Herpes zoster vaccination: Primary care provider knowledge, attitudes, and practices

Primary care providers (PCPs) play a key role in vaccine recommendations and uptake, but limited information exists about PCP knowledge, attitudes, and practices regarding herpes zoster (HZ) vaccination. Clinical trials have shown that recombinant zoster vaccine (RZV) significantly reduces the risk of developing HZ. Hence, RZV is recommended by the US Advisory Committee on Immunization Practices (ACIP) for adults aged ≥50 years and immunocompromised adults aged ≥19 years. However, RZV uptake varies across age groups, and is lower for adults aged 50-59 compared to those aged ≥60 years. Using a cross-sectional web-based survey, this study described provider knowledge of HZ risk factors, ACIP recommendations, attitudes toward HZ vaccination, and HZ vaccination practices/barriers. Among 301 licensed PCPs in the US, knowledge of HZ risk factors was high, but only 29% were fully aware of the ACIP recommendations. PCPs indicated that HZ vaccination was important for patients aged 50-59, 60-69, and ≥70 years, with importance increasing with advancing age. During a typical week, an average of 44% (standard deviation = 32%) of PCPs reported initiating a conversation about HZ vaccination among adults aged 50-59 years. Key perceived barriers to recommending HZ vaccines to adults were contraindications and insufficient time to assess risk factors, while perceived HZ vaccine administration challenges included patients' out-of-pocket costs and lack of motivation. Results suggest that PCPs may benefit from updated information about ACIP recommendations, while both patients and providers may benefit from streamlining the vaccination process and educational efforts focused on addressing perceived barriers.