Factors associated with herpes zoster vaccination status and acceptance of vaccine recommendation in community pharmacies

Abstract

Objectives: 1. Identify patient characteristics, awareness and knowledge associated with herpes zoster (HZ) vaccination status. 2. Identify self-reported reasons for not receiving Zostavax(®). 3. Assess the impact of a patient education program by measuring post-intervention interest in obtaining the Zostavax(®) vaccine across reasons for being unvaccinated.

Methods: A cross-sectional design with patients aged 60 years or older in 51 community pharmacies in Alabama and Florida was utilized. During the Introductory Pharmacy Practice Experience in summer 2013, 137 immunization-certified student pharmacists provided patient education on HZ and Zostavax(®) to unvaccinated patients using the Shingles Vaccine Information Statement. An interviewer-administered questionnaire assessed patient awareness of HZ, receipt of recommendations to receive Zostavax(®), and patient characteristics as well as vaccination status, reasons for being unvaccinated and interest in obtaining Zostavax(®) after the educational session.

Results: A total of 681 patients participated in a conversation with a student pharmacist regarding their HZ vaccination status. The majority were female (57.6%), white (84.6%), and unvaccinated (73.6%). Results from logistic regression suggest that participants were more likely to be vaccinated if they received a recommendation from a healthcare provider (OR=5.15), received the influenza vaccine during the previous year (OR=3.56), or knew that Zostavax(®) was recommended for individuals over 60 years of age (OR=3.55). The most frequently provided reasons for being unvaccinated were "haven't gotten around to it/forgot" (27.2%) and "didn't know it was needed" (27.1%). After the educational session, the majority (72.5%) of unvaccinated patients were interested in speaking with their pharmacist or physician about receiving Zostavax(®). Analysis suggests that interest differed across initial reason for being unvaccinated (χ(2)=64.44; p<0.01).

Implications/conclusions: Recommendations from healthcare providers are valued by patients and can improve vaccination rates. The patient education program increased interest in receiving Zostavax(®) and this interest differed depending on the reason provided for being unvaccinated.

Keywords: Education; Herpes zoster; Pharmacy; Shingles; Vaccination; Zostavax(®).