lymphomas (including Hodgkin's lymphoma), who are less than 12 months since achieving cure 
    • Under follow up for chronic lymphoproliferative disorders including haematological malignancies such as indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom's macroglobulinemia and other plasma cell dyscrasias (N.B.: this list is not exhaustive)
    • Immunosuppression due to HIV/AIDS with a current CD4 count of below 200 cells/µl.
    • Primary or acquired cellular and combined immune deficiencies - those with lymphopaenia (<1,000 lymphocytes/µl) or with a functional lymphocyte disorder
    • Received an allogenic (cells from a donor) or an autologous (using their own cells) stem cell transplant in the previous 24 months
    • Received a stem cell transplant more than 24 months ago but have ongoing immunosuppression or graft versus host disease

    • Receiving or have received in the past 6 months immunosuppressive chemotherapy or radiotherapy for any indication
    • Receiving or have received in the previous 6 months immunosuppressive therapy for a solid organ transplant
    • Receiving or have received in the previous 3 months targeted therapy for autoimmune disease, such as JAK inhibitors or biologic immune modulators including
      • B-cell targeted therapies (including rituximab but for which a 6 month period should be considered immunosuppressive), this should be monoclonal tumour necrosis factor inhibitors (TNFi), T-cell co-stimulation modulators, soluble TNF receptors, interleukin (IL)-6 receptor inhibitors.
      • IL-17 inhibitors, IL 12/23 inhibitors, IL 23 inhibitors (N.B.: this list is not exhaustive)

    • Moderate to high dose corticosteroids (equivalent ≥ 20mg prednisolone per day) for more than 10 days in the previous month
    • Long term moderate dose corticosteroids (equivalent to ≥10mg prednisolone per day for more than 4 weeks) in the previous 3 months
    • Any non-biological oral immune modulating drugs in the previous 3 months
      • methotrexate >20mg per week (oral and subcutaneous)
      • azathioprine >3.0mg/kg/day
      • 6-mercaptopurine >1.5mg/kg/day
      • mycophenolate >1g/day
    • Certain combination therapies at individual doses lower than stated above, including those on ≥7.5mg prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine) and those receiving methotrexate (any dose) with leflunomide in the previous 3 months

    • equivalent to >40mg prednisolone per day for more than a week, for any reason in the previous month

Learn more about SHINGRIX

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What is the impact of shingles on IC patients?

Patients who are immunocompromised have an increased risk of shingles and its complications compared to those who are not.9

IMPACT OF SHINGLES

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Learn more about SHINGRIX clinical trial data on IC patients

SHINGRIX has been studied in a range of immunocompromised populations ≥18 years of age (including haematological malignancies, autologous haematopoietic stem cell transplant, renal transplant and solid tumours).5-8

CLINICAL TRIAL DATA IN IC PATIENTS

References

  1. UKHSA Green Book: Shingles (herpes zoster): the green book chapter
  2. SHINGRIX. Summary of product characteristics (UK)
  3. UK Health Security Agency. Shingles vaccination programme: expansion of Shingrix vaccine eligibility to all those who are severely immunosuppressed and aged 18 years and over. Published July 2025.
  4. UK Health Security Agency. Shingles vaccine coverage in England: annual report September 2024 to August 2025. Updated 28 May 2026.
  5. Bastidas A, de la Serna J, El Idrissi M, et al.; for the ZOE-HSCT Study Group Collaborators. Effect of recombinant zoster vaccine on incidence of herpes zoster after autologous stem cell transplantation: a randomized clinical trial [suppl]. JAMA. 2019 July;322(2):123-133.
  6. Dagnew AF, Ilhan O, Lee WS, et al.; on behalf of the Zoster-039 Study Group. Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in adults with haematological malignancies: a phase 3, randomised, clinical trial and post-hoc efficacy analysis. Lancet Infect Dis. 2019 September;19(9):988-1000.
  7. Vink P, Torelle JMR, Sanchez Fructuoso A, et al.; for the Z-041 Study Group. Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in chronically immunosuppressed adults following renal transplant: a phase 3, randomized clinical trial. Clin Infect Dis. 2020 January;70(2):181-190.
  8. Vink P, Mignorance ID, Alonso CM, et al.; on behalf of the Zoster-028 Study Group. Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in patients with solid tumors, vaccinated before or during chemotherapy: a randomized trial. Cancer. 2019 April;125(8):1301-1312.
  9. Yanni EA, Ferreira G, Guennec M, et al. BMJ Open 2018;8:e020528

Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/ or search for MHRA Yellowcard in the Google Play or Apple App Store. Adverse events should also be reported to GSK on 0800 221 441 or UKSafety@gsk.com

SHINGRIX is owned by or licensed to the GSK group of companies.
© 2026 GSK group of companies or its licensor.
Trade marks are owned by or licensed to the GSK group of companies.

September 2026 | PM-GB-SGX-WCNT-230042 (V3.0)