Increasing Use of the Vaccine Against Zoster Through Recommendation and Administration by Ophthalmologists at a City Hospital

• Published in: American journal of ophthalmology Vol. 155; no. 5; pp. 787 - 795.e2
• Main Authors: Jung, Jesse J, Elkin, Zachary P, Li, Xiaochun, Goldberg, Judith D, Edell, Aimée R, Cohen, Michael N, Chen, Kevin C, Perskin, Michael H, Park, Lisa, Cohen, Elisabeth J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2013; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Chicken pox; Confidence intervals; Consent; Disease control; Female; Health Insurance Portability & Accountability Act 1996-US; Heart attacks; Herpes Zoster Ophthalmicus - prevention & control; Herpes Zoster Vaccine - therapeutic use; Herpesvirus 3, Human - immunology; Hospitals, Urban - statistics & numerical data; Humans; Male; Medicaid; Middle Aged; Ophthalmology; Pain; Personal health; Practice Guidelines as Topic; Prospective Studies; Vaccination - utilization; Vaccines
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2012.11.022

Purpose To increase the vaccination rate and identify barriers to administration of the vaccine against herpes zoster by having ophthalmologists screen and provide the vaccine. Design Prospective interventional cohort study. Methods setting : Academic City Hospital, Bellevue Hospital. participants : A total of 100 eligible patients based on recommended Centers for Disease Control (CDC) criteria and ability to speak English and Spanish who received the herpes zoster vaccine were compared with 66 patients who declined the vaccine. interventions : The vaccine was administered after written informed consent was obtained to complete a screening questionnaire evaluating the participants' eligibility and interest in receiving the vaccine. main outcome measures : Barriers to administration of the vaccine were evaluated. Results A total of 170 consenting patients, including 100 patients who were vaccinated, 66 patients who declined vaccination, and 4 patients who were ineligible, were analyzed. The proportion of subjects who would consider receiving the vaccine if recommended by a doctor among those who received the shingles vaccine, 98.0% (95% CI: 95%-100%), was significantly greater than the proportion in the group that declined, 74.2% (95% CI: 64%-85%) ( P ≤ .0001). The most common reason that patients declined the vaccine was wanting to speak with their primary care physician, 46.9% (95% CI: 33%-61%). Conclusions Ophthalmologists can screen, educate, and prescribe the vaccine against herpes zoster in order to increase utilization of this vaccine. Nonfinancial or access barriers of this vaccine among underserved eligible patients include absence of recommendation by their primary care doctor.