Shingles Vaccination: A Missed Opportunity in Preventative Care?
Written by Professor Christine Loscher, Head of School and Full Professor of Immunology, School of Biotechnology, Dublin City University
Source: Irish Pharmacy News, April 2026, pages 32.
Shingles is a viral infection caused by the reactivation of the varicella-zoster virus – the same virus responsible for the common childhood illness, chickenpox. Following initial infection, the virus does not leave the body but instead remains dormant in nerve cells, often for decades.
As individuals age or experience a weakening of the immune system, the virus can reactivate. When this occurs, it travels along nerve pathways to the skin, producing the characteristic blistering rash typically seen on one side of the body or face. This process is often accompanied by intense pain, which can persist even after the visible rash has resolved. In some cases, this leads to postherpetic neuralgia, a debilitating condition that can significantly impact quality of life.
A vaccine for shingles has been available for approximately 20 years, with a newer, more effective version introduced in 2017. This updated vaccine offers around 90% protection against infection and represents a major advancement in the prevention of shingles and its complications.
While the primary aim of vaccination is to prevent shingles itself, emerging research suggests that its benefits may extend beyond this. A recent large-scale study in Wales, which compared vaccinated and unvaccinated older adults, found that those who received the shingles vaccine had a 20% lower risk of developing dementia. This may be linked to the role of the varicella-zoster virus in triggering chronic inflammation in the brain, which has been associated with neurodegenerative processes.
In addition, research from Korea has indicated a 26% reduction in cardiovascular events among individuals who had been vaccinated against shingles. This may be explained by the fact that shingles infection can contribute to blood vessel damage, inflammation, and clot formation – factors known to increase the risk of heart disease. By preventing infection, vaccination may therefore help reduce these downstream risks.
The Role of Pharmacy in Vaccine Delivery
Community pharmacy has played an increasingly important role in vaccine delivery in Ireland over the past decade. Pharmacists first became involved in national vaccination efforts in 2011 with the rollout of the influenza vaccine. Their role expanded significantly during the Covid-19 pandemic, when pharmacy teams were instrumental in delivering vaccines at scale across the country.
Pharmacies are deeply embedded within communities and have established, trusted relationships with patients – particularly older adults, who are most at risk from shingles. This accessibility and trust are key reasons why pharmacy-led vaccination programmes have proven so effective.
Given this track record, community pharmacy is well positioned to support the delivery of a national shingles vaccination programme, should one be introduced. Pharmacists have the clinical expertise, infrastructure, and patient engagement necessary to improve access and uptake.
Access and Affordability: A Key Barrier
Despite the availability of an effective vaccine, access remains a significant challenge in Ireland.
The National Immunisation Advisory Committee (NIAC) has approved the shingles vaccine for use in Ireland. However, it has not yet been prioritised for inclusion in a publicly funded national programme. As a result, the vaccine is currently only available on a private basis, at a cost of approximately €500 for the required two-dose course.
For many patients – particularly older adults – this cost represents a substantial barrier. The consequence is that a highly effective preventative intervention remains out of reach for a large proportion of the population.
This situation is in stark contrast to other countries. The shingles vaccine is available free of charge in several healthcare systems, including those in the UK, the United States, Canada, Australia, and a number of European countries. These programmes recognise not only the direct benefits of preventing shingles, but also the wider health and economic benefits associated with reducing complications and hospitalisations.
The Case for Prevention
The growing body of evidence linking shingles vaccination to reduced risks of dementia and cardiovascular disease adds further weight to the case for wider access. These findings suggest that the benefits of vaccination extend beyond infection control and into broader areas of public health.
Preventative medicine offers significant long-term value, both in improving patient outcomes and reducing pressure on healthcare systems. However, it is not always prioritised in funding decisions.
Ireland has a strong and successful childhood vaccination programme, but adult vaccination remains more limited. Vaccines such as influenza and shingles are often not publicly funded, leaving patients to bear the cost themselves. This has a direct impact on uptake, particularly among those who may benefit most.
Lower uptake not only increases the burden of disease but also contributes to seasonal pressures on healthcare services, as seen each winter with influenza.
Looking Ahead
The current situation presents a clear opportunity for policy reconsideration. The availability of an effective shingles vaccine, combined with emerging evidence of wider health benefits, strengthens the argument for its inclusion in a national vaccination programme.
Community pharmacy stands ready to support such an initiative. With its accessibility, trusted relationships, and proven track record in vaccine delivery, pharmacy could play a central role in improving uptake and ensuring equitable access.
Ultimately, the question is not whether the shingles vaccine works – it does – but whether it should be made more widely available to those who need it most.
As the focus of healthcare increasingly shifts towards prevention, ensuring access to effective vaccines such as this will be critical in improving long-term health outcomes for the population.
