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The shingles vaccine (Zostavax®) is produced in the same way as chickenpox (varicella) vaccine but contains significantly more antigen. It appears to be more effective in preventing shingles when given to younger adults aged 50 -60 years but the risk of severe disease and sequelae (particularly neuralgia) is greatest in the elderly aged over 70 years of age. In these older age groups, the role of the vaccine is particularly for reducing the incidence of debilitating pain and long term complications. Duration of immunity has yet to be ascertained so the optimum age at which to give shingles vaccine is unknown. The US Advisory Committee on Immunization Practices (ACIP) current recommendation is that one dose of shingles vaccine is administered to immune-competent adults aged from 60 years (Hales et al 2014) In the UK and Australia (from November 2016) it is offered on the national schedule to all at 70 years of age. Knowledge about which vaccines to offer and recommend older patients is important but is unlikely to do much to improve protection unless vaccinators discuss within their practice strategies to deliver these vaccines. As mentioned at the start, we can December 2016 L.O.G.I.C build on the skills developed through vaccinating our youngest patients. Some actions we can consider include: 1. Raising awareness with ALL provider staff so that they can play their part. Discuss incorporating adult immunisation into your services provision and how staff and time can be dedicated to this, with practice managers 2. Utilise your patient management system’s audit and status query tools to identify un(der)-immunised older adults and put pre-call and recall systems in place 3. Adopt an opportunistic immunisation approach at all consultations with older adults 4. Be aware of which adult vaccines are added to the National Immunisation Register (NIR) and include discussion of NIR in your consent process with older patients 5. Have up-to-date, ageappropriate vaccine information available in your waiting areas and consultation rooms, and use these in vaccine conversations with your patients. Examples include Ministry of Health resources; Adult tetanus and diphtheria immunisation (HE1514), After your immunisation (HE2505) and annual influenza resources from the National Influenza Specialist Group resources (see your 2016 Influenza kit) As primary health care nurses we can do more to protect our patients through immunisation. You have taken the first step by reading this article. Now have discussions with your team to see what you can do in your practice to protect your vulnerable older adult population. References CDC (2011) Updated Recommendations for the use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010 Morbidity and Mortality Weekly Report 14/1/11 60 (1) ESR (2016) Surveillance Report: Invasive pneumococcal disease in New Zealand 2014. Available at https://surv.esr.cri.nz/PDF_surveill ance/IPD/2014/2014IPDAnnualRe port.pdf Hales CM, Harpaz R, OrtegaSanchez I, Bialek SR (2014) Update on Recommendations for Use of Herpes Zoster Vaccine. Morbidity and Mortality Weekly Report August 22, 2014 63 (33) Immunisation Advisory Centre (2016) IMAC Factsheet: Guide to additional vaccines for special groups from 1st March 2016. Available at http://www.immune.org.nz/sites/ default/files/resources/Programm 24