Summaries for Patients |

Barriers to the Use of a Vaccine to Prevent Shingles FREE

[+] Article, Author, and Disclosure Information

The summary below is from the full report titled “Barriers to the Use of Herpes Zoster Vaccine.” It is in the 4 May 2010 issue of Annals of Internal Medicine (volume 152, pages 555-560). The authors are L.P. Hurley, M.C. Lindley, R. Harpaz, S. Stokley, M.F. Daley, L.A. Crane, F. Dong, B.L. Beaty, L. Tan, C. Babbel, L.M. Dickinson, and A. Kempe.

Ann Intern Med. 2010;152(9):I-36. doi:10.7326/0003-4819-152-9-201005040-00002
Text Size: A A A

What is the problem and what is known about it so far?

Shingles is a rash that usually starts with localized pain and is followed by blisters that eventually burst and then crust over and heal. This process takes several weeks. After the rash heals, some people have persistent pain that can be severe and difficult to manage. The herpes zoster virus that causes shingles is the same virus that causes chickenpox, and only people who have had chickenpox get shingles. Research has shown that a vaccine to prevent shingles will prevent about half of cases of shingles and persistent pain. The U.S. Food and Drug Administration approved the vaccine in 2006, and experts recommend that it be given to people who have had chickenpox, have a competent immune system (the vaccine contains a live virus), and are 60 years of age or older (shingles is more common in older people). The problem is that fewer than 10% of the people who are eligible for the vaccine have received it.

Why did the researchers do this particular study?

To find out why so few eligible people have gotten the herpes zoster vaccine.

Who was studied?

301 general internists and 297 family medicine doctors.

How was the study done?

The researchers sent surveys to the doctors as e-mail messages or by standard mail.

What did the researchers find?

72% of doctors responded. Of these doctors, 93% make the vaccine available to their patients—49% by stocking the vaccine in the office and administering it there, 36% by asking the patient to buy the vaccine in a pharmacy and then administering it in the office, and 33% by referring patients to a pharmacy for vaccine administration (some physicians provide multiple options). 12% of doctors who started administering vaccine in the office have stopped. Doctors identified financial reasons for infrequent use of the herpes zoster vaccine. It is more expensive than most other adult vaccines, with a price of about $200, which may not be covered by insurance. Medicare pays for it with the system it uses to pay pharmacists (Part D), which most doctors are not familiar with, instead of the system it uses to pay doctors for nearly all other services (Part B).

What were the limitations of the study?

Some of the results are self-reported behavior, not observed behavior. The doctors who responded to the survey may not represent other doctors.

What are the implications of the study?

It may be necessary to change the way this vaccine is paid for to have more eligible people get the vaccine.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Herpes zoster and the search for an effective vaccine. Clin Exp Immunol Published online May 10, 2016;
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.