Pain doctors want free shingles vaccine for all over-65s
Specialist pain doctors want the shingles vaccine to be free for all New Zealanders over 65.
The call comes from the Faculty of Pain Medicine, part of the New Zealand College of Anaesthetists. Its chair, Charlotte Hill, says one in three people will get shingles in their lifetime, rising to one in two for people over 85 RNZ.
About one-third of people with shingles go on to develop chronic nerve pain. It can last for months or years. Pain doctors tend to see these patients when GP care and antiviral medicines have not resolved the symptoms.
Shingles is caused by the same virus as chickenpox. After chickenpox, the virus stays dormant in the nerves for decades, then can reactivate as shingles, or herpes zoster. Vaccination from age 60 lowers the rate of shingles and of ongoing nerve pain, known as postherpetic neuralgia.
Health New Zealand recommends the two-dose vaccine for everyone over 50. But public funding is narrower. It is only free if people get their first dose in the year they turn 65 RNZ. Outside that year, patients can pay up to $800 for the full course.
The vaccine used here is Shingrix, given in two doses. Pharmac advice is that the doses are given six months apart. That interval matters for GP recall systems and completion rates. People who miss the second dose are left partly protected and out of pocket.
The current rule has a history. From 1 April 2018, people aged 65 could get a funded shingles vaccine from their GP, after a Pharmac decision in late 2017 Pharmac. Pharmac later described funding as for people aged 65, with a catch-up for people aged 66 to 80 Pharmac. That catch-up group has now aged through. What remains is a single-year window.
Australia funds the vaccine for everyone over 65. The College points to that model in pressing for change here.
The politics are direct. The College urged whoever formed the next government to widen free access as a priority. That wording is aimed at post-election formation talks and the Budget cycle, not at Pharmac alone. A wider rollout would need new money in the Budget and a change to Pharmac's schedule, then delivery through Health New Zealand and primary care.
The broader context here is the choice between a birth-year entitlement and an age-threshold entitlement. A single-year window keeps costs contained and is simple to administer. It also creates a cliff. People who miss that year because they are not enrolled, move practices, or are unwell lose funded access. Clinicians say the clinical risk does not fall after a 65th birthday. It rises with age.
Looking at what this means for policymakers, the trade-offs are familiar. Funding all over-65s would increase upfront vaccine costs and GP workload. It could also reduce later demand on GPs, emergency departments and pain services treating ongoing nerve pain. Ministers will weigh that against other immunisation bids and pressure on the primary care workforce. The College is betting that chronic pain, cost to patients and the Australian precedent will move shingles up the list.
