Iwu Chidozie Declan, Shrestha Pramita, Littman Alyson J, Hood Julia E
Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America.
Department of Global Health, School of Public Health, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2025 Apr 15;20(4):e0316429. doi: 10.1371/journal.pone.0316429. eCollection 2025.
Shingles is a debilitating vaccine preventable disease that poses a health threat to older adults. However, the uptake of shingles vaccines remains low, and the factors contributing to the low uptake are not clearly understood. This study assessed the association between healthcare access and shingles vaccination among older adults, as well as the impact of COVID-19 pandemic on vaccine uptake.
This was a cross-sectional study among adults 50 + years in Virginia (n = 16,576) using data from the Behavioral Risk Factor Surveillance System (2018, 2019, and 2021). We calculated the prevalence of shingles vaccination by health insurance and access to primary health care provider (used as proxies for healthcare access) and in relation to the COVID-19 pandemic (pre vs during). Log binomial regression models were used to estimate prevalence ratios (PR), adjusting for confounders.
Shingles vaccination was substantially higher among those with healthcare access compared to those without. Specifically, shingles vaccination was 35% among those with health insurance vs. 10% among those without (adjusted PR (aPR): 2.03, 95% CI 1.44, 2.86), and 36% among those with a primary healthcare provider vs 15% among those without (aPR: 1.99, 95% CI: 1.65-2.41). Finally, shingles vaccination was 41% during the COVID-19 pandemic vs. 30% before (aPR:1.26, 95% CI: 1.20-1.33).
Individuals with health insurance and access to a primary healthcare provider were significantly more likely to receive the shingles vaccine compared to those without such access. Moreover, the prevalence of shingles vaccination during the pandemic period was substantially higher compared with shingles vaccination before the pandemic.
带状疱疹是一种可通过疫苗预防的使人衰弱的疾病，对老年人构成健康威胁。然而，带状疱疹疫苗的接种率仍然很低，导致接种率低的因素尚不清楚。本研究评估了老年人获得医疗服务与接种带状疱疹疫苗之间的关联，以及新冠疫情对疫苗接种的影响。
这是一项对弗吉尼亚州50岁及以上成年人（n = 16576）进行的横断面研究，使用行为风险因素监测系统（2018年、2019年和2021年）的数据。我们根据健康保险、获得初级医疗服务提供者的情况（用作获得医疗服务的替代指标）以及与新冠疫情的关系（疫情前与疫情期间）计算了带状疱疹疫苗的接种率。采用对数二项回归模型估计患病率比（PR），并对混杂因素进行调整。
与没有医疗服务的人相比，有医疗服务的人接种带状疱疹疫苗的比例要高得多。具体而言，有健康保险的人接种带状疱疹疫苗的比例为35%，而没有健康保险的人为10%（调整后的PR（aPR）：2.03，95%置信区间1.44，2.86）；有初级医疗服务提供者的人接种比例为36%，没有的人为15%（aPR：1.99，95%置信区间：1.65 - 2.41）。最后，在新冠疫情期间，带状疱疹疫苗的接种率为41%，而疫情前为30%（aPR：1.26，95%置信区间：1.20 - 1.33）。
与没有健康保险和无法获得初级医疗服务提供者的人相比，有健康保险且能获得初级医疗服务提供者的人接种带状疱疹疫苗的可能性显著更高。此外，疫情期间带状疱疹疫苗的接种率相比疫情前大幅提高。
