Decision to limit funding for zoster vaccine to people aged 65 years

Thank you for your request under the Official Information Act 1982 (OIA) for information relating to the decision to fund the zoster vaccine for the prevention of shingles. 

Questions 1, 2, 3 and 5 of your request were transferred from the Ministry of Health on 2 May 2022 for response by Pharmac. You requested: 

All information on the decision to:

• limit the shingles vaccine to those aged 65
• how this decision was communicated to those aged 65 and were at risk of missing out on their 66 birthday
• what consideration was given to the 65+ people who have a weaken immune system
• what date was your website updated with the new 65 year criterion for shingles
• has any exemptions to the policy been granted to those 65+ since 31 December 2021.

 The Ministry of Health also transferred one of your requests to us on 27 May 2022 for response. You asked:

• What was the eligibility criteria on 1 April 2018 for the shingles vaccine? 

Background about the decision to fund zoster vaccine (Zostavax) for the prevention of shingles

From 31 December 2021, Zostavax became the sole funded brand of zoster vaccine for patients aged 65 years. The decision to fund zoster vaccine for people aged 65 years, with a catch-up programme for people aged 66 to 80 years inclusive, was announced in November 2017 following a two-month consultation period. 

In April 2018, Pharmac funded Zostavax for people aged 65 years and ran an initial catch-up programme where the vaccine was funded for people aged 66 to 80 years. This programme was extended twice, so it ran for a total of 3 years, and now that it has finished, Zostavax is funded just for people who are 65 years of age. 

The decision to fund Zostavax (‘vaccination for herpes zoster’) and the catch-up programme (‘vaccination for herpes zoster, catchup program’) were informed by clinical advice from the Pharmacology and Therapeutics Advisory Committee (PTAC) and the Immunisation Advisory Committee (formerly called the Immunisation Subcommittee of PTAC). Copies of the records of the PTAC and Immunisation Advisory Committee meetings are available under the clinical advice sections of the ‘zoster vaccine live’ applications on the Pharmac Application Tracker(external link). 

Response to your requests for information

I am pleased to provide information below in response to your questions.

• The PTAC and the Immunisation Advisory Committee meeting records include information considered, and recommendations made, by the committees to Pharmac which informed the decision to limit the vaccine to people aged 65 years:
  • PTAC meeting held on 14 &15 August 2014 [PDF, 240 KB]
  • Immunisation Subcommittee of PTAC meeting held 18 February 2015 [PDF, 142 KB]
  • PTAC meeting held on 13 & 14 August 2015 [PDF, 378 KB]
  • PTAC meeting held on 11 & 12 February 2016 [PDF, 847 KB]

We have also recently identified the proposal paper to fund Zostavax, submitted to the Pharmac Board in October 2017, and the associated meeting record as relevant to your request. However, these documents were only identified recently – to avoid delaying our response to you any further, we have decided to provide you with the information we have already collated within this response and will provide you with copies of the remaining documents as soon as possible once consultation for their release is completed.

• Pharmac communicates new funding decisions and changes to funded medicines with clinicians, clinical interest groups, and patient advocacy groups. We also publish all pharmaceutical funding decisions on our website (pharmac.govt.nz).

Pharmac generally does not have a way to communicate directly with members of the public (such as patients) about funding decisions. We rely on clinicians (such as general practitioners and pharmacists) to discuss relevant medicine decisions with their patients.

• Zostavax should not be given to people who have a weakened immune system due to disease, medicines or other treatment(s). This is because it is a live attenuated vaccine, which means it contains a weakened form of live virus. The Zostavax consumer medicine information (CMI) leaflet(external link) provided by the pharmaceutical supplier has more information about using the vaccine.
• On 9 November 2017, the decision to fund Zostavax was published to our website and emailed to everyone who was subscribed to our email mailing list (for example, general practitioners, pharmacists, special interest groups and consumer advocacy groups such as Grey Power and Aged Care Associations).
• No exemptions have been granted through Pharmac’s Exceptional Circumstances Framework since 31 December 2021.
• The eligibility criteria for Zostavax on 1 April 2018 was:
  • One dose for all people aged 65 years; or
  • One dose for all people aged between 66 and 80 years inclusive from 1 April 2018 and 31 March 2020.

The catch-up programme (criteria two) was extended on 1 December 2019 to end 31 December 2020. It was extended again on 1 November 2020 to end on 31 December 2021. 

We trust that this information answers your queries. We will provide the remaining Board documents from 2017 (as referenced in response to question one) as soon as possible. 

We are making our information more freely available, so we now publish selected OIA responses (excluding personal details) on our website. Please get in touch with us if you have any questions about this.