Shingrix may be available on Australia's National Immunisation Program for those with CLL from 1 November 2023

[CLLerinOz]

The Pharmaceutical Benefits Advisory Committee has recommended that Shingrix be included on Australia's National Immunisation Program for some Australians later this year. An announcement by the Victorian Government indicates that Shingrix might be available from the start of November for particular categories of people, including "immunocompromised people aged 18 years and older with conditions at ‘high risk’ of herpes zoster infection".

The criteria for the 'high risk' category is yet to be announced. Those diagnosed with CLL should be considered to be at high risk but, until there is greater detail, we await confirmation.

Here is the statement from the Victorian Department of Health:

immunisation.health.vic.gov...

“From 1 November 2023, Shingrix® vaccine for the prevention of herpes zoster (shingles) and post-herpetic neuralgia will replace Zostavax® vaccine on the National Immunisation Program (NIP) (pending final regulatory approvals).

Vaccines can only be provided for free on the NIP after the Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that the vaccine, and the eligible cohorts, be included on the NIP.

PBAC has recommended Shingrix® vaccine as a two-dose primary course for the following eligible cohorts:

- all adults aged 70 years (only)

- First Nations Australian adults aged 50 years and older

- immunocompromised people aged 18 years and older with conditions at ‘high risk’ of herpes zoster infection.

The general population aged younger than 70 years, or 71 years and older will not be eligible to receive Shingrix®.

Currently, some adults may be unable to receive Zostavax® as it is contraindicated for immunocompromised people.

From 1 November 2023, immunocompromised people will be able to receive Shingrix® under the NIP if they meet the eligibility requirements.

Communications to support the introduction of Shingrix® to the NIP Schedule will be undertaken in the coming months to support awareness and implementation of the program changes.”

Zostavax® will continue to be administered until 31 October 2023. Take care: Zostavax is a live vaccine and not recommended for those who are immunocompromised.

“With supplies available, immunisation providers are encouraged to promote availability of Zostavax® to eligible patients, particularly to those who will not be eligible for Shingrix® under the expected program changes from 1 November 2023.”

Unfortunately, at this stage, it doesn’t look as if immunocompetent household contacts who are aged under 70 or who are 71 and older will have access to Shingrix through the NIP from 1 Nov 2023. The current cost of Shingrix outside the NIP is approximately $500 - 600 for the two-vaccine course.

Last month, GPs expressed their concern about the decision to limit Shingrix on the NIP to immunocompetent people only if they are 70 years old (ie not younger, not older).

www1.racgp.org.au/newsgp/cl...

"Shingrix demonstrated a high efficacy against herpes zoster of about 97% in adults 50 years and older and about 91% in those aged 70 years and older.

In clinical trials, Zostavax efficacy was lower and decreased with increasing age (70% in people aged 50-59 years, 64% in those aged 60-69 years, 41% in 70-79 years, and 18% in 80-89 years (no longer statistically significant in this age group)."

immunisationcoalition.org.a...

As  AussieNeil has reminded people on many occasions, shingles should not be underestimated and it is important for those with CLL to protect themselves from it and from the danger of post herpetic neuralgia which can be an extremely painful long-lasting complication of Shingles.

I'll provide an update when the final details and criteria for the inclusion of Shingrix on the NIP become available.

See our pinned post about vaccinations for general guidance about Shingles vaccination and about prophylactic antivirals which in certain circumstances can be recommended either in lieu of or in addition to vaccination to protect CLL patients against Shingles and PHN.

healthunlocked.com/cllsuppo...

(my emphasis)

CLLerinOz

Note: This is an unlocked post.

[Kiwidi]

Since NZ is usually around 5 years behind Australia guessing it won’t be funded here for a while. At the moment those who realise they are able can have it in the year they turn 65. What a farce! Happy for those in Australia though. You may see me there!

Just wondering if the agencies responsible for funding medications in other countries have this ‘claytons’ approach. Venetoclax funded if chemotherapy fails, ibrutinib funded if venetoclax fails and then…..😢 so we all have to go through chemo ( even me at 76) before we qualify.

An excerpt from a recent comparison study

In summary: …of the best-selling cancer drugs across a variety of cancer types, Germany funded all of them; followed by Italy with 94 percent; Japan with 82 percent; then England, Canada, France and Australia with 79 percent. Finally, New Zealand funded 35 percent.

Very depressing!

[CLLerinOz Administrator in reply to Kiwidi]

It's not much help but I do understand how frustrating and worrying it can be to be living somewhere that hasn't approved treatments that are available elsewhere. I had to seek a clinical trial about four years ago when I was approaching treatment for my CLL and there was nothing suitable funded in Australia for those like me with unmutated IGHV and a TP53 mutation.

In 2022, New Zealand announced that it was phasing out Zostavax and gradually moving towards the provision of Shingrix through its funded vaccination schedule. However, it hasn't yet funded Shingrix for the immunocompromised. You can track its progress through the approval process here:

connect.pharmac.govt.nz/app...

In the meantime, it is available for purchase for people over 50, according to this article from the University of Auckland:

auckland.ac.nz/en/news/2022...

"The downside is that it is expensive – you won’t get a lot of change out of $350 per dose. The Government announced last month that Shingrix will replace Zostavax as the funded vaccine for people aged 65 later this year. If you are outside the eligible age group, you will still need to pay."

CLLerinOz

[Guffy]

Hooray!

[Kjke]

Thanks for the info. Fingers xed that it becomes more widely available.