Just who is entitled to a shingles jab?

Q I RECENTLY read that there has been a drop in the number of 70-year-olds having the shingles jab, which is worrying ‘health chiefs’.

I suspect the reason is that the way the NHS is rolling out the vaccination process is too complicated for patients to understand, hence they are not applying for the jab.

Can you explain the process?

A I HAVE to agree – my own head swims when I try to explain this. The start of any vaccination programme is fraught with difficulties in terms of logistics and who to include. Currently we are seeing this issue with the new meningitis B vaccination programme, which is fantastic for those included but seems unfair to those who have just missed out thanks to the date they were born.

Why should a baby born on May 1 be vaccinated, but not those born on April 30?

The reality is that a programme has to start somewhere and when we are dealing with finite resources – not just money but actual vaccination supply – boundaries do have to be set. This is what accounts for the very confusing recommendations for the national shingles vaccination programme.

The Joint Committee on Vaccination and Immunisation recommended that all 70-yearolds be vaccinated: this is deemed to be the most at-risk age group, and the age at which we know the vaccine is most effective.

The protection is thought to last eight years so vaccinating a 70-year-old takes them through most of their 70s.

We know vaccinating those over 80 becomes much less effective, so those in this age group will not be offered the jab on the NHS.

Here is where it gets cryptic: the jab is currently being offered to all people who are aged 70 and 78 between October 1 2015 and before August 31 2016.

In addition, anyone who WAS eligible for immunisation in the first two years of the programme but has not yet been vaccinated against shingles remains eligible until their 80th birthday. This includes people aged 71 and 72 on September 1 2015 and people aged 79. Everyone eligible should automatically receive a letter. If you are in any doubt, call your GP.

Q I AM a 72-year-old man in reasonably good health, other than a problem with the tips of my thumbs. They become very dry and the skin flakes off in large chunks, sometimes down to the raw flesh, which is very painful and disabling. My doctor simply recommends keeping them moisturised. The only thing that helps is to use hydrocortisone cream and wrap the end of my thumbs in micropore plaster. Any other suggestions?

A THIS is a typical description of dermatitis, an inflammatory condition of the skin that can be widespread or just focused on one area.

The fingers and thumbs are a common site, possibly because the condition is linked to the abundant use of harsh soaps and highly irritant handwashes.

Treating any type of dermatitis takes a lot of effort, which constitutes more than simply moisturising them. Dermatological advice would be to avoid soap and handwash altogether and to use an emollient to wash with. Aqueous cream, from pharmacies, is perfect for this.

Moisturising well is the crucial next part of treatment; a simple moisturiser will not be enough for dermatitis, while cosmetic moisturisers can contain irritants such as perfume. A suitable cream or ointment can be prescribed or bought from the pharmacist; these are usually paraffin-based and need to be applied at least four times a day.

This can be tricky with fingers and thumbs as greasiness can affect daily activities.

For bad dermatitis, the last step of treatment is to add in a steroid cream, which will treat and lessen the inflammation.

Hydrocortisone is a mild steroid cream that can suffice. Often with dermatitis affecting hands, we use a stronger prescription, a once-daily steroid cream that can be applied at night. This gives it a chance to work overnight.