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Herpes Zoster Vaccination Among Adults Aged 60 Years and Older, in the U.S., 2008

      Background

      Shingles (herpes zoster [HZ]) is a localized, generally painful and debilitating disease that occurs most frequently among older adults. It is caused by reactivation of varicella-zoster virus. HZ causes substantial morbidity, especially among older adults. The vaccine to prevent HZ was approved by Food and Drug Administration and recommended by the Advisory Committee for Immunization Practices for people aged ≥60 years in 2006 (these recommendations were published in 2008).

      Purpose

      To examine HZ vaccination among people aged ≥60 years in the U.S. in 2008.

      Methods

      Data from the 2008 National Health Interview Survey among people aged ≥60 years were analyzed in 2010. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with HZ vaccination. Potential missed opportunities also were assessed.

      Results

      By 2008, only 6.7% (95% CI=5.9%, 7.6%) of adults aged ≥60 years reported having had HZ vaccination. The level of HZ vaccination coverage was lower (4.7%) among people aged 60–64 years compared to people aged 65–74 years (7.4%); 75–84 years (7.6%); and ≥85 years (8.2%). Coverage was statistically higher for non-Hispanic whites (7.6%) compared with non-Hispanic blacks (2.5%) and Hispanics (2.1%). Among people aged ≥60 years who reported never receiving HZ vaccination, 95.1% reported at least one missed opportunity to be vaccinated. People more likely to report ever having been vaccinated were older, female, non-Hispanic white, married, more educated, and reporting received influenza vaccination in the past year.

      Conclusions

      By 2008, HZ vaccination coverage was 6.7%. The coverage level was low among all groups, but it was lowest among minority groups. Increased efforts are needed to remove barriers and to enable HZ vaccination among all adults aged ≥60 years.
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      References

        • Gnann Jr, J.W.
        • Whitely R.J.
        Herpes zoster.
        N Engl J Med. 2002; 347: 340-346
        • Katz J.
        • Copper E.M.
        • Walther R.R.
        • Sweeney E.W.
        • Dworkin R.H.
        Acute pain in herpes zoster and its impact on health related quality of life.
        Clin Infect Dis. 2004; 39: 342-348
        • Oxman M.N.
        • Levin M.J.
        • Johnson G.R.
        • et al.
        A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
        N Engl J Med. 2005; 352: 2271-2284
        • CDC
        Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP).
        MMWR Recomm Rep. 2008; 57: 1-30
        • Yawn B.P.
        • Saddier P.
        • Wollan P.C.
        • St Sauver J.L.
        • Kurland M.J.
        • Sy L.S.
        A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction.
        Mayo Clin Proc. 2007; 82: 1341-1349
        • Insinga R.P.
        • Itzler R.F.
        • Pellissier J.M.
        Acute/subacute herpes zoster: healthcare resource utilisation and costs in a group of U.S. health plans.
        Pharmacoeconomics. 2007; 25: 155-169
        • Jumaan A.O.
        • Yu O.
        • Jackson L.A.
        • Bohlke K.
        • Galil K.
        • Seward J.F.
        Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002.
        J Infect Dis. 2005; 191: 2002-2007
        • Donahue J.G.
        • Choo P.W.
        • Manson J.E.
        • Platt R.
        The incidence of herpes zoster.
        Arch Intern Med. 1995; 155: 1605-1609
        • Richards P.
        Shingles in one family practice.
        Arch Fam Med. 1996; 5: 42-46
        • Mullooly J.P.
        • Riedlinger K.
        • Chun C.
        • Weinmann S.
        • Houston H.
        Incidence of herpes zoster, 1997–2002.
        Epidemiol Infect. 2005; 133: 245-253
        • Soni A.
        • Hill S.C.
        Average Annual Health Care Use and Expenses for HZ among the U.S. Civilian Noninstitutionalized Population, 2003–2005. Statistical Brief #194. December 2007. Agency for Healthcare Research and Quality, Rockville MD.
        • Pellissier J.M.
        • Brisson M.
        • Levin M.J.
        Evaluation of the cost-effectiveness in the U.S. of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
        Vaccine. 2007; 25: 8326-8337
        • CDC
        Proposed recommendations and ACIP vote on use of zoster vaccine.
        • Lu P.J.
        • Euler G.L.
        • Jumaan A.O.
        • Harpaz R
        Herpes zoster vaccination among adults aged 60 years or older in the U.S., 2007: uptake of the first new vaccine to target seniors.
        Vaccine. 2009; 27: 882-887
        • CDC
        National Health Interview Survey.
        • Shah B.
        • Barnwell B.
        • Bieier G.
        SUDAAN user's manual, release 10.0.
        Research Triangle Institute, Research Triangle Park NC2008
        • Korn E.L.
        • Graubard B.I.
        Predictive margins (direct standardization).
        in: Analysis of Health Surveys. John Wiley & Sons, New York NY1999: 126-140
        • Nadel M.R.
        • Shapiro J.A.
        • Klabunde C.N.
        • et al.
        A national survey of primary care physicians' methods for screening for fecal occult blood.
        Ann Intern Med. 2005; 142: 86-94
        • Korn E.L.
        • Graubard B.L.
        Analysis of health surveys.
        Wiley, New York1999
        • CDC
        National, state, and local area vaccination coverage among adolescents aged 13–17 years—U.S., 2008.
        MMWR Morb Mortal Wkly Rep. 2009; 58: 997-1001
        • Hurley L.P.
        • Lindley M.C.
        • Harpaz R.
        • et al.
        Barriers to the use of herpes zoster vaccine..
        Ann Intern Med. 2010; 152: 555-560
        • Lu P.J.
        • Singleton J.A.
        • Rangel M.C.
        • Wortley P.M.
        • Bridges C.B.
        Influenza vaccination trends among adults 65 years or older in the U.S., 1989–2002.
        Arch Intern Med. 2005; 165: 1849-1856
        • Wortley P.M.
        • Jain N.
        Influenza vaccination coverage among adults aged ≥50 years and pneumococcal vaccination coverage among adults aged ≥65 years—U.S., 2002.
        MMWR Morb Mortal Wkly Rep. 2003; 52: 987-992
        • Egede L.E.
        • Zheng D.
        Racial/ethnic differences in influenza vaccination coverage in high-risk adults.
        Am J Pub Health. 2003; 93: 2074-2078
        • Link M.W.
        • Ahluwalia I.B.
        • Euler G.L.
        • et al.
        Racial and ethnic disparities in influenza vaccination coverage among adults during the 2004–2005 season.
        Am J Epidemiol. 2006; 163: 571-578
        • CDC
        Hepatitis B vaccination coverage among adults—U.S., 2004.
        MMWR Morb Mortal Wkly Rep. 2006; 55: 509-511
        • Singleton J.A.
        • Greby S.M.
        • Wooten K.G.
        • Walker F.J.
        • Strikas R.
        Influenza, pneumococcal, and tetanus toxoid vaccination of adults—U.S., 1993–1997.
        MMWR Morb Mortal Wkly Rep. 2000; 49: 39-50
        • Donald R.M.
        • Baken L.
        • Nelson A.
        • Nichol K.L.
        Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients.
        Am J Prev Med. 1999; 16: 173-177
        • Nichol K.L.
        • Korn J.E.
        • Baum P.
        Estimation of outpatient risk characteristics and influenza vaccination status: validation of a self-administered questionnaire.
        Am J Prev Med. 1991; 7: 199-203
        • Gelb L.D.
        Preventing herpes zoster through vaccination.
        Ophthalmology. 2008; 115: S35-S38
        • Betts R.F.
        Vaccination strategies for the prevention of herpes zoster and postherpetic neuralgia.
        J Am Acad Dermatol. 2007; 57: S143-S147