Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Vaccine. 2021 Feb 5;39(6):926-932. doi: 10.1016/j.vaccine.2020.12.076. Epub 2021 Jan 11.
In 2017, a new adjuvanted recombinant zoster vaccine (RZV) was recommended for adults ≥50 years as two-dose series 2-6 months apart. We evaluated two-dose RZV completion and factors associated with completion.
The study included Kaiser Permanente Southern California members ≥50 years who received an RZV dose during April-November 2018 and had continuous membership 12 months before to 9 months after the first RZV dose. Completion was defined as receipt of the second dose ≥4 weeks to 9 months after the first dose (allowing 3-month grace period). Characteristics including age, sex, race/ethnicity, Medicaid status, neighborhood level income and education, comorbidities, history of zoster, health care utilization before and after the first dose, receipt of influenza vaccine, vaccination month (supply shortage proxy), concomitant vaccine, medical center, and medically attended reactions, pain, or gout after the first dose were compared between completers and non-completers. Adjusted odds ratios and 95% confidence intervals for factors associated with completion were estimated by multivariable logistic regression.
Among 31,120 first dose recipients, 67.2% completed the series within 9 months. In adjusted analyses, higher completion was associated with White compared with Black or Hispanic race/ethnicity, higher neighborhood income and education, no chronic pulmonary disease, diabetes, or dementia, more outpatient visits and fewer emergency department visits before or after the first dose, no hospitalizations after the first dose, receipt of influenza vaccine, receipt of the first dose in June-November rather than April-May 2018, and no concomitant vaccine with the first dose. Systemic reactions or pain after the first dose was not associated with completion.
Completion of RZV series appears suboptimal in the early phase of implementation. Despite similar accessibility in a health care system, completion varied by race/ethnicity, socioeconomic status, health status, and care seeking behavior, suggesting areas to target for improvement.
2017 年，一种新的佐剂重组带状疱疹疫苗（RZV）被推荐用于 50 岁以上成年人，采用两剂程序，间隔 2-6 个月。我们评估了两剂 RZV 的完成情况和与完成相关的因素。
该研究包括 Kaiser Permanente Southern California 的 50 岁以上成员，他们在 2018 年 4 月至 11 月期间接受了一剂 RZV，并在第一剂 RZV 前 12 个月至后 9 个月内连续拥有会员资格。完成定义为第二剂在第一剂后 4 周到 9 个月内（允许 3 个月宽限期）接种。比较了完成组和未完成组之间的特征，包括年龄、性别、种族/民族、医疗补助状况、社区收入和教育水平、合并症、带状疱疹史、第一剂前后的医疗保健利用情况、流感疫苗接种情况、接种月份（供应短缺代理）、同时接种的疫苗、医疗中心以及第一剂后出现的医疗反应、疼痛或痛风。使用多变量逻辑回归估计与完成相关的因素的调整后优势比和 95%置信区间。
在 31120 名第一剂接种者中，67.2%在 9 个月内完成了系列接种。在调整分析中，与黑人或西班牙裔种族/民族相比，白人种族/民族、更高的社区收入和教育水平、无慢性肺部疾病、糖尿病或痴呆、第一剂前后更多的门诊就诊次数和更少的急诊就诊次数、第一剂后无住院治疗、流感疫苗接种、2018 年 6 月至 11 月而非 4 月至 5 月接种第一剂以及第一剂与同时接种疫苗无关，与更高的完成率相关。第一剂后出现全身反应或疼痛与完成情况无关。
在实施的早期阶段，RZV 系列的完成情况似乎并不理想。尽管在医疗保健系统中可获得性相似，但完成情况因种族/民族、社会经济地位、健康状况和寻求医疗服务的行为而异，这表明需要针对这些因素进行改进。
