713. When zoster hits close to home: impact of personal zoster awareness on zoster vaccine uptake
Session: Poster Abstract Session: Vaccines
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Marketscan HZV Uptake and HZ Disease in Spouse_FINAL.pdf (227.5 kB)
  • Background: The vaccine for herpes zoster (HZ) was recommended in 2008 for adults aged 60 years and older yet by 2014 uptake of HZ vaccine (HZV) was just 28%. We evaluated whether personal experience with HZ and enhanced awareness of the condition could motivate vaccination behavior.

    Methods: We used medical claims data from 2013-2014 Truven Health MarketScanĀ® Commercial Databases to evaluate the association of HZ and subsequent HZV uptake by their spouses aged ā‰„60 years. We defined HZ using ICD-9 codes, HZV uptake using CPT or NDC codes, and spouses as age-matched co-beneficiaries of the opposite gender. We used self-controlled case series methods to assess the incidence rate ratio (IRR) for HZV uptake during the 3-month risk window following HZ in the spouse compared to a 6-month control window (days 180-1) prior to HZ disease in the spouse. We looked for a dose-response by comparing the magnitude of any associations for all persons with HZ versus those in the subset of HZ with new prescriptions for antivirals along with opioid analgesics. Finally, as a negative control, we looked for associations of HZ and pneumococcal vaccine uptake (defined using CPT or NDC codes) to make sure that the vaccination behavior triggered by HZ was specific to HZV.

    Results: There were 1,637 adults who experienced HZ and whose spouse received HZV. The IRR for HZV uptake by spouses was significantly elevated following HZ, peaking during days 1-30 (7.3 [95% CI: 6.5, 8.1]) and declining during days 31-60 and 61-90 (2.0 [95% CI: 1.7, 2.4] and 1.4 [95% CI: 1.2, 1.7], respectively). This pattern was seen among all age groups. The effect was significantly greater for the subset of 135 adults whose spouses experienced HZ that was severe, with an IRR ranging from 14.0 (95% CI: 9.3, 21.1) during days 1-30 and declining to 1.27 (95% CI: 0.6, 2.9). In contrast, among 574 adults who experienced HZ and whose spouse received pneumococcal vaccine, IRR was unchanged during days 1-30 [1.1 (95% CI: 0.9, 1.4)].

    Conclusion: Personal awareness of HZ motivates HZV vaccination, suggesting that better communication and messaging may improve HZV uptake as well.

    Rafael Harpaz, MD, MPH, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA and Jessica Leung, MPH, Division of Viral Diseases, National Center Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    R. Harpaz, None

    J. Leung, None

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