A recent survey conducted by researchers at NYU Langone Health found that only 35% of primary care physicians strongly agreed that vaccination against herpes zoster (HZ) is important.
From January to March 2017, the researchers distributed a cross-sectional online survey to all physicians in the Division of General Internal Medicine and Clinical Innovation at NYULH, across 5 different practice settings. A total of 138 (out of 530) responded (26%).
Results showed that 76% (100/132) agreed that the HZ vaccine was an important clinical priority, vs 93% and 94% for influenza and pneumococcal vaccination, respectively (P<0.001). This discrepancy grew when the proportion of physicians who ‘strongly agreed’ that vaccinations were important was considered, with just 35% strongly agreeing that the HZ vaccine was important compared with 68% and 74% for pneumococcal and influenza vaccines, respectively.
With regard to vaccine administration, surveyed physicians self-reported that approximately 43% of their immunocompetent patients aged ≥60 years received the HZ vaccine vs 11% of patients aged 50 to 59 years. Patients were more likely to receive the pneumococcal vaccine (72%) and the influenza vaccine (67%) annually. Sixty-nine percent of respondents stated that cost of the vaccine for patients was considered a top barrier to HZ vaccination.
Almost all of the respondents (99%) agreed that recommendations of the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices (ACIP) are important in determining vaccination practices and that the HZ vaccine is safe. In October 2017, the ACIP voted in favor of the use of Shingrix (zoster vaccine recombinant, adjuvanted; GlaxoSmithKline) for the prevention of shingles in immunocompetent adults aged ≥50 years and adults who previously received Zostavax (zoster vaccine live; Merck). The Committee considered Shingrix the preferred vaccine over Zostavax for the prevention of zoster and related complications.
The CDC’s 2018 Recommended Immunization Schedule for Adults now includes this recommendation. The authors hope that this update “will encourage primary care doctors to recommend the vaccine as strongly for people in their fifties as 60 years and above.”
Tsui E, Gillespie C, Perskin M, Zabar S, Wu M, Cohen EJ. Evaluating physician attitudes and practices regarding herpes zoster vaccination [published online March 23, 2018]. Cornea. doi: 10.1097/ICO.0000000000001582
This article originally appeared on MPR