In the UK, vaccination against herpes zoster vaccine is not licensed for use in adults under 50 years.
The Green Book on Immunisation against Infectious Diseases states that the vaccine should only be offered to people over the age of 70 years, with a catch-up programme for those aged 70 to 79 years. Whilst the vaccine is authorised for use from age 50 years and is effective in this age group, the burden of shingles disease is generally not as severe in those aged 50-69 years when compared with older ages. Furthermore, given that the duration of protection is not known to last for more than ten years and the need for a second dose is not known, the vaccine is not recommended to be offered routinely below 70 years of age.
The vaccine is contra-indicated in those who are receiving or have received in the past 12 months, biological therapy (e.g. anti-TNF therapy such as alemtuzumab, ofatumumab and rituximab) unless otherwise directed by a specialist. It is also contra-indicated in those who are receiving or have received in the past 3 months, immunosuppressive therapy including short term high-dose corticosteroids (>40mg prednisolone per day for more than 1 week), or long term lower dose corticosteroids (>20mg prednisolone per day for more than 14 days).