Zoster Vaccine Underutilized

May 4th, 2010

Zoster Vaccine Underutilized

shingles From the Annals of Internal Medicine:

Eighty-eight percent of providers recommend herpes zoster vaccine and 41% strongly recommend it, compared with more than 90% who strongly recommend influenza and pneumococcal vaccines. For physicians in both specialties [Internal Medicine and Family Practice], the most frequently reported barriers to vaccination were financial.

From my admittedly biased perspective as an ID doctor, recommending the zoster vaccine is a no-brainer. The cases of zoster I see are severe, and complicated, and people with post-herpetic neuralgia (who sometimes find their way erroneously to our clinic) are miserable.

But I’m also biased in that I’m not in a private, independent practice, and hence not responsible for getting reimbursed for giving a vaccine with irregular insurance coverage and finicky storage requirements.

So my guess is that were the vaccine universally covered (i.e., “free”), that there would be much broader uptake.

After all, for most Americans over 60, which is more likely to prevent illness — the zoster vaccine or the tetanus booster?

HIV and ID Observations

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May 4th, 2010