Background: Zostavax®, a herpes zoster (HZ) vaccine, was licensed in the U.S. and recommended by ACIP in 2006 for prevention of HZ among adults aged 60 years and older. In March 2011, FDA approved the use of Zostavax in adults aged 50 through 59 years. The objectives of this study were to assess the coverage of the HZ vaccine among privately insured individuals aged 50 years and older from 2007 to 2013, and to determine the factors associated with being vaccinated.
Methods: This was a retrospective, observational study using the Truven Health MarketScan® Commercial and Medicare Supplemental databases. The study population was adults aged ≥60 years during 2007-2013 and adults aged 50-59 years during 2011-2013 who were continuously enrolled in a health plan for at least one year. Following the index date, all claims of the eligible enrollees were evaluated to assess vaccination. Cox proportional hazards model was performed to understand factors associated with receiving the HZ vaccine.
Results: We identified 6,746,476 eligible adults aged ≥60 years in 2007-2013 and 6,770,294 eligible adults aged 50-59 years in 2011-2013. The average age at entry into the study was 65.3 years (SD=8.03) in adults aged ≥60 years and 53.7 years (SD=3.09) in adults aged 50-59 years. Overall, the HZ vaccine uptake improved from 2007 to 2013. By year 2013, 14.5% of adults aged 65+ years, 23.9% of adults aged 60-64 years, and 1.7% of adults aged 50-59 years had received the HZ vaccine (See Figure 1). Individuals aged 65+ years were less likely to receive the vaccine than those 60-64 years old (HR=0.543, 95%CI (0.539, 0.547)). Individuals who were female, immunocompetent as well as those who had more visits to outpatient hospital, doctor office, and pharmacy were more likely to receive the HZ vaccine than their counterparts.
Figure 1. Cumulative Herpes Zoster Vaccine Coverage
Conclusion: The estimated cumulative HZ vaccine coverage was 19.5% in adults aged 60 years and older. This is lower than the 30% target coverage level in Healthy People 2020, which outlines national objectives for health improvement. It is important for providers to identify every opportunity for vaccination against HZ and to assure that older adults get protection against this vaccine-preventable disease.
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C. Newransky, Merck Co., Inc.: Consultant , Consulting fee and Salary
C. Acosta, Merck & Co., Inc: Employee , Salary