Cost is Significant Barrier to Herpes Zoster Vaccination Use
The herpes zoster vaccine or shingles vaccine is recommended for adults 60 years of age or older to reduce the risk of shingles and its associated pain and morbidities. Less than 8% of this age group have received the vaccination even though the herpes zoster vaccine is the first vaccine to be reimbursed through Medicare Part D.
Results of a national survey of physicians has revealed cost is a major barrier to in getting herpes zoster vaccine to older adults.
Laura P. Hurley, MD, MPH, Wellington Webb Center for Primary Care, and colleagues have published the results of their survey looking at the barriers to vaccination in the May 4 issue of the Annuals of Internal Medicine journal.
The national mail and internet-based survey was designed through an iterative process and conceptually based on the Health Belief Model. It was conducted between July to September 2008, targeting general internists and family medicine physicians.
The survey had a 72% response rate in both specialties (301 general internists and 297 family medicine physicians). Questions looked at current vaccination practices, knowledge and practice regarding reimbursement, and barriers to vaccination.
Both internal medicine and family practice physicians reported similar practices of delivering the vaccine. Less than half stocked and administered the vaccination in their offices. Just over a third (36%) referred patients to a pharmacy to purchase the vaccine and bring it back to the office for administration or simply to have the pharmacy administer the vaccine (33%).
Most physicians (88%) recommended the herpes zoster vaccine, but only 41% strongly recommend it. Yet more than 90% strongly recommend influenza and pneumococcal vaccines.
The most common barrier for the surveyed physicians in both specialties was reported to be financial. Not even half of the responding physicians knew that herpes zoster vaccine is reimbursed through Medicare Part D.
Of the physicians who began administering herpes zoster vaccine in their office, 12% stopped because of cost and reimbursement issues.
Barriers to the Use of Herpes Zoster Vaccine; Laura P. Hurley, MD, MPH, Megan C. Lindley, MPH, Rafael Harpaz, MD, MPH, Shannon Stokley, MPH, Matthew F. Daley, MD, Lori A. Crane, PhD, MPH, Fran Dong, MS, Brenda L. Beaty, MSPH, Litjen Tan, PhD, MS, Christine Babbel, MSPH, L. Miriam Dickinson, PhD, and Allison Kempe, MD, MPH; Annual of Internal Medicine, May 4, 2010 vol. 152 no. 9 555-560