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Request the doctor: My GP won’t produce the shingles jab – Day-to-day Mail

By Martin Scurr


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Recently, I read that the Government provides started a shingles vaccination program. However , I was dismayed to see this is available only for those aged seventy or 79.

This means that anyone over 70 will not have this jab until they reach seventy nine. Are you not supposed to get shingles during this nine-year period? As I very nearly died with an attack associated with chickenpox in my early 40s, We are concerned.

Douglas Cannon, simply by email.

Concerning: The rationing of the UK vaccination programme is a debacle

Concerning: The rationing of the UK vaccination program is a debacle

You are right to be concerned: shingles is an unpleasant illness that impacts one person in four over the age of 50.

The condition causes a painful blistering allergy and a feverish illness that usually lasts between two and four weeks, but up to one in five patients may experience pain – known as post herpetic neuralgia – in the site of the rash for days or even months after it has disappeared. Shingles is caused by the same trojan that causes chickenpox, the herpes varicella-zoster virus.

You can only get shingles if you’ve previously had chickenpox – the immune system imprisons the virus in nerve cells, but years down the road it can escape these shackles (perhaps because the immune system is less effective due to old age, or is occupied fighting another illness), triggering shingles.

Every year around 50, 000 individuals above the age of 70 develop the disease, and one in 1, 000 of those will die of it, which makes protection very important.

And now at last we have the vaccine for it. Called Zostavax, it was developed in the U. S. several years ago and studies confirm it reduces the incidence of shingles by more than 50 per cent in those over 60 – as well as if the condition does develop, it is a milder version and the lasting discomfort (post herpetic neuralgia) is less severe.

The vaccine is just intended for those aged 50 and over (this is the most at-risk group), and is slightly less effective that individuals in their 70s, and very much less effective in those over 80.

The united kingdom vaccination programme was launched on Sept 1, but the vaccine is being restricted – rationed in my view – presumably for reasons of economic climate.

At the moment it is only available to the people who are either 70 or seventy nine, although the Department of Health states it may be rolled out to other age groups in the future. But , as you rightly mention – what of those aged through 71 to 78? To make individuals wait up to eight years to get an important protection is not only ridiculous, but it is also unethical.

The excuse given by the Department of Health is it is impractical to vaccinate everybody in their 70s in a single year. This really is flimsy at best: GPs and their practice nurses are immunising vast numbers of patients against flu, and Zostavax could easily and safely be given at the same time.

CONTACT DR SCURR

To contact Dr Scurr with a health query, write to him from Good Health Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail. co. uk — including contact details.

Doctor Scurr cannot enter into personal correspondence.

His replies cannot apply at individual cases and should be taken within a general context.

And exactly what of those aged between 50 and 70 – many of whom continue to be in the workplace?

The studies have shown that Zostavax reduces the risk of building shingles by 70 per cent within this age group.

To fail to take advantage of that will flies in the face of common sense, let alone healthcare ethics. What is the Department of Wellness thinking? It would make best feeling to give the protection to everybody of the age group.

Worse still, the manufacturer is currently declining to make supplies offered to non-NHS doctors, presumably because the Authorities has meanly commandeered the total supply: another breach of ethics, since it is not even available privately.

The company that makes the vaccine, Sanofi Pasteur MSD, appears to have bent in order to pressure, but it tells me it hopes to increase the availability in due course, though when remains uncertain.

And, despite this, there is now look at a vaccine shortage in the NHS – Public Health England (the Government organisation responsible for co-ordinating the campaign), has blamed GPs to get over-ordering Zostavax, and has limited purchases to 25 vaccines per exercise per week.

Yet a spokesperson to get Sanofi Pasteur says that it provides delivered 500, 000 doses up to now, while official figures suggest you can find around 800, 000 people from the ages of 70 and 79 in the UK. The numbers are not adding up.

This particular vaccination programme is a debacle, and seems to be driven by a policy associated with cost-cutting and rationing.

D espite being a virgin, I keep having recurrent bouts of thrush. The doctor won’t give me anything for this unless I have a smear test, but I’m too embarrassed to have this particular done. I am 38.








A lot more from Martin Scurr…




Name and address withheld.

Thrush may be the old-fashioned term describing infection with all the common yeast candida albicans. It occurs most commonly in the vagina, but can also affect the mouth, throat or other parts of the body – anywhere that is comfortable and moist.

Typically it causes a discharge, not usually unpleasant, but with itching, soreness or both.

Some doctors will suggest a treatment from description of the signs and symptoms alone – typically a lotion, vaginal pessaries or a single-dose dental anti-yeast capsule (fluconazole 150mg, simply no prescription needed).

However , in the case of recurrent episodes, a more detailed investigation is necessary. I am surprised to hear your doctor provides placed pressure on you to undergo the cervical smear test.

This is not necessary for diagnosis – however , one does need to steel yourself for a mild physical examination and a swab associated with inside the vagina.

This is sent to get analysis in a laboratory, and is the only way to be certain candida albicans is the culprit.

The symptoms could also be aggravated by some other bugs, such as the common bacterias streptococci. This can confuse the picture, besides needing a different type of treatment.

And a doctor should also check out whether there is any background reason a woman keeps getting infected.

There are a number of possible reasons for this particular, including treatment with antibiotics to get other conditions (a dental infections, for example), diabetes or a reduced immune system caused by some other reason.

But the first stage is going for the swab. Some women feel more comfortable with a female doctor or practice health professional – maybe this is a possibility for you.

By the way… Precisely why won’t health visitors help the elderly?

Subtle change: These days health visitors are focused on children, not the elderly, housebound or infirm

Refined change: These days health visitors are usually focused on children, not the elderly, housebound or infirm

When I was a trainee in general practice in West London within the Seventies I was encouraged to go on home visits with the health website visitor.

Accompanying her on her calls was an invaluable learning experience, the work being roughly divided between schedule visits to the elderly and periodic calls to see infants or young kids at home.

At a time when proper care of the elderly and housebound and infirm is so much in the news, health visitors should play an important role – but these days health website visitors are now focused on children.

The questions I have been asking are whenever did health visitor’s responsibilites modify, why they change, and who else made and agreed to that decision? In the event that keeping a regular skilled eye on old people in their homes has been ever a worthwhile commitment, how could anyone have decided otherwise?

Regardless of my research it seems that no one can tell me when the role of the health website visitor changed, and the exact history continues to be lost. My guess is that child protection work gradually eclipsed dull, schedule care of the elderly at home – who else didn’t complain.

We do now have district nurses, who are involved in the useful aspects of home care such as wound dressings, catheter care and medicine support.

However , figures show that the number of these district nurses has fallen by 40 per cent in the past decade.

Just as losing a named GP has eroded confidence and damaged continuity associated with care, so this subtle change within the role and activity of health website visitors has been slipped in as a cutback without any consultation with either the public or the medical fraternity. Free healthcare at the point of delivery: this is the boast.

Yet now we are witness to recurrent erosions that are tantamount to death by a 1000 cuts – gradually leading to the death of a service.

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