Patterson Brandon J, Chen Chi-Chang, McGuiness Catherine B, Ma Siyu, Glasser Lisa I, Sun Kainan, Buck Philip O
J Am Pharm Assoc (2003). 2022 Mar-Apr;62(2):526-536.e10. doi: 10.1016/j.japh.2021.11.010. Epub 2021 Nov 12.
BACKGROUND/OBJECTIVES: Vaccination against herpes zoster (HZ) is an effective strategy in protecting the population against consequences of varicella zoster virus reactivation. Optimal immunogenicity with recombinant zoster vaccine (RZV) relies on completion of the 2-dose series within 2-6 months from the first dose. The objectives of this study were to estimate RZV completion rates and adherence with the recommended administration schedule in the general United States population aged at least 50 years and to evaluate factors influencing completion rates.
Longitudinal, open-source pharmacy and medical claims databases were analyzed for adults aged at least 50 years with a first RZV prescription filled between October 2017 and September 2019. The data were linked to Experian Marketing Services Consumer View data to obtain information regarding race. Completion rates and adherence were calculated overall and stratified according to claim source, age class, sex, and payer type. Logistic regression models were built for each subpopulation of interest to identify factors correlating with completion rates.
Overall, cumulative completion rates were 70.41% and 81.80% at 6 and 12 months, respectively. Median time to second dose was approximately 4 months (4.08-5.13 months) and adherence 67.62%. Completion rates were lower in the medical claims database compared with the pharmacy claims database (48.98% vs. 73.23% at 6 months). Regression models confirmed that pharmacy claim was an independent factor for higher completion rates, while African American race and Medicaid status were associated with lower completion rates. Most comorbidities, including chronic obstructive pulmonary disease and type 2 diabetes mellitus, were associated with lower completion rates.
Pharmacists contribute substantially to the overall high RZV completion rates in the United States. However, completion rates can be improved, especially in people receiving their first RZV dose at a physician's office. Future strategies should aim at lowering barriers to completing vaccination series in African Americans, Medicaid beneficiaries, and people with comorbidities.
背景/目的：接种带状疱疹（HZ）疫苗是保护人群免受水痘带状疱疹病毒再激活后果影响的有效策略。重组带状疱疹疫苗（RZV）的最佳免疫原性依赖于在第一剂接种后的2至6个月内完成2剂接种程序。本研究的目的是估计美国至少50岁的普通人群中RZV的完成率以及对推荐接种计划的依从性，并评估影响完成率的因素。
对2017年10月至2019年9月期间至少50岁且首次开具RZV处方的成年人的纵向、开源药房和医疗理赔数据库进行分析。这些数据与益百利营销服务消费者视图数据相关联，以获取有关种族的信息。总体及按理赔来源、年龄组、性别和付款人类型分层计算完成率和依从性。为每个感兴趣的亚组建立逻辑回归模型，以确定与完成率相关的因素。
总体而言，6个月和12个月时的累积完成率分别为70.41%和81.80%。第二剂的中位时间约为4个月（4.08 - 5.13个月），依从性为67.62%。与药房理赔数据库相比，医疗理赔数据库中的完成率较低（6个月时为48.98%对73.23%）。回归模型证实，药房理赔是完成率较高的独立因素，而非裔美国人种族和医疗补助状态与较低的完成率相关。大多数合并症，包括慢性阻塞性肺疾病和2型糖尿病，与较低的完成率相关。
药剂师对美国RZV总体较高的完成率有很大贡献。然而，完成率仍可提高，尤其是在医生办公室接受首次RZV剂量接种的人群中。未来的策略应旨在降低非裔美国人、医疗补助受益人和合并症患者完成疫苗接种系列的障碍。
