Study: Health Care Professionals Should Recommend Herpes Zoster Vaccine for Patients With COPD

Among heath care professional (HCPs) who recommend the herpes zoster (HZ) vaccine, pulmonologists were found to consistently recommended the vaccination at lower rates, according to authors of a recently published study. The study investigators found that a short education could increase pulmonologists' awareness, knowledge, and recommendations for the HZ vaccine, in accordance with Advisory Committee on Immunization Practices (ACIP).

“The HZ recommendations reported were often not concordant with the 2018 ACIP HZ recommendations which were the most recent at the time of fielding the survey,” study authors wrote.

Patients with chronic obstructive pulmonary disease (COPD) are at an increased risk of HZ. The ACIP recently said that HCPs should recommend the HZ vaccine for those with COPD, who may experience more complications—the 2-dose HZ vaccine is also recommended for those aged 50 years and older. Despite these recommendations, many practitioners with a focus on COPD do not recommend the HZ vaccine for this population.

During the study, investigators aimed to address how to increase HZ vaccine knowledge and recommendations among HCPs who work with patients with COPD. The investigators gave 1020 HCPs an online survey to gauge HCP knowledge of ACIP HZ vaccine recommendations, risk among patients with COPD, and current HZ vaccine recommendation practices compared to influenza and pneumococcal vaccine recommendations. HCPs were given an educational video at the end to improve future recommendation practices.

HCPs reported recommending the influenza and pneumococcal vaccines at high rates. Accordingly, 94.8% of all respondents said that vaccine recommendations are the responsibility of the HCP. However, the data suggests that HCPs recommended the HZ vaccine at a significantly low rate.

“Opportunities to enhance knowledge and increase awareness and vaccine recommendations appeared to be highest for HZ vaccine in adults 50 to 59, those with prior HZ or prior one-dose HZ vaccine receipt and concerns about possible immunosuppression (prior cancer therapy and use of [inhaled corticosteroids] inhalers) with the greatest opportunities among pulmonologists,” study authors wrote.

Among patients, 26.6% said that their pulmonologist recommended the HZ vaccine, compared to 68.8% of participants who reported their primary care office recommended the HZ vaccine. However, after watching a short educational video on the HZ vaccine and at-risk patients, most HCPs responded that they intend to recommend the HZ vaccine for these patients in the future.

However, the study authors noted that the study does have limitations. The first limitation they noted is that the HCP response rate to the survey was low in both physician groups. Additionally, respondents may inherently have a greater interest in COPD or adult immunization due to their interest in responding to the survey. Additionally, the results were also self-reported, which limits objectivity and the results were taken during the COVID-19 pandemic when vaccine awareness was high.

“Post-video responses suggest that short, focused education can enhance knowledge and vaccine recommendation intent,” study authors wrote in the report. “Improvements were specifically noted for reported future HZ vaccine recommendation intent and perceived newness of video information on the risk of HZ in those with COPD and current ACIP HZ vaccine recommendations.”

Reference

Yawn B, Loskutova N, Merrill D, et al. Health Care Professionals' Herpes Zoster Awareness and Vaccine Recommendations for Patients with COPD. Chronic Obstr Pulm Dis. 2022 Oct 4. doi:10.15326/jcopdf.2022.0322