Absurd rules that mean you can get a vital shingles jab if you’re 65 or 70 – but not if you’re aged 66 to 69: Ask the GP DR MARTIN SCURR

With its painfully painful rash, fever and headaches – and the risk of serious complications including pneumonia, permanent vision and hearing loss, as well as nerve pain and even death – shingles is a disease best avoided.

And it's something you can largely avoid thanks to a highly effective vaccine, Shingrix, which reduces the risk of developing shingles by more than 90 percent – ​​and is available free on the NHS.

But who will get this vaccine? This, you might think, would be simple enough to answer, but when I read the new guidelines on this I was left completely confused, and I'm not alone in that.

Our mailbag is overflowing with letters from readers who feel the same way.

Furthermore, many share my view that the way it is made available defies logic and gives the impression that it is in fact being rationed.

Under the microscope

Choirmaster Gareth Malone, 48, answers our health quiz

CAN YOU RUN UP THE STAIRS?

Yes, I recently had a head to toe medical MOT and got a score of 10/10, so I think I can say I'm reasonably fit. I go to the gym twice a week – light weights, a little balancing on one leg, squats, lunges, that kind of thing. If I have time, I walk at high speed instead of taking the bus or subway. And I cycle when I can.

EVER DIET?

No, but I am genetically blessed. My father, James, was a marathon runner.

ANY VICES?

I try to leave out biscuits (too easy to pack in a packet when you work from home) and single malt whisky. I always get my five a day: apples, bananas, vegetables. I love broccoli. My wife, Becky, is an English teacher and very organized. We post a weekly meal plan on the refrigerator so that people don't cook or eat haphazardly.

POP PILLS?

Vitamin D in winter. I tend to avoid the sun because of my Celtic color. I just finished my Sing-Along-A-Gareth tour and have been taking vitamin C and zinc the entire time in an attempt to keep colds at bay. I also take fish oil tablets because my mother, Sian, suffers from arthritis and I'm worried I might get it too.

FAMILY ILLUMINATES?

My father had a heart attack in 2007, caused by a buildup of plaque in the arteries. My recent test showed that I am doing well; medically boring actually.

WORST INJURY?

When I competed on The Masked Dancer in 2002, I planned to practice every day. But at the end of the first day, I bent down to pick up an envelope, missed a step and sprained my ankle. A black line formed along the side of the foot, indicating a deep sprain. For three weeks I had to sit with my foot elevated. Very annoying!

I had an ear infection in 2013 that left me with a slight ringing in my right ear – like a high-pitched whistle – not great for a musician. This has made me very careful and I don't stand next to loudspeakers. But there is no degeneration in my hearing.

Dealing well with pain?

I'm not a fan of suffering in silence, so I'll take paracetamol if I need it. I have never dabbled in alternative medicine, although we did occasionally use Manuka honey diluted in boiled water to cure one of the children's eye infections. (They have daughters Esther, 13, and Dvora, four, and son Gilbert, 10.)

WHAT KEEPS YOU AWAKE?

The neighbor's child. But I'm not worried, never have been.

ANY PHOBIES?

I'm afraid of diving under large ships and getting tangled in the propellers. Weird, I know, because it's never going to happen.

DO YOU WANT TO LIVE FOREVER?

If I could stay healthy, fine. But I remember my grandparents falling into poor health and thinking that when the quality of life is gone, it's time to let go.

Interview: RICHARD BARBER

Shingles is not passed from person to person, but develops in people who have previously been infected with chickenpox.

The varicella-zoster virus that causes chickenpox lies dormant in the nerves and for some reason – such as another illness, stress or age – the immune system can no longer keep it under control and the virus reactivates, which is often quite causes disabling symptoms.

One in four people will get shingles, but the risk of getting it – and the severity if it does occur – increases with age and is also higher in people with a weakened immune system, for example as a result of taking immunosuppressive medications or chemotherapy.

A vaccine has been offered to people turning 70 since 2013, following a study that showed shingles was so deadly that it proved fatal in one in 1,000 cases in the over-70s. The shot available at the time was a single-dose live virus vaccine. , Zostavax. Because it was live, it meant there was a risk, albeit rare, of getting sick from it.

In 2017, a newer vaccine came to market, the two-dose Shingrix, administered six months and a year apart. Not only is this more effective, it also contains no live virus.

In July this year, the NHS announced a ten-year plan to eventually extend the invitation to receive the shingles vaccine to a million more people than were currently eligible.

So while the vaccine was previously only available to people in the year they turned 70, from September NHS England said the Shingrix vaccine will be offered to 'all adults turning 65, those aged 70 to 79 (who may be taking Zostavax or Shingrix ) and people aged 50 and over with a severely weakened immune system.'

You won't have missed the full-page newspaper ads promoting the vaccine, funded by the manufacturer.

But the eligibility information is anything but clear: it means that if you are 65 after September this year you can get the jab, but if you are not yet 70 you cannot – and the guidance seems to indicate this have caused chaos.

Typical of the letters we received was one from Nick Sterling, from Huddersfield, who writes: 'Unsolicited, my doctors have signed me up for the shingles vaccine later this week. But they called me today and canceled it. They said they had received advice from the government explaining the eligibility criteria, and it appears I am now ineligible. Apparently I'll be eligible when I'm 65 or 70. But if I'm 66, 67, 68 or 69, that's not me. I'm 69 and have to wait until I'm 70.'

It seems to be as confusing for GP practices as it is for the public.

As Alison Braycotton, from Walsall in the West Midlands, writes: 'When I heard that the vaccination was now being offered to 65-year-olds, I tried to make an appointment but was told by the doctor's surgery that I was already 65 (before September). I am not eligible and will not be eligible until my 70th birthday.

'However, someone who turns 65 between September 1 this year and August 31 next year is immediately eligible for the vaccine. How can this be fair? It seems that, not for the first time, the NHS is overcomplicating what should be simple.”

I completely agree. The health prevention messages about the shingles vaccine are confusing at best and many doctors will be inundated with patients seeking clarification.

As it stands, from 2028 the vaccine will also be extended to those turning 60, as well as those turning 65, but not to those aged 61 to 64.

And then in ten years, in 2033, it will become a routine offer for anyone over 60 who has not yet been vaccinated. But what does this achieve? Why don't we at least make it available now to all people between 65 and 70?

After all, this is not a rare condition. According to the NHS, one in four people who have had chickenpox (and that's more than 90 percent of the population) will develop shingles.

Could this be due to costs? The vaccine is expensive, over £100 per dose, but the economic impact of a patient suffering from shingles is much greater.

Raw health

Sexual activity is beneficial for the brain as we age, according to a recent study in the Journal of Sex Research. US researchers analyzed the results of health surveys and cognitive tests of 1,600 elderly people and found that those who reported feeling satisfied with their sex lives and who had sex regularly also scored better on cognitive function tests. They said future studies should look at the underlying neural pathways.

Apart from the short-term symptoms mentioned, long-term complications include post-herpetic neuralgia, pain in the area of ​​the rash caused by the virus damaging the nerves (this can be extreme and debilitating), depression and general weakness which can lead to an elderly patient being cared for.

Moreover, these are not rare. For example, post-herpetic neuralgia occurs in more than 30 percent of cases, and according to one study, about a third of them will suffer from it for more than a year.

A review published in the Journal of Stroke & Cerebrovascular Diseases in 2016 found that a patient's risk of stroke increased by almost 60 percent in the year after shingles.

The UK Health Security Agency says the rollout is based on advice from the Joint Committee on Vaccination and Immunization, adding that 'when a vaccination program is introduced, difficult decisions need to be made about who will be eligible first and in what form '. so that they would be offered the vaccine'.

It continues: 'These decisions are based on a combination of factors including the risk of the disease and the effectiveness of the vaccine in different age groups, vaccine supply and the ability of the NHS to deliver the program alongside other healthcare priorities.'

My view is that Shingrix should now be made routinely available to all patients over 60 years of age and that the ten-year limited access program should be discontinued. To do otherwise would be irrational, unfair and reckless.